﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2024v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-04-08T15:15:35-04:00</ReturnTs>
    <TaxPeriodEndDt>2024-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>141800427</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>CUSACK &amp; COMPANY CPAS LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>7 AIRPORT PARK BLVD</AddressLine1Txt>
        <CityNm>LATHAM</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>12110</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>141747742</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>THE NEW YORK STATE ASSOCIATION OF</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>COUNTY HEALTH OFFICIALS INC</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>NEWY</BusinessNameControlTxt>
      <PhoneNum>5184567905</PhoneNum>
      <USAddress>
        <AddressLine1Txt>8 AIRPORT PARK BLVD</AddressLine1Txt>
        <CityNm>LATHAM</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>12110</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>SARAH RAVENHALL</PersonNm>
      <PersonTitleTxt>EXECUTIVE DIRECTOR</PersonTitleTxt>
      <PhoneNum>5184567905</PhoneNum>
      <SignatureDt>2025-04-08</SignatureDt>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>false</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>KENNETH B CLAFLIN CPA</PreparerPersonNm>
      <PTIN>P00301582</PTIN>
      <PhoneNum>5187863550</PhoneNum>
      <PreparationDt>2025-04-08</PreparationDt>
      <SelfEmployedInd>X</SelfEmployedInd>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc2" referenceDocumentId="RetDoc5">
      <PrincipalOfficerNm>SARAH RAVENHALL</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>8 AIRPORT PARK BLVD</AddressLine1Txt>
        <CityNm>LATHAM</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>12110</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>2105922</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2008</FormationYr>
      <ActivityOrMissionDesc>TO SUPPORT AND EMPOWER LOCAL HEALTH DEPARTMENTS IN THEIR WORK TO PROMOTE HEALTH AND WELLNESS AND PREVENT DISEASE, DISABILITY AND INJURY THROUGHOUT NEW YORK STATE.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>12</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>12</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>13</TotalEmployeeCnt>
      <TotalVolunteersCnt>12</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>1303250</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>1599248</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>335837</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>486462</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>10591</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>20212</CYInvestmentIncomeAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>1649678</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>2105922</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>823461</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>864808</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>778229</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>1011744</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>1601690</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>1876552</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>47988</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>229370</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>810143</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>1191293</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>269043</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>408910</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>541100</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>782383</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>TO SUPPORT AND EMPOWER LOCAL HEALTH DEPARTMENTS IN THEIR WORK TO PROMOTE HEALTH AND WELLNESS AND PREVENT DISEASE, DISABILITY AND INJURY THROUGHOUT NEW YORK STATE.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>353821</ExpenseAmt>
      <Desc>IMMUNIZATION GRANT - SUPPORTS THE PROVISION OF TECHNICAL ASSISTANCE AND TRAINING FOR IMMUNIZATION COORDINATORS AT LOCAL HEALTH DEPARTMENTS IN NEW YORK STATE TO INCREASE ACCESS TO IMMUNIZATIONS.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>249449</ExpenseAmt>
        <RevenueAmt>210942</RevenueAmt>
        <Desc>EDUCATION AND TRAINING GRANT - SUPPORTS THE PROVISION OF TECHNICAL ASSISTANCE AND TRAINING FOR PUBLIC HEALTH PROFESSIONALS IN NEW YORK STATE WORKING AT LOCAL HEALTH DEPARTMENTS. TRAININGS RELATED TO CORE PUBLIC HEALTH AND LEADERSHIP DEVELOPMENT.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>155702</ExpenseAmt>
        <Desc>VACCINE EQUITY GRANT - SUPPORTS THE PROVISION OF EDUCATION ON THE VALUE OF PREVENTING COMMUNICABLE DISEASE, INCLUDING COVID, THROUGH INCREASING IMMUNIZATION RATES WITH A FOCUS ON REDUCING HEALTH DISPARITIES AND IMPROVING HEALTH EQUITY IN NEW YORK STATE.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>966805</ExpenseAmt>
        <RevenueAmt>275520</RevenueAmt>
        <Desc>OTHER GRANTS AND MEMBERSHIP SERVICES.</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcExpenseAmt>966805</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcRevenueAmt>275520</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>1725777</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc6">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc3">false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="RetDoc3">true</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc3">false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc4">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc4">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc4">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc4">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="RetDoc4">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc4">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc4">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc4">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc4">true</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc4">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc4">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc4">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc4">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>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <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>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>16</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>13</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <Form8899Filedind>false</Form8899Filedind>
      <Form1098CFiledInd>false</Form1098CFiledInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>12</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>12</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>true</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>true</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</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>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>NY</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>SARAH RAVENHALL</PersonNm>
        <PhoneNum>5184567905</PhoneNum>
        <USAddress>
          <AddressLine1Txt>8 AIRPORT PARK BLVD</AddressLine1Txt>
          <CityNm>LATHAM</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>12110</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>SARAH RAVENHALL</PersonNm>
        <TitleTxt>EXECUTIVE DI</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>119669</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7180</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHERLITA AMLER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LINDA BEERS</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HEIDI BOND</PersonNm>
        <TitleTxt>VP/TEASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KEITH BROWN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SARA BOERENKO</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PETER BUZZETTI</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATHLEEN CUDDY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DIANE DEVLIN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MAURA KENNELLY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREGSON PIGOTT</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TYLER SHAW</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ASHLEY WAITE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>119669</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>7180</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>1</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>false</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <GovernmentGrantsAmt>1597616</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>1632</AllOtherContributionsAmt>
      <TotalContributionsAmt>1599248</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>MEMBERSHIP DUES</Desc>
        <TotalRevenueColumnAmt>275520</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>275520</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONFERENCES AND OTHER</Desc>
