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        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JD Fuiten</PersonNm>
        <TitleTxt>Director</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Paul Main</PersonNm>
        <TitleTxt>Director</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Jimmy Pierson</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Allyson Pharr</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>646982</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>66822</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>3</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Lester Health Law PLLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>601 13th St NW 11th Flr S</AddressLine1Txt>
            <CityNm>Washington</CityNm>
            <StateAbbreviationCd>DC</StateAbbreviationCd>
            <ZIPCd>20005</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Legal services</ServicesDesc>
        <CompensationAmt>208310</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Capital Counsel LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>700 13th St NW</AddressLine1Txt>
            <CityNm>Washington</CityNm>
            <StateAbbreviationCd>DC</StateAbbreviationCd>
            <ZIPCd>20005</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Professional services</ServicesDesc>
        <CompensationAmt>205376</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Alston Bird LLP</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1201 West Peachtree St</AddressLine1Txt>
            <CityNm>Atlanta</CityNm>
            <StateAbbreviationCd>GA</StateAbbreviationCd>
            <ZIPCd>30309</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Professional services</ServicesDesc>
        <CompensationAmt>201408</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Moore EMS Consulting LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>118th Main St</AddressLine1Txt>
            <CityNm>Topsfield</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01983</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HR and Oeprations Consultant</ServicesDesc>
        <CompensationAmt>139286</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Mercury Public Affairs</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>218 E Bearss Ave 405</AddressLine1Txt>
            <CityNm>Tampa</CityNm>
            <StateAbbreviationCd>FL</StateAbbreviationCd>
            <ZIPCd>33613</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Professional services</ServicesDesc>
        <CompensationAmt>120000</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>6</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>Membership dues</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>2013017</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2013017</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Conferences &amp; seminars</Desc>
        <BusinessCd>611710</BusinessCd>
        <TotalRevenueColumnAmt>1468222</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1468222</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>State association fee</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>270000</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>270000</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Medicaid UPL Program</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>222154</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>222154</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Publications</Desc>
        <BusinessCd>513120</BusinessCd>
        <TotalRevenueColumnAmt>2573</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2573</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>3975966</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>70955</TotalRevenueColumnAmt>
        <ExclusionAmt>70955</ExclusionAmt>
      </InvestmentIncomeGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>195732</TotalRevenueColumnAmt>
        <ExclusionAmt>195732</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <OtherRevenueMiscGrp>
        <Desc>Other revenue</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>120</TotalRevenueColumnAmt>
        <ExclusionAmt>120</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>120</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>4242773</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3975966</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>266807</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>313413</TotalAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>584746</TotalAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>20654</TotalAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>17105</TotalAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>57268</TotalAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>17063</TotalAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>67108</TotalAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>631102</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>150</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>702635</TotalAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>118726</TotalAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>46996</TotalAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>17343</TotalAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>185376</TotalAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>840908</TotalAmt>
      </ConferencesMeetingsGrp>
      <InsuranceGrp>
        <TotalAmt>12713</TotalAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Bad debt</Desc>
        <TotalAmt>67084</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Dues &amp; subscriptions</Desc>
        <TotalAmt>14139</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Membership expenses</Desc>
        <TotalAmt>5070</TotalAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>3719599</TotalAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
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        <EOYAmt>241044</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>0</EOYAmt>
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      <AccountsReceivableGrp>
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        <EOYAmt>471867</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>123920</EOYAmt>
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      <InvestmentsPubTradedSecGrp>
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        <EOYAmt>2799717</EOYAmt>
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        <EOYAmt>3636548</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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      <DeferredRevenueGrp>
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        <EOYAmt>1487027</EOYAmt>
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        <EOYAmt>832</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>1631348</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
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      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>1434981</BOYAmt>
        <EOYAmt>2005200</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>3636548</EOYAmt>
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      <ReconcilationRevenueExpnssAmt>523174</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>64045</NetUnrlzdGainsLossesInvstAmt>
      <PriorPeriodAdjustmentsAmt>-17000</PriorPeriodAdjustmentsAmt>
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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>0</FSAuditedInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleC documentId="RetDoc1039700001">
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      <OnlyInHouseLobbyingInd>0</OnlyInHouseLobbyingInd>
      <AgreeCarryoverPriorYearInd>1</AgreeCarryoverPriorYearInd>
      <DuesAssessmentsAmt>2013017</DuesAssessmentsAmt>
      <NonDeductibleLbbyngPltclCYAmt>1120089</NonDeductibleLbbyngPltclCYAmt>
      <NonDedLbbyngPltclCyovAmt>553950</NonDedLbbyngPltclCyovAmt>
      <NonDeductibleLbbyngPltclTotAmt>1674039</NonDeductibleLbbyngPltclTotAmt>
      <AggregateReportedDuesNtcAmt>1006509</AggregateReportedDuesNtcAmt>
      <CarriedOverAmt>667530</CarriedOverAmt>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
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      <OtherLiabilitiesOrgGrp>
        <Desc>Due to related party</Desc>
        <Amt>832</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>832</TotalLiabilityAmt>
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    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Maria Bianchi</PersonNm>
        <TitleTxt>CEO</TitleTxt>
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        <BonusFilingOrganizationAmount>47866</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Tristan M North</PersonNm>
        <TitleTxt>Sr VP, Government Affairs</TitleTxt>
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        <BonusFilingOrganizationAmount>24377</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>8717</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>1077</NontaxableBenefitsFilingOrgAmt>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Amanda P Riordan</PersonNm>
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        <BonusFilingOrganizationAmount>20178</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>155074</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
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    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 1, Description of Organization Mission:</FormAndLineReferenceDesc>
        <ExplanationTxt>AAA represents ambulance services across the United States that participate in serving more than 75% of the urban U.S. population with emergency and non-emergency care and transportation services.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>AAA has active members, associate members, international members, affiliate members, honorary members, individual members, and state association members. Only active members have voting privileges.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>Active members vote annually for the Board of Directors in accordance with AAA bylaws.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>The bylaws can be amended with a 3/4 vote of the Board of Directors or with a simple majority vote of 25 percent of the active membership.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>A copy of the 990 is first reviewed by the CEO. The draft is then sent to the Audit Committee and full Board for review and approval prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Each director and officer is required to review a copy of the conflict of interest policy, which requires each person to disclose any relationships, positions or circumstances in which he or she believes could contribute to a conflict. Following full disclosure of a possible conflict of interest, the Board of Directors shall determine whether an actual conflict of interest exists and, if so, the Board shall vote to authorize or reject the transaction or take any other action deemed necessary to address the conflict and protect AAA's best interests.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation review process includes an evaluation with the executive committee using certain agreed upon performance measures. The initial salary was determined using the ASAE salary benchmark report AND the CEO update salary update for trade associations, of equal size and CEO experience.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AAA makes its governing documents, conflict of interest policy, and financial statements available to the public on the AAA website and upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Consultants, contractors, and other professional fees 702,635.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>American Ambulance Association Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 96503 72319</AddressLine1Txt>
          <CityNm>Washington</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>200906503</ZIPCd>
        </USAddress>
        <EIN>522192593</EIN>
        <PrimaryActivitiesTxt>Education</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>VA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12b, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>AAA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>AMBUPAC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 96503 72319</AddressLine1Txt>
          <CityNm>Washington</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>200906503</ZIPCd>
        </USAddress>
        <EIN>680055558</EIN>
        <PrimaryActivitiesTxt>Political Action Committee</PrimaryActivitiesTxt>
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</Return>