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        <RelatedOrExemptFuncIncomeAmt>39685</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>Symbria Pharmacy, net</Desc>
        <BusinessCd>621399</BusinessCd>
        <TotalRevenueColumnAmt>6845</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6845</RelatedOrExemptFuncIncomeAmt>
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      <TotalProgramServiceRevenueAmt>175387</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>2724</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2724</RelatedOrExemptFuncIncomeAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>Managed Care/Group Pur</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>36556</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>36556</RelatedOrExemptFuncIncomeAmt>
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      <OtherRevenueMiscGrp>
        <Desc>Management Fee Reimbur</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>9990</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9990</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>46546</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>224657</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>224657</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>18460</TotalAmt>
        <ProgramServicesAmt>17906</ProgramServicesAmt>
        <ManagementAndGeneralAmt>554</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
        <TotalAmt>1592</TotalAmt>
        <ProgramServicesAmt>1592</ProgramServicesAmt>
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      <OtherEmployeeBenefitsGrp>
        <TotalAmt>3773</TotalAmt>
        <ProgramServicesAmt>3660</ProgramServicesAmt>
        <ManagementAndGeneralAmt>113</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>9459</TotalAmt>
        <ProgramServicesAmt>9175</ProgramServicesAmt>
        <ManagementAndGeneralAmt>284</ManagementAndGeneralAmt>
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      <FeesForServicesLegalGrp>
        <TotalAmt>6831</TotalAmt>
        <ProgramServicesAmt>6831</ProgramServicesAmt>
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      <FeesForServicesAccountingGrp>
        <TotalAmt>1190</TotalAmt>
        <ProgramServicesAmt>815</ProgramServicesAmt>
        <ManagementAndGeneralAmt>375</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
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        <ManagementAndGeneralAmt>935</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>8340</ProgramServicesAmt>
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      <OfficeExpensesGrp>
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        <ProgramServicesAmt>1241</ProgramServicesAmt>
        <ManagementAndGeneralAmt>14</ManagementAndGeneralAmt>
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      <InformationTechnologyGrp>
        <TotalAmt>3505</TotalAmt>
        <ProgramServicesAmt>3400</ProgramServicesAmt>
        <ManagementAndGeneralAmt>105</ManagementAndGeneralAmt>
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      <TravelGrp>
        <TotalAmt>1972</TotalAmt>
        <ProgramServicesAmt>1972</ProgramServicesAmt>
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      <ConferencesMeetingsGrp>
        <TotalAmt>1350</TotalAmt>
        <ProgramServicesAmt>1350</ProgramServicesAmt>
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      <InterestGrp>
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        <ProgramServicesAmt>8261</ProgramServicesAmt>
        <ManagementAndGeneralAmt>255</ManagementAndGeneralAmt>
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      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>992</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
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        <ProgramServicesAmt>4588</ProgramServicesAmt>
        <ManagementAndGeneralAmt>142</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Nurse Aide Training</Desc>
        <TotalAmt>8656</TotalAmt>
        <ProgramServicesAmt>8656</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>78779</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2777</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
        <BOYAmt>69164</BOYAmt>
        <EOYAmt>3453</EOYAmt>
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      <SavingsAndTempCashInvstGrp>
        <BOYAmt>410587</BOYAmt>
        <EOYAmt>318303</EOYAmt>
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      <AccountsReceivableGrp>
        <BOYAmt>660368</BOYAmt>
        <EOYAmt>814161</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>4733</BOYAmt>
        <EOYAmt>19913</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>93715</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>91107</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>3600</BOYAmt>
        <EOYAmt>2608</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>325497</BOYAmt>
        <EOYAmt>318666</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>2371153</BOYAmt>
        <EOYAmt>2503768</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <TotalAssetsGrp>
        <BOYAmt>3845102</BOYAmt>
        <EOYAmt>3980872</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>752276</BOYAmt>
        <EOYAmt>744010</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>454171</BOYAmt>
        <EOYAmt>454171</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>1206447</BOYAmt>
        <EOYAmt>1198181</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>2638655</BOYAmt>
        <EOYAmt>2782691</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>2638655</BOYAmt>
        <EOYAmt>2782691</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>3845102</BOYAmt>
        <EOYAmt>3980872</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>143101</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>935</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>0</FSAuditedInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>7500</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>7500</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>629224</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>514777</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>513168</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>422495</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>221933</CurrentTaxYearAmt>
