<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2022v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-05-15T20:34:44-04:00</ReturnTs>
    <TaxPeriodEndDt>2023-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>844233121</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>SHARPE PATEL CPA</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>325 ARLINGTON AVE STE 630</AddressLine1Txt>
        <CityNm>CHARLOTTE</CityNm>
        <StateAbbreviationCd>NC</StateAbbreviationCd>
        <ZIPCd>28203</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2022-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>261705419</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>NORTH CAROLINA ASSOCIATION OF LOCAL</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>HEALTH DIRECTORS INC</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>NORT</BusinessNameControlTxt>
      <PhoneNum>9198286201</PhoneNum>
      <USAddress>
        <AddressLine1Txt>222 N PERSON STREET 208</AddressLine1Txt>
        <CityNm>RALEIGH</CityNm>
        <StateAbbreviationCd>NC</StateAbbreviationCd>
        <ZIPCd>27601</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>BECKY HUGHES</PersonNm>
      <PersonTitleTxt>SR DIR OF FIN &amp; OPER</PersonTitleTxt>
      <PhoneNum>9198286201</PhoneNum>
      <SignatureDt>2024-05-15</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>BECKY</PersonFirstNm>
        <PersonLastNm>HUGHES</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>false</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>MEGAN A RIDGLEY CPA</PreparerPersonNm>
      <PTIN>P01317611</PTIN>
      <PhoneNum>7044993893</PhoneNum>
      <PreparationDt>2024-05-15</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2022</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="5">
    <IRS990 documentId="RetDoc3" referenceDocumentId="RetDoc5">
      <PrincipalOfficerNm>LILLIAN KOONTZ</PrincipalOfficerNm>
      <GrossReceiptsAmt>459346</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501cInd organization501cTypeTxt="6">X</Organization501cInd>
      <WebsiteAddressTxt>WWW.NCALHD.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2008</FormationYr>
      <LegalDomicileStateCd>NC</LegalDomicileStateCd>
      <ActivityOrMissionDesc>THE ASSOCIATIONS MISSION IS TO PROMOTE HEALTH, PREVENT DISEASE, AND PROTECT THE ENVIRONMENT IN ORDER TO ENSURE THE PUBLIC'S HEALTH IN NORTH CAROLINA.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>15</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>15</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <TotalVolunteersCnt>15</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>158574</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>166076</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>276250</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>279500</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>801</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>3770</CYInvestmentIncomeAmt>
      <CYOtherRevenueAmt>10000</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>435625</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>459346</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <CYSalariesCompEmpBnftPaidAmt>0</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>402512</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>492905</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>402512</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>492905</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>33113</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-33559</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>518531</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>487072</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>85467</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>87567</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>433064</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>399505</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>THE ASSOCIATIONS MISSION IS TO PROMOTE HEALTH, PREVENT DISEASE, AND PROTECT THE ENVIRONMENT IN ORDER TO ENSURE THE PUBLIC'S HEALTH IN NORTH CAROLINA.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <Desc>THE MEMBERS OF THE ASSOCIATION ARE PUBLIC HEALTH DIRECTORS FROM 85 COUNTIES AND ADMINISTRATIVE DISTRICTS ACROSS NORTH CAROLINA. THE ASSOCIATIONS LEADERSHIP SETS LEGISLATIVE PRIORITIES EACH YEAR AND SEEKS TO LEAD EFFORTS TO OPPOSE ANY BILL OR AMENDMENT THAT WEAKENS THE ABILITY OF LOCAL HEALTH DEPARTMENTS TO PROTECT AND PROMOTE THE PUBLICS HEALTH. ACCREDITATION- NORTH CAROLINA'S LOCAL HEALTH DEPARTMENT ACCREDITATION PROGRAM FOCUSES ON THE LOCAL HEALTH DEPARTMENT'S CAPACITY TO PERFORM AT A PRESCRIBED, BASIC LEVEL OF QUALITY IN THE THREE CORE FUNCTIONS OF ASSESSMENT, ASSURANCE, AND POLICY DEVELOPMENT AND THE 10 ESSENTIAL SERVICES AS DETAILED IN THE NATIONAL PUBLIC HEALTH PERFORMANCE STANDARDS PROGRAM. THE PROGRAM FOCUSES ON A SET OF MINIMAL STANDARDS THAT MUST BE PROVIDED TO ENSURE THE PROTECTION OF THE HEALTH OF THE PUBLIC. THE ACCREDITATION PROGRAM SERVED 85 HEALTH DEPARTMENTS.</Desc>
