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        <ExclusionAmt>0</ExclusionAmt>
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        <ExclusionAmt>0</ExclusionAmt>
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      <CompCurrentOfcrDirectorsGrp>
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      <OtherExpensesGrp>
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      <ReconcilationRevenueExpnssAmt>-839306</ReconcilationRevenueExpnssAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
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        <CurrentTaxYearMinus2YearsAmt>1491</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2234</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>4279</CurrentTaxYearAmt>
        <TotalAmt>22720</TotalAmt>
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      <TotalSupportCalendarYearGrp>
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        <CurrentTaxYearMinus1YearAmt>6142500</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3359893</CurrentTaxYearAmt>
        <TotalAmt>19297804</TotalAmt>
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      <InvestmentIncomeCYPct>0.04720</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.03670</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Pt III Ln 12</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Income Part III, Line 12 Description: Other income 2021: 10892. 2022: 3824. 2023: 1491. 2024: 2234. 2025: 4279.</ExplanationTxt>
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        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
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      <GrassrootsNontaxableGrp>
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      <TotLbbyExpendMnsLbbyngNonTxGrp>
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      <AvgLobbyingNontaxableAmountGrp>
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        <CurrentYearMinus2Amt>0</CurrentYearMinus2Amt>
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        <CurrentYearMinus1Amt>38493</CurrentYearMinus1Amt>
        <CurrentYearAmt>44998</CurrentYearAmt>
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      <AvgGrassrootsNontaxableGrp>
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        <CurrentYearMinus2Amt>0</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>81275</CurrentYearMinus1Amt>
        <CurrentYearAmt>88547</CurrentYearAmt>
        <TotalAmt>169822</TotalAmt>
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      <GrassrootsCeilingAmt>254733</GrassrootsCeilingAmt>
      <AvgGrassrootsLobbyingExpendGrp>
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        <CurrentYearMinus2Amt>0</CurrentYearMinus2Amt>
        <CurrentYearMinus1Amt>0</CurrentYearMinus1Amt>
        <CurrentYearAmt>861</CurrentYearAmt>
        <TotalAmt>861</TotalAmt>
      </AvgGrassrootsLobbyingExpendGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt II-A, Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>State and local lobbying on behalf of local health departments.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
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        <BookValueAmt>0</BookValueAmt>
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      <EquipmentGrp>
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        <DepreciationAmt>40245</DepreciationAmt>
        <BookValueAmt>24035</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>24035</TotalBookValueLandBuildingsAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
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      <RevenueSubtotalAmt>3244441</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>3244441</TotalRevenuePerForm990Amt>
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      <ExpensesSubtotalAmt>4083747</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>4083747</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt X, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken by the Association and recognize a tax liability (or asset) if the Association has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. The Association is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. Management believes it is no longer subject to income tax examinations for years prior to 2022. The Associations policy is to include penalties and interest associated with income tax expense and interest expense respectively. The Association did not incur any penalties or interest on income taxes for the periods being reported.</ExplanationTxt>
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    <IRS990ScheduleO documentId="IRS990ScheduleO-01" softwareId="25022686">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Members of the Organization are directors of local public health departments in Nebraska</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>All directors of local public health departments in Nebraska who join the Organization also serve as directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The form 990 is reviewed by the executive director and treasurer and then is sent to the entire board for their review.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>At the start of a new board members tenure and again as part of the annual renewal process, members review and sign a conflict of interest statement. Potential conflicts of interest are addressed according to the procedures in the conflict of interest policy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>Members of the executive committee develop the position description, review executive director performance based upon the description, and review data on comparable positions statewide. Based upon this, the compensation for the executive director is proposed and approved by the full board of directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>All documents would be made available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>Neither the oversight nor the selection processes have been changed during the current year.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Professional Services 3049017. 2982155. 66862. 0.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>