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        <TotalRevenueColumn>0</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>0</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>0</UnrelatedBusinessRevenue>
        <ExclusionAmount>0</ExclusionAmount>
      </RoyaltiesRevenue>
      <RentalIncomeOrLoss>
        <Real>0</Real>
        <Personal>0</Personal>
      </RentalIncomeOrLoss>
      <GainOrLoss>
        <Securities>0</Securities>
        <Other>0</Other>
      </GainOrLoss>
      <CntrbtnsRprtdFundraisingEvents>0</CntrbtnsRprtdFundraisingEvents>
      <TotalOtherRevenue>0</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>5640234</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>3677201</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>0</UnrelatedBusinessRevenue>
        <ExclusionAmount>0</ExclusionAmount>
      </TotalRevenue>
      <InfoInScheduleOPartIX>X</InfoInScheduleOPartIX>
      <GrantsToDomesticOrgs>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>376998</Total>
        <ProgramServices>227439</ProgramServices>
        <ManagementAndGeneral>149559</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </CompCurrentOfficersDirectors>
      <CompDisqualPersons>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </CompDisqualPersons>
      <OtherSalariesAndWages>
        <Total>824643</Total>
        <ProgramServices>708853</ProgramServices>
        <ManagementAndGeneral>115790</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>68884</Total>
        <ProgramServices>53661</ProgramServices>
        <ManagementAndGeneral>15223</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>121320</Total>
        <ProgramServices>94508</ProgramServices>
        <ManagementAndGeneral>26812</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>90731</Total>
        <ProgramServices>70679</ProgramServices>
        <ManagementAndGeneral>20052</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>25939</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>25939</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
        <Total>0</Total>
        <Fundraising>0</Fundraising>
      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </FeesForServicesInvstMgmntFees>
      <FeesForServicesOther>
        <Total>189517</Total>
        <ProgramServices>151614</ProgramServices>
        <ManagementAndGeneral>37903</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </FeesForServicesOther>
      <Advertising>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </Advertising>
      <OfficeExpenses>
        <Total>97568</Total>
        <ProgramServices>87809</ProgramServices>
        <ManagementAndGeneral>9759</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>1524113</Total>
        <ProgramServices>1371702</ProgramServices>
        <ManagementAndGeneral>152411</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </InformationTechnology>
      <Royalties>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </Royalties>
      <Occupancy>
        <Total>128798</Total>
        <ProgramServices>100720</ProgramServices>
        <ManagementAndGeneral>28078</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </Occupancy>
      <Travel>
        <Total>67809</Total>
        <ProgramServices>53027</ProgramServices>
        <ManagementAndGeneral>14782</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </Travel>
      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>52314</Total>
        <ProgramServices>40910</ProgramServices>
        <ManagementAndGeneral>11404</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </ConferencesMeetings>
      <Interest>
        <Total>17383</Total>
        <ProgramServices>13594</ProgramServices>
        <ManagementAndGeneral>3789</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </Interest>
      <PaymentsToAffiliates>
        <Total>0</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>94413</Total>
        <ProgramServices>73831</ProgramServices>
        <ManagementAndGeneral>20582</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </DepreciationDepletion>
      <Insurance>
        <Total>6498</Total>
        <ProgramServices>0</ProgramServices>
        <ManagementAndGeneral>6498</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </Insurance>
      <OtherExpenses>
        <Description>Subcontracts to Medicaid Enrollment Organizations</Description>
