﻿<?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="2018v3.2">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2020-07-15T15:14:37-05:00</ReturnTs>
    <TaxPeriodEndDt>2019-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>593040705</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>RIVERO GORDIMER &amp; COMPANY PA</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>P O BOX 172359</AddressLine1Txt>
        <CityNm>TAMPA</CityNm>
        <StateAbbreviationCd>FL</StateAbbreviationCd>
        <ZIPCd>33672</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2018-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>592092715</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>DIRECTIONS FOR MENTAL HEALTH INC</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>DBA DIRECTIONS FOR LIVING</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>DIRE</BusinessNameControlTxt>
      <PhoneNum>7275244464</PhoneNum>
      <USAddress>
        <AddressLine1Txt>1437 SOUTH BELCHER ROAD</AddressLine1Txt>
        <CityNm>CLEARWATER</CityNm>
        <StateAbbreviationCd>FL</StateAbbreviationCd>
        <ZIPCd>33764</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>APRIL LOTT</PersonNm>
      <PersonTitleTxt>PRESIDENT &amp; CEO</PersonTitleTxt>
      <PhoneNum>7275244464</PhoneNum>
      <SignatureDt>2020-07-15</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>SAM A LAZZARA</PreparerPersonNm>
      <PTIN>P01342929</PTIN>
      <PhoneNum>8138757774</PhoneNum>
    </PreparerPersonGrp>
    <FilingSecurityInformation>
      <IPAddress>
        <IPv4AddressTxt>209.202.225.84</IPv4AddressTxt>
      </IPAddress>
      <IPDt>2020-07-15</IPDt>
      <IPTm>11:35:21</IPTm>
      <IPTimezoneCd>ED</IPTimezoneCd>
      <FilingLicenseTypeCd>P</FilingLicenseTypeCd>
      <AtSubmissionCreationDeviceId>69A26F9334EBCBBAE563FF7F9523795D603EB3D5</AtSubmissionCreationDeviceId>
      <AtSubmissionFilingDeviceId>1D48D5154011648C24DCBA8EEBC3CA708CDB402D</AtSubmissionFilingDeviceId>
    </FilingSecurityInformation>
    <TaxYr>2018</TaxYr>
    <BuildTS>2021-01-29 14:40:06Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="8">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>DIRECTIONS FOR LIVING</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>APRIL LOTT</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>1437 SOUTH BELCHER ROAD</AddressLine1Txt>
        <CityNm>CLEARWATER</CityNm>
        <StateAbbreviationCd>FL</StateAbbreviationCd>
        <ZIPCd>33764</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>24231670</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.DIRECTIONSFORLIVING.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1981</FormationYr>
      <LegalDomicileStateCd>FL</LegalDomicileStateCd>
      <ActivityOrMissionDesc>OUR MISSION IS TO BE A WELCOMING AND COMPASSIONATE PROVIDER, ADVOCATE AND PARTNER TO CHILDREN, ADULTS, AND FAMILIES IN NEED OF INTEGRATED HEALTHCARE, SOCIAL SUPPORT, SAFETY, AND HOPE FOR THE FUTURE.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>7</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>7</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>554</TotalEmployeeCnt>
      <TotalVolunteersCnt>7</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>15738647</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>21748925</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>2028536</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>2156087</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>224</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>236</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>172979</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>273420</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>17940386</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>24178668</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>14670742</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>19686805</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>25920</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>3666508</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>4065463</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>18337250</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>23752268</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-396864</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>426400</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>3589981</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>4111888</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>2185813</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>2276146</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>1404168</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>1835742</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>OUR MISSION IS TO BE A WELCOMING AND COMPASSIONATE PROVIDER, ADVOCATE AND PARTNER TO CHILDREN, ADULTS AND FAMILIES IN NEED OF INTEGRATED HEALTHCARE, SOCIAL SUPPORT, SAFETY AND HOPE FOR THE FUTURE.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>2927983</ExpenseAmt>
      <Desc>CASE MANAGEMENT SERVICES: AS PART OF THE CHILD WELFARE, DIRECTIONS FOR LIVING SERVES AS A CASE MANAGEMENT ORGANIZATION BY PROVIDING RECOVERY-BASED, INDIVIDUALIZED SUPPORT, AND DEPENDENCY CASE MANAGEMENT SERVICES FOR CHILDREN AND FAMILIES THROUGH ASSESSMENT LINKAGE, ADVOCACY AND MONITORING. DIRECTIONS FOR LIVING IS DEDICATED TO RESPECTING THE INTEGRITY OF EACH FAMILY MEMBER, FOCUSING ON THE STRENGTHS OF THE FAMILY, REUNIFYING WHEN POSSIBLE AND COORDINATING THE BEST POSSIBLE FOREVER FAMILY PLACEMENT OUTSIDE OF THE FAMILY THROUGH ADOPTION WHEN NECESSARY.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>11681297</ExpenseAmt>