        <TotalAmt>2301597</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>636724</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>514777</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>513168</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>422495</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>221933</CurrentTaxYearAmt>
        <TotalAmt>2309097</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>2309097</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>30556</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>13059</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>523</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>12094</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2724</CurrentTaxYearAmt>
        <TotalAmt>58956</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
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        <CurrentTaxYearMinus3YearsAmt>13059</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>523</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>12094</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2724</CurrentTaxYearAmt>
        <TotalAmt>58956</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>667280</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>527836</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>513691</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>434589</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>224657</CurrentTaxYearAmt>
        <TotalAmt>2368053</TotalAmt>
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      <PublicSupportCY509Pct>0.97510</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.98800</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.02490</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.01200</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>3-Month Short year</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization has decided to change its accounting period to March 31st to align more closely with its operational calendar. The result of changing the accounting period to March 31st is a short period return beginning 1/1/2026 and ending 3/31/2026.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>93715</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>91107</DepreciationAmt>
        <BookValueAmt>2608</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>2608</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>FNB of PA investment account</Desc>
        <BookValueAmt>318666</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>318666</TotalBookValueSecuritiesAmt>
      <InvstProgramRelatedOrgGrp>
        <Desc>40% interest in Symbria Rehab HVA LLC</Desc>
        <BookValueAmt>809047</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </InvstProgramRelatedOrgGrp>
      <InvstProgramRelatedOrgGrp>
        <Desc>15.5% interest in Covenant Alliance Rehab East LLC</Desc>
        <BookValueAmt>233609</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </InvstProgramRelatedOrgGrp>
      <InvstProgramRelatedOrgGrp>
        <Desc>30% interest in Symbria Pharmacy Holding Company, LLC</Desc>
        <BookValueAmt>1461112</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </InvstProgramRelatedOrgGrp>
      <TotalBookValueProgramRltdAmt>2503768</TotalBookValueProgramRltdAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Note payable - Symbria Rx Services</Desc>
        <Amt>454171</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>454171</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken by the Organization and recognize a tax liability or asset if it has taken any uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. Management has analyzed the tax positions taken, and has concluded that as of the end of the year there are no uncertain positions taken or expected to be taken that would require recognition of a tax liability or asset or a disclosure in the notes to the financial statements.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <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>Thomas W Erickson</PersonNm>
        <TitleTxt>Dir of Operations, HVA</TitleTxt>
        <BaseCompensationFilingOrgAmt>176100</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3818</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>1538</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>181456</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Recommended salary of the Director is approved by the Board as part of the annual budget process.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Jill Krueger of Symbia, Inc. has assumed the responsibilities of the Chief Executive Officer after the retirement of Michael Gallagher. Symbia, Inc. is paid a fee for Ms. Krueger's work.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>HVA's members are the nonprofit organizations that are its' owners. These nonprofit organizations created HVA and are considered its members.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>HVA's members elect the Board of Directors and the Board elects its governing body and officers at the annual meeting.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is provided to the governing committee for its review and comment prior to filing with the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Each year at the annual meeting, conflict of interest statements are distributed to the Board to be completed, signed and filed</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The process for determing the Executive Director and other key employee compensation includes approval by an independent Board committee using camparability matrix data. The final committee decisions are documented and forwarded to employee personnel files.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's governing documents, conflict of interest policy and financial statements are available for review upon written request of the Executive Director/CEO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Consultants/Medical Advisors: Program service expenses 8340. Management and general expenses 0. Fundraising expenses 0. Total expenses 8340.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>