﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2024v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-06-23T14:39:41-05:00</ReturnTs>
    <TaxPeriodEndDt>2024-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>263824391</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Laura Lindal CPA</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>5509 Canvasback Rd</AddressLine1Txt>
        <CityNm>Blaine</CityNm>
        <StateAbbreviationCd>WA</StateAbbreviationCd>
        <ZIPCd>98230</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>910906330</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Pierce County Alliance</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>PIER</BusinessNameControlTxt>
      <PhoneNum>2535724750</PhoneNum>
      <USAddress>
        <AddressLine1Txt>510 Tacoma Ave S</AddressLine1Txt>
        <CityNm>Tacoma</CityNm>
        <StateAbbreviationCd>WA</StateAbbreviationCd>
        <ZIPCd>98402</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Terree Schmidt-Whelan</PersonNm>
      <PersonTitleTxt>Executive Director</PersonTitleTxt>
      <PhoneNum>2535724750</PhoneNum>
      <SignatureDt>2025-06-09</SignatureDt>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>0</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>Laura Lindal</PreparerPersonNm>
      <PTIN>P01267403</PTIN>
      <PhoneNum>2067348134</PhoneNum>
      <SelfEmployedInd>X</SelfEmployedInd>
    </PreparerPersonGrp>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>Terree Schmidt-Whelan</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>510 Tacoma Ave S</AddressLine1Txt>
        <CityNm>Tacoma</CityNm>
        <StateAbbreviationCd>WA</StateAbbreviationCd>
        <ZIPCd>98402</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>10368061</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.piercecountyalliance.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1972</FormationYr>
      <LegalDomicileStateCd>WA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>The purpose of Pierce County Alliance is to plan, organize, operate, establish, and evaluate human and social services for the residents of Pierce County.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>8</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>7</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>117</TotalEmployeeCnt>
      <TotalVolunteersCnt>7</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>0</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>0</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>9364992</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>10354665</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>0</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>13396</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>9364992</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>10368061</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>492227</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>656406</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>6475714</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>7322420</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>2429937</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>2429335</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>9397878</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>10408161</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-32886</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-40100</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>5435928</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>5469908</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>918740</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>992820</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>4517188</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>4477088</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>The purpose of Pierce County Alliance is to plan, organize, operate, establish, and evaluate human and social services for the residents of Pierce County.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>3866039</ExpenseAmt>
      <GrantAmt>656406</GrantAmt>
      <RevenueAmt>4219540</RevenueAmt>
      <Desc>Drug Court - Established in 1994 in cooperation witht he Pierce County Superior Court, County Prosecutor, and the Department of Assigned Counsel, the Alliance provides court-supervised drug and alcohol treatment services for eligible offenders. In 2010, a dedicated treatment track was added to serve veterans.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>2567421</ExpenseAmt>
        <RevenueAmt>3116068</RevenueAmt>
        <Desc>Adult Treatment - This program provides state certified drug and alcohol intensive outpatient treatment services, targeting low-income citizens of Pierce County. Services include assessment; individual, group and family counseling; gender specific treatment programs; and DUI assessment and treatment.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>2065455</ExpenseAmt>
        <RevenueAmt>1761126</RevenueAmt>
        <Desc>Outreach Services - Recovery is hope in action. The Recovery Navigator Program uses a harm reduciton approach, specifically targeting justice-involved members of our community for the purpose of diversion and recovery from the underlying causes of criminal behavior, including untreated Subsance Use Disorder and Mental Health Disorders. The program strengthens the connections between systems of care, increasing community-based capacity in the integration of trauma-informed care and reinforcing health promotion in the community.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>176330</ExpenseAmt>
        <RevenueAmt>1257931</RevenueAmt>
        <Desc>Adolescent services, Chemical detection services, and Mental health services</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcExpenseAmt>176330</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcRevenueAmt>1257931</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>8675245</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>0</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc1041900001">0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc1041900001">1</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>6</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>117</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>8</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>7</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>0</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <OtherWebsiteInd>X</OtherWebsiteInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>The Organization</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>2535724750</PhoneNum>
        <USAddress>
          <AddressLine1Txt>510 Tacoma Ave S</AddressLine1Txt>
          <CityNm>Tacoma</CityNm>
          <StateAbbreviationCd>WA</StateAbbreviationCd>
          <ZIPCd>98402</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Barry Reid</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>Tess Mandapat</PersonNm>
        <TitleTxt>Vice President</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Priscilla Lisisich</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>David Jones</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Darrel Addington</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Joyce Singleton</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dave Parkhurst</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Terree Schmidt-Whelan</PersonNm>
        <TitleTxt>Executive Director</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>296932</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Phi-Diep Damo</PersonNm>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>160327</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>457259</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>2</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>Grants and contracts</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>5123657</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>5123657</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Services contracted with medical</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>4992907</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4992907</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Worker retention and other</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>238101</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>238101</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>10354665</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>13396</TotalRevenueColumnAmt>
        <ExclusionAmt>13396</ExclusionAmt>
      </InvestmentIncomeGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>10368061</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10354665</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>13396</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>656406</TotalAmt>
        <ProgramServicesAmt>656406</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>5942777</TotalAmt>
        <ProgramServicesAmt>5260590</ProgramServicesAmt>
        <ManagementAndGeneralAmt>682187</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>826889</TotalAmt>
        <ProgramServicesAmt>695580</ProgramServicesAmt>