        <Total>1452109</Total>
        <ProgramServices>1452109</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Subcontractors Emergency Prparedness and Disease prevention</Description>
        <Total>39200</Total>
        <ProgramServices>39200</ProgramServices>
        <ManagementAndGeneral>0</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Telephone</Description>
        <Total>94694</Total>
        <ProgramServices>74051</ProgramServices>
        <ManagementAndGeneral>20643</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Staff Training and Development</Description>
        <Total>27735</Total>
        <ProgramServices>21689</ProgramServices>
        <ManagementAndGeneral>6046</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </OtherExpenses>
      <TotalFunctionalExpenses>
        <Total>5300666</Total>
        <ProgramServices>4635396</ProgramServices>
        <ManagementAndGeneral>665270</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
        <BOY>506697</BOY>
        <EOY>284166</EOY>
      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
        <BOY>100000</BOY>
        <EOY>100000</EOY>
      </SavingsAndTempCashInvestments>
      <PledgesAndGrantsReceivable>
        <BOY>2238117</BOY>
        <EOY>1990166</EOY>
      </PledgesAndGrantsReceivable>
      <AccountsReceivable>
        <BOY>1274992</BOY>
        <EOY>1041386</EOY>
      </AccountsReceivable>
      <ReceivablesFromOfficersEtc>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </ReceivablesFromOfficersEtc>
      <ReceivablesFromDisqualPersons>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </ReceivablesFromDisqualPersons>
      <OtherNotesLoansReceivableNet>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </OtherNotesLoansReceivableNet>
      <InventoriesForSaleOrUse>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </InventoriesForSaleOrUse>
      <PrepaidExpensesDeferredCharges>
        <BOY>14398</BOY>
        <EOY>1736</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>1435375</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>384758</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>1059984</BOY>
        <EOY>1050617</EOY>
      </LandBuildingsEquipmentBasisNet>
      <TotalAssets>
        <BOY>5194188</BOY>
        <EOY>4468071</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>601935</BOY>
        <EOY>784455</EOY>
      </AccountsPayableAccruedExpenses>
      <GrantsPayable>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </GrantsPayable>
      <DeferredRevenue>
        <BOY>24250</BOY>
        <EOY>25250</EOY>
      </DeferredRevenue>
      <TaxExemptBondLiabilities>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </TaxExemptBondLiabilities>
      <EscrowAccountLiability>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </EscrowAccountLiability>
      <LoansFromOfficersDirectors>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </LoansFromOfficersDirectors>
      <MortNotesPyblSecuredInvestProp>
        <BOY>338165</BOY>
        <EOY>232043</EOY>
      </MortNotesPyblSecuredInvestProp>
      <TotalLiabilities>
        <BOY>964350</BOY>
        <EOY>1041748</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>1740743</BOY>
        <EOY>2080311</EOY>
      </UnrestrictedNetAssets>
      <TemporarilyRestrictedNetAssets>
        <BOY>2489095</BOY>
        <EOY>1346012</EOY>
      </TemporarilyRestrictedNetAssets>
      <PermanentlyRestrictedNetAssets>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </PermanentlyRestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>4229838</BOY>
        <EOY>3426323</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>5194188</BOY>
        <EOY>4468071</EOY>
      </TotalLiabNetAssetsFundBalances>
      <InfoInScheduleOPartXI>X</InfoInScheduleOPartXI>
      <ReconcilationRevenueExpenses>339568</ReconcilationRevenueExpenses>
      <ReconciliationUnrealizedInvest>0</ReconciliationUnrealizedInvest>
      <ReconcilationDonatedServices>0</ReconcilationDonatedServices>
      <ReconcilationInvestExpenses>0</ReconcilationInvestExpenses>
      <ReconcilationPriorAdjustment>0</ReconcilationPriorAdjustment>
      <ReconcilationOtherChanges>-1143083</ReconcilationOtherChanges>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>1</AccountantCompileOrReview>
      <AccountantCompileOrReviewBasis>