        <TotalRevenueColumnAmt>204937</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>204937</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER</Desc>
        <TotalRevenueColumnAmt>6005</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6005</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>486462</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>20212</TotalRevenueColumnAmt>
        <ExclusionAmt>20212</ExclusionAmt>
      </InvestmentIncomeGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>2105922</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>486462</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>20212</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>119669</TotalAmt>
        <ProgramServicesAmt>95735</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23934</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>513558</TotalAmt>
        <ProgramServicesAmt>462201</ProgramServicesAmt>
        <ManagementAndGeneralAmt>51357</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>34544</TotalAmt>
        <ProgramServicesAmt>30437</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4107</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>145608</TotalAmt>
        <ProgramServicesAmt>128295</ProgramServicesAmt>
        <ManagementAndGeneralAmt>17313</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>51429</TotalAmt>
        <ProgramServicesAmt>45314</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6115</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>12677</TotalAmt>
        <ProgramServicesAmt>11170</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1507</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>97921</TotalAmt>
        <ProgramServicesAmt>86278</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11643</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>41175</TotalAmt>
        <ProgramServicesAmt>41175</ProgramServicesAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>175459</TotalAmt>
        <ProgramServicesAmt>154597</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20862</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>53975</TotalAmt>
        <ProgramServicesAmt>47557</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6418</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>31821</TotalAmt>
        <ProgramServicesAmt>28037</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3784</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>71693</TotalAmt>
        <ProgramServicesAmt>71693</ProgramServicesAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>495607</TotalAmt>
        <ProgramServicesAmt>495607</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>8806</TotalAmt>
        <ProgramServicesAmt>7759</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1047</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>6579</TotalAmt>
        <ProgramServicesAmt>5797</ProgramServicesAmt>
        <ManagementAndGeneralAmt>782</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>COMMUNICATIONS</Desc>
        <TotalAmt>12097</TotalAmt>
        <ProgramServicesAmt>10659</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1438</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS</Desc>
        <TotalAmt>3934</TotalAmt>
        <ProgramServicesAmt>3466</ProgramServicesAmt>
        <ManagementAndGeneralAmt>468</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>1876552</TotalAmt>
        <ProgramServicesAmt>1725777</ProgramServicesAmt>
        <ManagementAndGeneralAmt>150775</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>63328</BOYAmt>
        <EOYAmt>348615</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>65329</BOYAmt>
        <EOYAmt>96835</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>240840</BOYAmt>
        <EOYAmt>330298</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>47228</BOYAmt>
        <EOYAmt>30323</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>56059</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>18560</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>46303</BOYAmt>
        <EOYAmt>37499</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>245716</BOYAmt>
        <EOYAmt>276060</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>101399</BOYAmt>
        <EOYAmt>71663</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>810143</BOYAmt>
        <EOYAmt>1191293</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>107280</BOYAmt>
        <EOYAmt>90381</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>60364</BOYAmt>
        <EOYAmt>246866</EOYAmt>
      </DeferredRevenueGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>101399</BOYAmt>
        <EOYAmt>71663</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>269043</BOYAmt>
        <EOYAmt>408910</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>541100</BOYAmt>
        <EOYAmt>782383</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>541100</BOYAmt>
        <EOYAmt>782383</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>810143</BOYAmt>
        <EOYAmt>1191293</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>229370</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>11913</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc6">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>967693</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>701109</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1098966</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1303250</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1599248</CurrentTaxYearAmt>
        <TotalAmt>5670266</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>967693</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>701109</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1098966</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1303250</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1599248</CurrentTaxYearAmt>
        <TotalAmt>5670266</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>5670266</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>7099</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>18006</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>10041</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>10591</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>20212</CurrentTaxYearAmt>
        <TotalAmt>65949</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <TotalSupportAmt>5736215</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>1561412</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.98850</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.98910</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <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="RetDoc3">
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>true</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>true</PublicationsOrBroadcastInd>
      <PublicationsOrBroadcastAmt>100</PublicationsOrBroadcastAmt>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>true</DirectContactLegislatorsInd>
      <DirectContactLegislatorsAmt>67500</DirectContactLegislatorsAmt>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>false</OtherActivitiesInd>
      <TotalLobbyingExpendituresAmt>67600</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc4">
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>56059</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>18560</DepreciationAmt>
        <BookValueAmt>37499</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>37499</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>RIGHT-OF-USE ASSET</Desc>
        <BookValueAmt>71663</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>71663</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE PAYABLE</Desc>
        <Amt>71663</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>71663</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>2117835</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>11913</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>11913</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>2105922</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>2105922</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>1876552</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>1876552</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>1876552</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="RetDoc5">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4D</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER GRANTS AND MEMBERSHIP SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS CONSIST OF A REPRESENTATIVE FROM EACH OF THE COUNTY HEALTH DEPARTMENTS OF NEW YORK STATE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS VOTE IN MAY OF EACH YEAR TO ELECT THE DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 990 IS PREPARED BY THE INDEPENDENT ACCOUNTANT AND REVIEWED BY STAFF. IT IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>CONFLICT OF INTEREST STATEMENTS ARE OBTAINED ANNUALLY FROM ALL BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD PERFORMS AN ANNUAL PERFORMANCE AND SALARY REVIEW FOR THE EXECUTIVE DIRECTOR, THE ONLY KEY EMPLOYEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>