        <ManagementAndGeneralAmt>131309</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>552754</TotalAmt>
        <ProgramServicesAmt>415773</ProgramServicesAmt>
        <ManagementAndGeneralAmt>136981</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>325</TotalAmt>
        <ManagementAndGeneralAmt>325</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>35850</TotalAmt>
        <ManagementAndGeneralAmt>35850</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>643284</TotalAmt>
        <ProgramServicesAmt>517002</ProgramServicesAmt>
        <ManagementAndGeneralAmt>126282</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>37096</TotalAmt>
        <ManagementAndGeneralAmt>37096</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>282078</TotalAmt>
        <ProgramServicesAmt>131830</ProgramServicesAmt>
        <ManagementAndGeneralAmt>150248</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>183916</TotalAmt>
        <ProgramServicesAmt>146965</ProgramServicesAmt>
        <ManagementAndGeneralAmt>36951</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>230577</TotalAmt>
        <ProgramServicesAmt>204107</ProgramServicesAmt>
        <ManagementAndGeneralAmt>26470</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>190753</TotalAmt>
        <ProgramServicesAmt>147293</ProgramServicesAmt>
        <ManagementAndGeneralAmt>43460</ManagementAndGeneralAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>12185</TotalAmt>
        <ManagementAndGeneralAmt>12185</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>89488</TotalAmt>
        <ManagementAndGeneralAmt>89488</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>105029</TotalAmt>
        <ProgramServicesAmt>92971</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12058</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Client services</Desc>
        <TotalAmt>245255</TotalAmt>
        <ProgramServicesAmt>245255</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Other</Desc>
        <TotalAmt>91692</TotalAmt>
        <ManagementAndGeneralAmt>91692</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Communications</Desc>
        <TotalAmt>78537</TotalAmt>
        <ProgramServicesAmt>45545</ProgramServicesAmt>
        <ManagementAndGeneralAmt>32992</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Testing</Desc>
        <TotalAmt>76245</TotalAmt>
        <ProgramServicesAmt>76245</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>127025</TotalAmt>
        <ProgramServicesAmt>39683</ProgramServicesAmt>
        <ManagementAndGeneralAmt>87342</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>10408161</TotalAmt>
        <ProgramServicesAmt>8675245</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1732916</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>2412546</BOYAmt>
        <EOYAmt>1955526</EOYAmt>
      </CashNonInterestBearingGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1467975</BOYAmt>
        <EOYAmt>2061658</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>53179</BOYAmt>
        <EOYAmt>54055</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>71347</BOYAmt>
        <EOYAmt>89181</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>4135203</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>2918931</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>1280303</BOYAmt>
        <EOYAmt>1216272</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>150578</BOYAmt>
        <EOYAmt>93216</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>5435928</BOYAmt>
        <EOYAmt>5469908</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>667313</BOYAmt>
        <EOYAmt>896528</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>98443</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>152984</BOYAmt>
        <EOYAmt>96292</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>918740</BOYAmt>
        <EOYAmt>992820</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>4517188</BOYAmt>
        <EOYAmt>4477088</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>4517188</BOYAmt>
        <EOYAmt>4477088</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>5435928</BOYAmt>
        <EOYAmt>5469908</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-40100</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>0</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>717408</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>750000</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>500</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>1467908</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>7298238</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>7496140</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8949492</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9364992</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10354665</CurrentTaxYearAmt>
        <TotalAmt>43463527</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>8015646</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8246140</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8949992</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9364992</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10354665</CurrentTaxYearAmt>
        <TotalAmt>44931435</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>44931435</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearAmt>13396</CurrentTaxYearAmt>
        <TotalAmt>13396</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearAmt>13396</CurrentTaxYearAmt>
        <TotalAmt>13396</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>8015646</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8246140</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8949992</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9364992</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10368061</CurrentTaxYearAmt>
        <TotalAmt>44944831</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99970</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>1.00000</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00030</InvestmentIncomeCYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>424462</OtherCostOrOtherBasisAmt>
        <BookValueAmt>424462</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>2892378</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2126567</DepreciationAmt>
        <BookValueAmt>765811</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>748758</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>748758</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>69605</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>43606</DepreciationAmt>
        <BookValueAmt>25999</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>1216272</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Lease liabilities</Desc>
        <Amt>96292</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>96292</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>10368061</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>10368061</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>10368061</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>10408161</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>10408161</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>10408161</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>0</GrantRecordsMaintainedInd>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Rental assistance</GrantTypeTxt>
        <CashGrantAmt>656406</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Terree Schmidt-Whelan</PersonNm>
        <TitleTxt>Executive Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>276372</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>20560</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>296932</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Phi-Diep Damo</PersonNm>
        <TitleTxt>Chief Financial Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>149377</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>10950</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>160327</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>The executive committee shall consist of the four elected officers plus other members who may be appointed by the Board President or elected by the Board of Directors. A quorum for the executive committee shall have all the power of the Board of Directors between meetings of the Board, except the power to modify actions taken by the Board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>All board members are provided a complete copy of the Form 990 and asked to review it and provide any feedback before the return is filed.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>All board members must fill out and sign the conflict of interest statement listing any possible conflicts. If any are noted, they are brought to the attention of the board. If a conflict is discovered by the board, the member with the conflict is removed from the discussion and voting of the transaction.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>All governing and financial documents are kept in the business office and are available upon request. The audit is publicly available through fac.gov and the Form 990 is publicly available through guidestar.org.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>