      <DescribedInSection501c3Ind>false</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc4">false</PoliticalCampaignActyInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc4">true</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd>false</DonorAdvisedFundInd>
      <ConservationEasementsInd>false</ConservationEasementsInd>
      <CollectionsOfArtInd>false</CollectionsOfArtInd>
      <CreditCounselingInd>false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd>false</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd>false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd>false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd>false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd>false</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd>false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd>false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd>false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd>false</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>0</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>0</EmployeeCnt>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>15</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>15</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>true</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>true</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>true</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>false</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>false</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>NC</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>REBECCA HUGHES</PersonNm>
        <PhoneNum>9198286204</PhoneNum>
        <USAddress>
          <AddressLine1Txt>222 N PERSON STREET</AddressLine1Txt>
          <CityNm>RALEIGH</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27601</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <NoListedPersonsCompensatedInd>X</NoListedPersonsCompensatedInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>PATRICK BROWN</PersonNm>
        <TitleTxt>EXECUTIVE DI</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HELENE EDWARDS</PersonNm>
        <TitleTxt>REGIONAL REP</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JENNIFER GREENE</PersonNm>
        <TitleTxt>SECRETARY-TR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT HARRELSON</PersonNm>
        <TitleTxt>IMMEDIATE PA</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LISA HARRISON</PersonNm>
        <TitleTxt>REGIONAL REP</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID HOWARD</PersonNm>
        <TitleTxt>REGIONAL REP</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RODNEY JENKINS</PersonNm>
        <TitleTxt>VICE PRESIDE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LILLIAN KOONTZ</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TONY LOGIUDICE</PersonNm>
        <TitleTxt>REGIONAL REP</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JENNIFER MCCRACKEN</PersonNm>
        <TitleTxt>REGIONAL REP</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KAREN POWELL</PersonNm>
        <TitleTxt>REGIONAL REP</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELAINE RUSSELL</PersonNm>
        <TitleTxt>REGIONAL REP</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN SILVERNAIL</PersonNm>
        <TitleTxt>REGIONAL REP</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>QUINTANA STEWART</PersonNm>
        <TitleTxt>PRESIDENT- E</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ASHLEY STOOP</PersonNm>
        <TitleTxt>REGIONAL REP</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JESSICA WALL</PersonNm>
        <TitleTxt>REGIONAL REP</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>false</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <MembershipDuesAmt>136076</MembershipDuesAmt>
      <AllOtherContributionsAmt>30000</AllOtherContributionsAmt>
      <TotalContributionsAmt>166076</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>CONSULTING SERVICES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>279500</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>279500</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>279500</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>3770</TotalRevenueColumnAmt>
        <ExclusionAmt>3770</ExclusionAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>SUSPENSE - REFUND</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>10000</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10000</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>10000</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>459346</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>289500</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>3770</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <FeesForServicesLegalGrp>
        <TotalAmt>28277</TotalAmt>
        <ManagementAndGeneralAmt>28277</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>1000</TotalAmt>
        <ManagementAndGeneralAmt>1000</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>30000</TotalAmt>
        <ProgramServicesAmt>30000</ProgramServicesAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>331578</TotalAmt>
