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      <RevenueNotReportedAmt>405160</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>40185368</RevenueSubtotalAmt>
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        <FormAndLineReferenceDesc>Part X : FIN48 Footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization has qualified as a nonprofit organization and has been granted tax-exempt status pursuant to Internal Revenue Code Section 501(c)(3) and California Revenue and Taxation Code Section 23701(d) and is exempt from Federal and State of California income taxes.Generally accepted accounting principles provides accounting and disclosures guidance about positions taken by an organization in its tax returns that might be uncertain. Management has considered its tax positions and believes that all of the positions taken in its federal and state exempt organization tax returns are more likely than not to be sustained upon examination. The Organizations returns are subject to examination by federal and state taxing authorities, generally for three years and four years, respectively, after they are filed.</ExplanationTxt>
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        <PersonNm>Aaron Kissel</PersonNm>
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        <DeferredCompensationFlngOrgAmt>18000</DeferredCompensationFlngOrgAmt>
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        <PersonNm>Christopher Garcia</PersonNm>
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        <PersonNm>Derik Keshishian</PersonNm>
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        <DeferredCompensationFlngOrgAmt>18000</DeferredCompensationFlngOrgAmt>
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        <PersonNm>Gurpal Bains</PersonNm>
        <TitleTxt>Executive Dir.</TitleTxt>
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        <PersonNm>James Tinio</PersonNm>
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        <PersonNm>Julie Ramsey</PersonNm>
        <TitleTxt>COO</TitleTxt>
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        <PersonNm>Matthew Easton</PersonNm>
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        <NontaxableBenefitsFilingOrgAmt>8216</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>327435</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>William Patterson</PersonNm>
        <TitleTxt>CFO</TitleTxt>
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        <NontaxableBenefitsFilingOrgAmt>6180</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>184949</TotalCompensationFilingOrgAmt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Board members are composed of two elected representatives from each of the six service areas. During the year, there were no changes to the board compensation.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is prepared by an independent accounting firm and reviewed for accuracy by the CFO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Business items are screened by staff prior to presenting them to the board of directors. Additionally, the staff, CFO, and CEO screen the items to ensure there is no conflict of interest. This is also a procedure that is checked by staff during quarterly compliance audits. Finally, with Central Valley Indian Health Inc. being such a small community (3 counties), the full board reviews the issues during business meetings. Great effort is put forth to ensure integrity on all business issues.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>The board annually reviews salary paid to the CEO and compares that pay to similar organizations. Board approves all salary adjustments.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organizations governing documents, conflicts of interest policy, and audit financial statements are available to the public upon request.</ExplanationTxt>
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