        <Desc>CHILD PROTECTIVE AND DIVERSION SERVICES: PROVIDES INTENSIVE IN-HOME FAMILY PRESERVATION SERVICES AND COMMUNITY OUTREACH WITH THE GOAL OF KEEPING AT-RISK CHILDREN "SAFE AT HOME." THE PROGRAMS HELPS THE FAMILY TO IDENTIFY, AND PROBLEM SOLVE REGARDING THOSE ISSUES THAT LEAD TO ABUSE AND NEGLECT; TO LEARN ABOUT, PRACTICE, AND DEVELOP PROFICIENCY IN STRATEGIES TO AVOID, DEAL WITH, OR OVERCOME THOSE ISSUES; AND TO TEACH AND MODEL WITH THE FAMILY REGARDING HOW TO UTILIZE COMMUNITY RESOURCES EFFECTIVELY AND TO THEIR BEST ADVANTAGE. FAMILIES AT-RISK OF HAVING THEIR CHILDREN REMOVED FROM THE HOME DUE TO ABUSE/NEGLECT ARE REFERRED TO THE PROGRAM BY CHILD PROTECTION INVESTIGATORS.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>5734696</ExpenseAmt>
        <RevenueAmt>2156087</RevenueAmt>
        <Desc>OUTPATIENT SERVICES: DIRECTIONS FOR LIVING HAS A 37-YEAR HISTORY OF PROVIDING TRAUMA-INFORMED, EVIDENCE-BASED, AND RESEARCH-SUPPORTED OUTPATIENT BEHAVIORAL HEALTH SERVICES FOR CHILDREN AND ADULTS, INCLUDING INDIVIDUAL, FAMILY, AND GROUP THERAPY SERVICES FOR THOSE AFFECTED BY TRAUMA, MENTAL ILLNESS, OR SUBSTANCE ABUSE. THROUGHOUT THE COMMUNITY, IN-HOME, AND IN-CLINIC SERVICES ARE PROVIDED, TO MEET THE NEED WHERE IT EXISTS AND RESTORE AND IMPROVE THE QUALITY OF LIFE FOR EACH INDIVIDUAL SERVED.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>1319917</ExpenseAmt>
        <Desc>HOMELESS SERVICES HELPS ADULTS AND FAMILIES LIVING WITHOUT HOMES, OR AT RISK OF HOMELESSNESS, BY LINKING THEM TO A VARIETY OF RESOURCES AND PROVIDING PSYCHIATRIC CARE THROUGHOUT THE COMMUNITY, INCLUDING AT LOCAL SHELTERS.</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcExpenseAmt>1319917</TotalOtherProgSrvcExpenseAmt>
      <TotalProgramServiceExpensesAmt>21663893</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</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>
      <TempOrPermanentEndowmentsInd referenceDocumentId="RetDoc1040000001">1</TempOrPermanentEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">0</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</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 referenceDocumentId="RetDoc1041300001">0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd referenceDocumentId="RetDoc1041300001">1</FundraisingActivitiesInd>
      <GamingActivitiesInd referenceDocumentId="RetDoc1041300001">0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</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>
      <BusinessRlnWithOfficerEntInd>0</BusinessRlnWithOfficerEntInd>
      <DeductibleNonCashContriInd referenceDocumentId="RetDoc1042900001">1</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd referenceDocumentId="RetDoc1042900001">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>0</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>554</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>7</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>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>FL</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>WENDY MERSON CFO</PersonNm>
        <PhoneNum>7275244464</PhoneNum>
        <USAddress>
          <AddressLine1Txt>1437 SOUTH BELCHER ROAD</AddressLine1Txt>
          <CityNm>CLEARWATER</CityNm>
          <StateAbbreviationCd>FL</StateAbbreviationCd>
          <ZIPCd>33764</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATRINA TRUMP</PersonNm>
        <TitleTxt>CHAIR PERSON</TitleTxt>
        <AverageHoursPerWeekRt>2.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NANCY CROY</PersonNm>
        <TitleTxt>VICE-CHAIR PERSON</TitleTxt>
        <AverageHoursPerWeekRt>2.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHELLE GILBERT ESQ</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>2.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHIEF DANIEL SLAUGHTER</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>2.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEFF RATHMELL</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TERESA CONTE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTINA DICKSON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>2.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>APRIL LOTT</PersonNm>
        <TitleTxt>PRESIDENT &amp; CEO</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>204675</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>6403</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KAREN YACHTUM</PersonNm>
        <TitleTxt>FORMER COO</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>87242</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>4639</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHELLE FURAN-SULLIVAN</PersonNm>
        <TitleTxt>FORMER CFO</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>128292</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TARA SCALISE</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>40114</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>1103</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SANGITA DESAI MD</PersonNm>
        <TitleTxt>PSYCHIATRIST</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>181134</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CONRAD WELLER</PersonNm>
        <TitleTxt>PSYCHIATRIST</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>131849</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARKIO BRANDON</PersonNm>
        <TitleTxt>PSYCHIATRIST</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>213706</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>6062</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RADHIKA SRIRAM</PersonNm>