        <ProgramServicesAmt>331578</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>267</TotalAmt>
        <ProgramServicesAmt>267</ProgramServicesAmt>
      </AdvertisingGrp>
      <InformationTechnologyGrp>
        <TotalAmt>834</TotalAmt>
        <ProgramServicesAmt>834</ProgramServicesAmt>
      </InformationTechnologyGrp>
      <TravelGrp>
        <TotalAmt>7611</TotalAmt>
        <ProgramServicesAmt>7611</ProgramServicesAmt>
      </TravelGrp>
      <OtherExpensesGrp>
        <Desc>ADMIN SERVICE EXPENSES</Desc>
        <TotalAmt>75000</TotalAmt>
        <ProgramServicesAmt>75000</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
        <TotalAmt>10148</TotalAmt>
        <ProgramServicesAmt>10148</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS</Desc>
        <TotalAmt>4924</TotalAmt>
        <ProgramServicesAmt>4924</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>COMMUNICATIONS</Desc>
        <TotalAmt>1203</TotalAmt>
        <ProgramServicesAmt>1203</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>2063</TotalAmt>
        <ProgramServicesAmt>2063</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>492905</TotalAmt>
        <ProgramServicesAmt>463628</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29277</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>122413</BOYAmt>
        <EOYAmt>110271</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>392518</BOYAmt>
        <EOYAmt>366232</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <EOYAmt>10000</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>3600</BOYAmt>
        <EOYAmt>569</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <TotalAssetsGrp>
        <BOYAmt>518531</BOYAmt>
        <EOYAmt>487072</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>45521</BOYAmt>
        <EOYAmt>58216</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>39946</BOYAmt>
        <EOYAmt>29351</EOYAmt>
      </DeferredRevenueGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>85467</BOYAmt>
        <EOYAmt>87567</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>433064</BOYAmt>
        <EOYAmt>211104</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <EOYAmt>188401</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>433064</BOYAmt>
        <EOYAmt>399505</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>518531</BOYAmt>
        <EOYAmt>487072</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-33559</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleB documentId="RetDoc1">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="RetDoc4">
      <SubstantiallyAllDuesNondedInd>true</SubstantiallyAllDuesNondedInd>
      <OnlyInHouseLobbyingInd>false</OnlyInHouseLobbyingInd>
      <AgreeCarryoverPriorYearInd>false</AgreeCarryoverPriorYearInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE C, PART II-A</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATION DID NOT REPORT LOBBYING EXPENSES IN 2020 AND 2019</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleO documentId="RetDoc5">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEMBERS OF THE ASSOCIATION ARE PUBLIC HEALTH DIRECTORS FROM 85 COUNTIES AND ADMINISTRATIVE DISTRICTS ACROSS NORTH CAROLINA. THE ASSOCIATIONS LEADERSHIP SETS LEGISLATIVE PRIORITIES EACH YEAR AND SEEKS TO LEAD EFFORTS TO OPPOSE ANY BILL OR AMENDMENT THAT WEAKENS THE ABILITY OF LOCAL HEALTH DEPARTMENTS TO PROTECT AND PROMOTE THE PUBLICS HEALTH. ACCREDITATION- NORTH CAROLINA'S LOCAL HEALTH DEPARTMENT ACCREDITATION PROGRAM FOCUSES ON THE LOCAL HEALTH DEPARTMENT'S CAPACITY TO PERFORM AT A PRESCRIBED, BASIC LEVEL OF QUALITY IN THE THREE CORE FUNCTIONS OF ASSESSMENT, ASSURANCE, AND POLICY DEVELOPMENT AND THE 10 ESSENTIAL SERVICES AS DETAILED IN THE NATIONAL PUBLIC HEALTH PERFORMANCE STANDARDS PROGRAM. THE PROGRAM FOCUSES ON A SET OF MINIMAL STANDARDS THAT MUST BE PROVIDED TO ENSURE THE PROTECTION OF THE HEALTH OF THE PUBLIC. THE ACCREDITATION PROGRAM SERVED 85 HEALTH DEPARTMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS 85 MEMBERS CONSISTING OF HEALTH DIRECTORS FROM EACH NORTH CAROLINA LOCAL HEALTH DEPARTMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>GENERAL ELECTION BY THE MEMBERSHIP.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>LEGISLATIVE AGENDA AND OPERATING BUDGET ARE APPROVED BY THE MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 IS PREPARED BY AN INDEPENDENT CPA WITH INPUT FROM MANAGEMENT. IT IS THEN MADE AVAILABLE TO THE BOARD OF DIRECTORS BY EMAIL COMMUNICATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD MEMBERS ARE REMINDED ON A REGULAR BASIS OF THEIR DUTY TO DISCLOSE TO THE BOARD ANY POTENTIAL CONFLICT OF INTEREST AS SOON AS THEY BECOME AWARE OF IT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATIONAL DOCUMENTS ARE AVAILABLE ON THE NC SECRETARY OF STATE'S WEBSITE OR UPON REQUEST OF NCALHD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>CONSULTING FEES 331,578 0 0</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <AveragingAttachment documentId="RetDoc2">
      <ExplanationTxt>ORGANIZATION DID NOT REPORT LOBBYING EXPENSES IN 2020 AND 2019</ExplanationTxt>
    </AveragingAttachment>
  </ReturnData>
</Return>