        <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      </AccountantCompileOrReviewBasis>
      <FSAudited>1</FSAudited>
      <FSAuditedBasis>
        <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      </FSAuditedBasis>
      <AuditCommittee>1</AuditCommittee>
      <FederalGrantAuditRequired>1</FederalGrantAuditRequired>
      <FederalGrantAuditPerformed>1</FederalGrantAuditPerformed>
    </IRS990>
    <IRS990ScheduleA documentId="R000002" softwareId="12000197" softwareVersion="v1.00">
      <PubliclySupportedOrg170b1Avi>X</PubliclySupportedOrg170b1Avi>
      <GiftsGrantsContribReceived170>
        <CurrentTaxYearMinus4Years>2989143</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>3802914</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>3703964</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>3316780</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>1963033</CurrentTaxYear>
        <Total>15775834</Total>
      </GiftsGrantsContribReceived170>
      <TaxRevLeviedForOrgBenefit170>
        <CurrentTaxYearMinus4Years>0</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>0</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>0</CurrentTaxYearMinus2Years>
        <Total>0</Total>
      </TaxRevLeviedForOrgBenefit170>
      <ValueSrvcFcltsFurnishedByGovt>
        <CurrentTaxYearMinus4Years>0</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>0</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>0</CurrentTaxYearMinus2Years>
        <Total>0</Total>
      </ValueSrvcFcltsFurnishedByGovt>
      <Total170>
        <CurrentTaxYearMinus4Years>2989143</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>3802914</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>3703964</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>3316780</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>1963033</CurrentTaxYear>
        <Total>15775834</Total>
      </Total170>
      <PublicSupportTotal170>15775834</PublicSupportTotal170>
      <GrossInvestmentIncome170>
        <CurrentTaxYearMinus4Years>23005</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>41</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>0</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>454</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>602</CurrentTaxYear>
        <Total>24102</Total>
      </GrossInvestmentIncome170>
      <NetUBI>
        <CurrentTaxYearMinus4Years>0</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>0</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>0</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>0</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>0</CurrentTaxYear>
        <Total>0</Total>
      </NetUBI>
      <OtherIncome170>
        <CurrentTaxYearMinus4Years>1873160</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>3040</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>0</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>0</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>0</CurrentTaxYear>
        <Total>1876200</Total>
      </OtherIncome170>
      <TotalSupport>17676136</TotalSupport>
      <GrossReceiptsFromAdmissionsEtc>3676599</GrossReceiptsFromAdmissionsEtc>
      <PublicSupportPertcentage170>0.89249</PublicSupportPertcentage170>
      <PublicSupportPertcentPriorYear>0.72870</PublicSupportPertcentPriorYear>
      <ThirtyThreePercntTestsCY170>X</ThirtyThreePercntTestsCY170>
      <GeneralExplanation>No Other Income</GeneralExplanation>
    </IRS990ScheduleA>
    <IRS990ScheduleC documentId="R000003" softwareId="12000197" softwareVersion="v1.00">
      <TotalGrassrootsLobbying>
        <FilingOrganizationsTotals>0</FilingOrganizationsTotals>
      </TotalGrassrootsLobbying>
      <TotalDirectLobbying>
        <FilingOrganizationsTotals>10363</FilingOrganizationsTotals>
      </TotalDirectLobbying>
      <TotalLobbyingExpenditures>
        <FilingOrganizationsTotals>10363</FilingOrganizationsTotals>
      </TotalLobbyingExpenditures>
      <OtherExemptPurposeExpenditures>
        <FilingOrganizationsTotals>0</FilingOrganizationsTotals>
      </OtherExemptPurposeExpenditures>
      <TotalExemptPurposeExpenditures>
        <FilingOrganizationsTotals>10363</FilingOrganizationsTotals>
      </TotalExemptPurposeExpenditures>
      <LobbyingNontaxableAmount>
        <FilingOrganizationsTotals>2073</FilingOrganizationsTotals>