        <TitleTxt>PSYCHIATRIST</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>107233</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>6900</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1094245</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>25107</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>6</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>LIGHTWAVE MANAGEMENT RESOURCES INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4707 140TH AVE N</AddressLine1Txt>
            <CityNm>CLEARWATER</CityNm>
            <StateAbbreviationCd>FL</StateAbbreviationCd>
            <ZIPCd>33762</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT SERVICES</ServicesDesc>
        <CompensationAmt>199711</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>NETSMART TECHNOLOGIES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4950 COLLEGE BLVD</AddressLine1Txt>
            <CityNm>OVERLAND PARK</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>66211</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ELECTRONIC HEALTH RECORDS</ServicesDesc>
        <CompensationAmt>195562</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>OPERATION PAR</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6655 66TH STREET NORTH</AddressLine1Txt>
            <CityNm>PINELLAS PARK</CityNm>
            <StateAbbreviationCd>FL</StateAbbreviationCd>
            <ZIPCd>33781</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SUBCONTRACTOR</ServicesDesc>
        <CompensationAmt>139600</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>3</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>21342285</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>406640</AllOtherContributionsAmt>
      <NoncashContributionsAmt>247133</NoncashContributionsAmt>
      <TotalContributionsAmt>21748925</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PROGRAM SERVICE REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>2156087</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2156087</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>2156087</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>236</TotalRevenueColumnAmt>
        <ExclusionAmt>236</ExclusionAmt>
      </InvestmentIncomeGrp>
      <FundraisingGrossIncomeAmt>72354</FundraisingGrossIncomeAmt>
      <FundraisingDirectExpensesAmt>53002</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>19352</TotalRevenueColumnAmt>
        <ExclusionAmt>19352</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER INCOME</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>254068</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>254068</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>254068</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>24178668</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2410155</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>19588</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>460323</TotalAmt>
        <ProgramServicesAmt>391275</ProgramServicesAmt>
        <ManagementAndGeneralAmt>69048</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>15095162</TotalAmt>
        <ProgramServicesAmt>13638705</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1449597</ManagementAndGeneralAmt>
        <FundraisingAmt>6860</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>586</TotalAmt>
        <ProgramServicesAmt>528</ProgramServicesAmt>
        <ManagementAndGeneralAmt>58</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>2910619</TotalAmt>
        <ProgramServicesAmt>2641195</ProgramServicesAmt>
        <ManagementAndGeneralAmt>267821</ManagementAndGeneralAmt>
        <FundraisingAmt>1603</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1220115</TotalAmt>
        <ProgramServicesAmt>1098387</ProgramServicesAmt>
        <ManagementAndGeneralAmt>121221</ManagementAndGeneralAmt>
        <FundraisingAmt>507</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>43155</TotalAmt>
        <ProgramServicesAmt>32927</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10228</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>121401</TotalAmt>
        <ProgramServicesAmt>121401</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>387800</TotalAmt>
        <ProgramServicesAmt>342260</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28727</ManagementAndGeneralAmt>
        <FundraisingAmt>16813</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>593850</TotalAmt>
        <ProgramServicesAmt>576096</ProgramServicesAmt>
        <ManagementAndGeneralAmt>17754</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>609961</TotalAmt>
        <ProgramServicesAmt>553008</ProgramServicesAmt>
        <ManagementAndGeneralAmt>56953</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>986414</TotalAmt>
        <ProgramServicesAmt>976692</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9722</ManagementAndGeneralAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>94312</TotalAmt>
        <ProgramServicesAmt>94312</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>102236</TotalAmt>
        <ProgramServicesAmt>93060</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9176</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>502650</TotalAmt>
        <ProgramServicesAmt>487623</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15027</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>CLIENT SUPPORT</Desc>
        <TotalAmt>295097</TotalAmt>
        <ProgramServicesAmt>294711</ProgramServicesAmt>
        <ManagementAndGeneralAmt>249</ManagementAndGeneralAmt>
