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        <ExplanationTxt>The Organization is exempt from income tax under Section 501(c)(3) of Internal Revenue Code and is classified as other than a private foundation. Management has reviewed all tax positions recognized in previously filed tax returns and those expected to be taken in future tax returns. As of December 31, 2018, the Organization had no amounts related to unrecognized income tax benefits and no amounts related to accrued interest and penalties. The Organization does not anticipate any significant changes to unrecognized income tax benefits over the next year.</ExplanationTxt>
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        </USAddress>
        <RecipientEIN>221487576</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>24978</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
        <PurposeOfGrantTxt>SMALL GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HOSPITAL FOR SPECIAL SURGERY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>541 E 71ST ST</AddressLine1Txt>
          <CityNm>NEW YORK</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>10021</ZIPCd>
        </USAddress>
        <RecipientEIN>131624135</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
        <PurposeOfGrantTxt>FELLOWS GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>INDIANA UNIVERSITY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>107 S INDIANA AVE</AddressLine1Txt>
          <CityNm>BLOOMINGTON</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>47405</ZIPCd>
        </USAddress>
        <RecipientEIN>356018940</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>70736</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
        <PurposeOfGrantTxt>SMALL GRANT/LARGE GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>RESEARCH INST AT NATIONWIDE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>700 CHILDRENS DR</AddressLine1Txt>
          <CityNm>COLOMBUS</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43205</ZIPCd>
        </USAddress>
        <RecipientEIN>316056230</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>49978</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
        <PurposeOfGrantTxt>SMALL GRANT/FELLOWS GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>RUTGERS UNIVERSITY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>57 US HIGHWAY 1</AddressLine1Txt>
          <CityNm>NEW BRUNSWICK</CityNm>
          <StateAbbreviationCd>NJ</StateAbbreviationCd>
          <ZIPCd>08901</ZIPCd>
        </USAddress>
        <RecipientEIN>122600108</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
        <PurposeOfGrantTxt>PUBLICATION GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SEATTLE CHILDRENS HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>400 SAND POINT WAY NE</AddressLine1Txt>
          <CityNm>SEATTLE</CityNm>
          <StateAbbreviationCd>WA</StateAbbreviationCd>
          <ZIPCd>98105</ZIPCd>
        </USAddress>
        <RecipientEIN>910564748</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>29985</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
        <PurposeOfGrantTxt>SMALL GRANT/FELLOWS GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SETON HEALTHCARE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1345 PHILOMENA ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78723</ZIPCd>
        </USAddress>
        <RecipientEIN>272193174</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
        <PurposeOfGrantTxt>SMALL GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>THE UNIVERSITY OF CALIFORNIA</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1111 FRANKLIN ST</AddressLine1Txt>
          <CityNm>OAKLAND</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>94607</ZIPCd>
        </USAddress>
        <RecipientEIN>946036493</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>59332</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
        <PurposeOfGrantTxt>SMALL GRANT/FELLOWS GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UNIVERSITY OF ALABAMA BIRM</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1720 2ND AVE</AddressLine1Txt>
          <CityNm>BIRMINGHAM</CityNm>
          <StateAbbreviationCd>AL</StateAbbreviationCd>
          <ZIPCd>35294</ZIPCd>
        </USAddress>
        <RecipientEIN>636005396</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>8369</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
        <PurposeOfGrantTxt>PUBLICATION GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UNIVERSITY OF PENNSYLVANIA</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>801 SPRUCE ST</AddressLine1Txt>
          <CityNm>PHILADELPHIA</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>19107</ZIPCd>
        </USAddress>
        <RecipientEIN>231352685</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>22032</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
        <PurposeOfGrantTxt>SMALL GRANT/FELLOWS GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>VANDERBILT UNIVERSITY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2201 WEST END AVE</AddressLine1Txt>
          <CityNm>NASHVILLE</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37235</ZIPCd>
        </USAddress>
        <RecipientEIN>352528741</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>24998</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
        <PurposeOfGrantTxt>FELLOWS GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>18</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>PRES. TRAVEL AWARD</GrantTypeTxt>
        <RecipientCnt>3</RecipientCnt>
        <CashGrantAmt>7659</CashGrantAmt>
        <ValuationMethodUsedDesc>FMV</ValuationMethodUsedDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Additional Supplemental Information</FormAndLineReferenceDesc>
        <ExplanationTxt>UNSPENT GRANTS OF $46,030 WERE REFUNDED THROUGHOUT THE YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="18007218" softwareVersionNum="2018v3.1">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d: Other Program Services Description</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER PROGRAM SERVICES 4: Other program services: Informatics/Programing, Leadership service associated with furthering the mission and ACR meeting expenses.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company</FormAndLineReferenceDesc>
        <ExplanationTxt>CARRA contracts with Executive Director Inc. (A for-profit Management Company) to provide office facilities, management, record keeping, accounting, storage, other significant services, plus related overhead costs.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents</FormAndLineReferenceDesc>
        <ExplanationTxt>Changes to the bylaws were made in the current year.Article VI: Deleted reference to membership charterArticle VII: Increased max number of directors from 7 to 11Changed director terms from 3 to 2 yearsChange the number of Board classes from 3 to 2Changed term end date from Dec 31 to June 30Article VIII: Added Executive Committee as a Board CommitteeUpdated Steering Committee duties to include 1) overseeing research activities of the corporation and (2) overseeing the structure, organization, and activities of the membershipArticle IX: Changed terms so that officers are chosen biannually</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b: Form 990 Review Process</FormAndLineReferenceDesc>
        <ExplanationTxt>PRIOR TO FILING, FORM 990 WILL BE REVIEWED BY THE CFO AND THE EXECUTIVE DIRECTOR AND THEN DISTRIBUTED TO THE FULL BOARD AND FINANCE COMMITTEE FOR REVIEW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</FormAndLineReferenceDesc>
        <ExplanationTxt>The Conflict of Interest policy is monitored by the Ethics Committee and reviewedand signed at the beginning of each fiscal year by all staff and Board members withsignificant decision making authority. It is each signator's obligation to discloseany potential conflict as soon as it is known, or reasonably should be known.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a: Compensation Review &amp; Approval Process - CEO, Top Management</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Directors shall review any compensation packages of the Executive Director and the Chief Financial Officer, and shall approve such compensation only after determining that the compensation is reasonable. Compensation is determined using information about compensation paid by similarly situated taxable and tax-exempt organizations for similar services. Such information may include up-to-date compensation surveys compiled by independent firms or actual written offers from similarly situated organizations. Approvals of all compensation must be documented in writing with the dates and terms of the agreement, a record of all individuals who voted in consideration, along with all information and the information's source.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</FormAndLineReferenceDesc>
        <ExplanationTxt>The most recent Form 990s (including financial information), the Bylaws, Articles ofIncorporation, Form 1023 Application for Exemption, and Conflict of Interest Policyare provided to the public upon request</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 2: Change of Oversight or Selection Process</FormAndLineReferenceDesc>
        <ExplanationTxt>CARRA now has a finance committee that oversees the approval of the audit.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>