      </LobbyingNontaxableAmount>
      <GrassrootsNontaxableAmount>
        <FilingOrganizationsTotals>518</FilingOrganizationsTotals>
      </GrassrootsNontaxableAmount>
      <TotLobbyingGrassrootMinusNonTx>
        <FilingOrganizationsTotals>0</FilingOrganizationsTotals>
      </TotLobbyingGrassrootMinusNonTx>
      <TotLobbyExpendMnsLobbyingNontx>
        <FilingOrganizationsTotals>8290</FilingOrganizationsTotals>
      </TotLobbyExpendMnsLobbyingNontx>
      <Form4720Filed>0</Form4720Filed>
      <LobbyingNontaxableAmount2>
        <CurrentYearMinus3>1179</CurrentYearMinus3>
        <CurrentYearMinus2>403990</CurrentYearMinus2>
        <CurrentYearMinus1>1240</CurrentYearMinus1>
        <CurrentYear>2073</CurrentYear>
        <Total>408482</Total>
      </LobbyingNontaxableAmount2>
      <LobbyingCeilingAmount>612723</LobbyingCeilingAmount>
      <TotalLobbyingExpenditures2>
        <CurrentYearMinus3>5896</CurrentYearMinus3>
        <CurrentYearMinus2>11537</CurrentYearMinus2>
        <CurrentYearMinus1>6200</CurrentYearMinus1>
        <CurrentYear>10363</CurrentYear>
        <Total>33996</Total>
      </TotalLobbyingExpenditures2>
      <GrassrootsNontaxableAmount2>
        <CurrentYearMinus3>295</CurrentYearMinus3>
        <CurrentYearMinus2>100998</CurrentYearMinus2>
        <CurrentYearMinus1>310</CurrentYearMinus1>
        <CurrentYear>518</CurrentYear>
        <Total>102121</Total>
      </GrassrootsNontaxableAmount2>
      <GrassrootsCeilingAmount>153182</GrassrootsCeilingAmount>
      <GrassrootsLobbyingExpenditures>
        <CurrentYearMinus3>0</CurrentYearMinus3>
        <CurrentYearMinus2>0</CurrentYearMinus2>
        <CurrentYearMinus1>0</CurrentYearMinus1>
        <CurrentYear>0</CurrentYear>
        <Total>0</Total>
      </GrassrootsLobbyingExpenditures>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="R000004" softwareId="12000197" softwareVersion="v1.00">
      <Land>
        <InvestmentCostOrOtherBasis>267265</InvestmentCostOrOtherBasis>
        <OtherCostOrOtherBasis>0</OtherCostOrOtherBasis>
        <BookValue>267265</BookValue>
      </Land>
      <Buildings>
        <InvestmentCostOrOtherBasis>504779</InvestmentCostOrOtherBasis>
        <OtherCostOrOtherBasis>0</OtherCostOrOtherBasis>
        <Depreciation>103059</Depreciation>
        <BookValue>401720</BookValue>
      </Buildings>
      <LeaseholdImprovements>
        <InvestmentCostOrOtherBasis>193273</InvestmentCostOrOtherBasis>
        <OtherCostOrOtherBasis>0</OtherCostOrOtherBasis>
        <Depreciation>61146</Depreciation>
        <BookValue>132127</BookValue>
      </LeaseholdImprovements>
      <Equipment>
        <InvestmentCostOrOtherBasis>470058</InvestmentCostOrOtherBasis>
        <OtherCostOrOtherBasis>0</OtherCostOrOtherBasis>
        <Depreciation>220553</Depreciation>
        <BookValue>249505</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <InvestmentCostOrOtherBasis>0</InvestmentCostOrOtherBasis>
        <OtherCostOrOtherBasis>0</OtherCostOrOtherBasis>
        <Depreciation>0</Depreciation>
        <BookValue>0</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>1050617</TotalOfBookValueLandBuildings>
      <TotRevenueEtcAuditedFinclStmt>5640234</TotRevenueEtcAuditedFinclStmt>
      <NetUnrealizedGainsInvestments>0</NetUnrealizedGainsInvestments>
      <DonatedSrvcAndUseOfFacilities>0</DonatedSrvcAndUseOfFacilities>
      <RecoveriesOfPriorYearGrants>0</RecoveriesOfPriorYearGrants>
      <OtherRevenues>0</OtherRevenues>
      <RevenueNotRptdF990>0</RevenueNotRptdF990>
      <RevenueSubtotal>5640234</RevenueSubtotal>
      <InvestmentExpensesNotIncluded>0</InvestmentExpensesNotIncluded>
      <OtherRevenuesNotIncluded>0</OtherRevenuesNotIncluded>
      <RevenueNotRptdOnFinStmt>0</RevenueNotRptdOnFinStmt>
      <TotalRevenuePerForm990>5640234</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>5300666</TotExpensesEtcAuditedFinclStmt>
      <DonatedServicesUseOfFacilities>0</DonatedServicesUseOfFacilities>
      <PriorYearAdjustments>0</PriorYearAdjustments>
      <LossesReported>0</LossesReported>
      <OtherExpensesIncluded>0</OtherExpensesIncluded>
      <ExpensesNotRptdF990>0</ExpensesNotRptdF990>
      <ExpensesSubtotal>5300666</ExpensesSubtotal>
      <InvestmentExpensesNotIncluded2>0</InvestmentExpensesNotIncluded2>
      <OtherExpensesNotIncluded>0</OtherExpensesNotIncluded>