        <FundraisingAmt>137</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>IN-KIND MEDICAL SUPPLIE</Desc>
        <TotalAmt>247133</TotalAmt>
        <ProgramServicesAmt>247133</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL &amp; PHARMACY</Desc>
        <TotalAmt>57117</TotalAmt>
        <ProgramServicesAmt>57117</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>EQUIPMENT RENTAL</Desc>
        <TotalAmt>24337</TotalAmt>
        <ProgramServicesAmt>17463</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6874</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>23752268</TotalAmt>
        <ProgramServicesAmt>21663893</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2062455</ManagementAndGeneralAmt>
        <FundraisingAmt>25920</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>252687</BOYAmt>
        <EOYAmt>160944</EOYAmt>
      </CashNonInterestBearingGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>1499805</BOYAmt>
        <EOYAmt>1683917</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>450240</BOYAmt>
        <EOYAmt>475325</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>16105</BOYAmt>
        <EOYAmt>36897</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>30972</BOYAmt>
        <EOYAmt>159084</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>5113379</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>3719631</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>1143372</BOYAmt>
        <EOYAmt>1393748</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>186674</BOYAmt>
        <EOYAmt>191847</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>10126</BOYAmt>
        <EOYAmt>10126</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>3589981</BOYAmt>
        <EOYAmt>4111888</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>902843</BOYAmt>
        <EOYAmt>592959</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>243291</BOYAmt>
        <EOYAmt>86722</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>1039679</BOYAmt>
        <EOYAmt>1596465</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>2185813</BOYAmt>
        <EOYAmt>2276146</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>1230611</BOYAmt>
        <EOYAmt>1681895</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TemporarilyRstrNetAssetsGrp>
        <BOYAmt>173557</BOYAmt>
        <EOYAmt>153847</EOYAmt>
      </TemporarilyRstrNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>1404168</BOYAmt>
        <EOYAmt>1835742</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>3589981</BOYAmt>
        <EOYAmt>4111888</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>426400</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>5173</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>13823001</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>13723178</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>14773002</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>15739647</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>21748925</CurrentTaxYearAmt>
        <TotalAmt>79807753</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>13823001</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>13723178</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>14773002</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>15739647</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>21748925</CurrentTaxYearAmt>
        <TotalAmt>79807753</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>79807753</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>167</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>196</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>109</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>224</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>236</CurrentTaxYearAmt>
        <TotalAmt>932</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>86717</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>77387</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>143211</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>111687</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>254068</CurrentTaxYearAmt>
        <TotalAmt>673070</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>80481755</TotalSupportAmt>
      <PublicSupportCY170Pct>0.99160</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.99100</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <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>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>148674</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>5173</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>153847</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>141687</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>6987</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>148674</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>132890</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>8797</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>141687</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>129430</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>3460</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>132890</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>130547</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>-1117</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>129430</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <TermEndowmentBalanceEOYPct>1.00000</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>1</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>0</EndowmentsHeldRelatedOrgInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>404970</OtherCostOrOtherBasisAmt>