      <ExpensesNotRptdOnFinStmt>0</ExpensesNotRptdOnFinStmt>
      <TotalExpensesPerForm990>5300666</TotalExpensesPerForm990>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="R000005" softwareId="12000197" softwareVersion="v1.00">
      <Form990OfOtherOrganizations>X</Form990OfOtherOrganizations>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>0</SeverancePayment>
      <SupplementalNonqualRetirePlan>0</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>0</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>0</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>0</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>0</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>0</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>0</AnyNonFixedPayments>
      <InitialContractException>0</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>David Roddy</NamePerson>
        <Title>Executive Director / Chief Financial Officer</Title>
        <BaseCompensationFilingOrg>183274</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>5000</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>11613</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>16361</NontaxableBenefitsFilingOrg>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
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    <IRS990ScheduleO documentId="R000006" softwareId="12000197" softwareVersion="v1.00">
      <GeneralExplanation>
        <Identifier>F990_P06_S0A_L06</Identifier>
        <ReturnReference>Form 990, Part VI, Section A, Line 6</ReturnReference>
        <Explanation>The Organization is a membership organization consisting of 501(c)3 and Governmental organizations committed to providing discounted access to primary care and other health and social services to low-income and rural residents.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>F990_P06_S0B_L11b</Identifier>
        <ReturnReference>Form 990, Part VI, Section B, Line 11b</ReturnReference>
        <Explanation>The Organization's Board of Directors reviews and approves the CPA OMB 133 audit and is sent a copy of the 990 for review and comment prior to its filing.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>F990_P06_S0B_L12c</Identifier>
        <ReturnReference>Form 990, Part VI, Section B, Line 12c</ReturnReference>
        <Explanation>Board Members elected at the Annual Meeting are required to fill out Conflict of Interest forms Any noted conflicts or potential conflicts are compiled and referenced if necessary at future board meetings.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>F990_P06_S0B_L15</Identifier>
        <ReturnReference>Form 990, Part VI, Section B, Line 15</ReturnReference>
        <Explanation>The salaries of Executives of comparable State Primary Care Association Executives (based on organizational budgets) are obtained from the 990 Forms, as well as salary information and budgets of comparable health-related associations in New Mexico and other states and are distributed to the Executive Committee of the board prior to the Executive Director's annual review and any salary adjustment. National and regional salary survey information collected and compiled by the National Association of Community Health centers is also provided. The Executive Director compiles the same information prior to any adjustment of the salary of the Director of Operations or other key staff. This process last occurred in March 2013 and occurs every year in March or April.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>F990_P06_S0C_L19</Identifier>
        <ReturnReference>Form 990, Part VI, Section C, Line 19</ReturnReference>
        <Explanation>Copies of governing documents, conflict of Interest policy, and financial statements are available to the public by request at the organization's office or through a written request to the organization.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>F990_P09_S00_L11g</Identifier>
        <ReturnReference>Form 990, Part IX, Line 11g</ReturnReference>
        <Explanation>Health Information Technology Program Director</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>F990_P11_S00_L09</Identifier>
        <ReturnReference>Form 990, Part XI, Line 9</ReturnReference>
        <Explanation>Change in Temporarily Restricted Net assets</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
  </ReturnData>
</Return>