        <BookValueAmt>404970</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>3325908</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2337130</DepreciationAmt>
        <BookValueAmt>988778</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>1382501</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1382501</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>1393748</TotalBookValueLandBuildingsAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>24446190</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>5173</NetUnrealizedGainsInvstAmt>
      <DonatedServicesAndUseFcltsAmt>209347</DonatedServicesAndUseFcltsAmt>
      <OtherRevenueAmt>53002</OtherRevenueAmt>
      <RevenueNotReportedAmt>267522</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>24178668</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>24178668</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>24014616</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>209347</DonatedServicesUseFcltsAmt>
      <OtherExpensesIncludedAmt>53002</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>262349</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>23752267</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>23752267</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS BEEN RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PRESENTED IN THESE FINANCIAL STATEMENTS. DIRECTIONS HAS NOT REPORTED ANY UNRELATED BUSINESS INCOME; HOWEVER, SUCH STATUS IS SUBJECT TO FINAL DETERMINATION UPON EXAMINATION, IF ANY, OF THE RELATED INCOME TAX RETURNS BY THE APPROPRIATE TAXING AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY TAX POSITIONS IT HAS TAKEN THAT ARE SUBJECT TO A SIGNIFICANT DEGREE OF UNCERTAINTY. TAX YEARS AFTER 2015 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>SPECIAL EVENT EXPENSES</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>SPECIAL EVENT EXPENSES</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART V, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>EXPLANATION: THE ORGANIZATION USES THE ENDOWNMENT FUNDS TO FURTHER THE PROGRAM OBJECTIVES OF THE ORGANIZATION ONCE THE TEMPORARY TIME RESTRICTIONS FOR THE ENDOWNMENT FUNDS HAVE BEEN MET.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="RetDoc1041300001">
      <FundraisingEventInformationGrp>
        <Event1Nm>PB&amp;J RUN</Event1Nm>
        <GrossReceiptsEvent1Amt>72354</GrossReceiptsEvent1Amt>
        <GrossRevenueEvent1Amt>72354</GrossRevenueEvent1Amt>
        <OtherDirectExpensesEvent1Amt>53002</OtherDirectExpensesEvent1Amt>
        <GrossReceiptsTotalAmt>72354</GrossReceiptsTotalAmt>
        <GrossRevenueTotalEventsAmt>72354</GrossRevenueTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>53002</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>53002</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>19352</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
    </IRS990ScheduleG>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <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>APRIL LOTT</PersonNm>
        <TitleTxt>PRESIDENT &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>204675</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>6403</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>211078</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SANGITA DESAI MD</PersonNm>
        <TitleTxt>PSYCHIATRIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>181134</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>181134</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARKIO BRANDON</PersonNm>
        <TitleTxt>PSYCHIATRIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>213706</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>6062</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>219768</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleM documentId="RetDoc1042900001">
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>6928</ContributionCnt>
        <NoncashContributionsRptF990Amt>247133</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FORMULARY LIST PRICE</MethodOfDeterminingRevenuesTxt>
      </DrugsAndMedicalSuppliesGrp>
      <AnyPropertyThatMustBeHeldInd>0</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>1</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>0</ThirdPartiesUsedInd>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FINAL 990 IS SUBMITTED FOR REVIEW TO THE FINANCE COMMITTEE AFTER THE FINANCE COMMITTEE REVIEWS THE 990, THEY SUBMIT THE RETURN, ALONG WITH THEIR COMMENTS, TO THE FULL BOARD. A DESIGNATED OFFICER THEN SIGNS THE RETURN AFTER CONSIDERING BOARD COMMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATIONS CONFLICT OF INTEREST POLICY REQUIRES THAT ALL OFFICERS, DIRECTORS, AND EMPLOYEES DISCLOSE ANY CONFLICTS IMMEDIATELY UPON DISCOVERY. COMPLIANCE IS CONSISTENTLY MONITORED AND REVIEWED ON AN ANNUAL BASIS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION IS DETERMINED BY REVIEWING MARKET RATES INCLUDING LOCAL, REGIONAL AND NATIONAL LEVELS ACTUAL COMPENSATION RATES ARE SET BASED ON THE MARKET RATES AND AVAIALABLE LEVELS OF FUNDING. THE PROCESS OF DETERMINATION AND THE FINAL DECISION IS CONTEMPORANEOUSLY DOCUMENTED IN THE MINUTES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANICAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANICAL INFORMATION IS ALSO AVAILABLE ON THEIR WEBSITE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 9990, PART XII, LINE 2C, FINANCIAL STATEMENTS AND REPORTING</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>