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        <ManagementAndGeneralAmt>1543</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>Dues and Journal Subscr</Desc>
        <TotalAmt>50534</TotalAmt>
        <ProgramServicesAmt>24727</ProgramServicesAmt>
        <ManagementAndGeneralAmt>25807</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>616862</TotalAmt>
        <ProgramServicesAmt>366199</ProgramServicesAmt>
        <ManagementAndGeneralAmt>250663</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
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        <EOYAmt>586225</EOYAmt>
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      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>2085830</EOYAmt>
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      <PledgesAndGrantsReceivableGrp>
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        <EOYAmt>233024</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>18270</EOYAmt>
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      <TotalAssetsGrp>
        <BOYAmt>2489452</BOYAmt>
        <EOYAmt>2923349</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>1939</EOYAmt>
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      <GrantsPayableGrp>
        <BOYAmt>111415</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </GrantsPayableGrp>
      <DeferredRevenueGrp>
        <BOYAmt>36850</BOYAmt>
        <EOYAmt>25864</EOYAmt>
      </DeferredRevenueGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>225000</EOYAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>148265</BOYAmt>
        <EOYAmt>252803</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>2218217</BOYAmt>
        <EOYAmt>2401718</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>122970</BOYAmt>
        <EOYAmt>268828</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>2341187</BOYAmt>
        <EOYAmt>2670546</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>2489452</BOYAmt>
        <EOYAmt>2923349</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>329359</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
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    <IRS990ScheduleA documentId="RetDoc1039100001">
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      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus3YearsAmt>4200</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>163064</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>554519</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>802232</CurrentTaxYearAmt>
        <TotalAmt>1524015</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>248977</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>126381</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>529730</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1711458</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>71866</CurrentTaxYearAmt>
        <TotalAmt>2688412</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>248977</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>130581</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>692794</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2265977</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>874098</CurrentTaxYearAmt>
        <TotalAmt>4212427</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <CurrentTaxYearMinus1YearAmt>2346</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2256</CurrentTaxYearAmt>
        <TotalAmt>4602</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <CurrentTaxYearMinus1YearAmt>1560381</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>1560381</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <CurrentTaxYearMinus1YearAmt>1562727</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2256</CurrentTaxYearAmt>
        <TotalAmt>1564983</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>2647444</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus2YearsAmt>4582</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>35949</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>72123</CurrentTaxYearAmt>
        <TotalAmt>112654</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus2YearsAmt>4582</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>35949</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>72123</CurrentTaxYearAmt>
        <TotalAmt>112654</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>248977</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>130581</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>697376</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2301926</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>946221</CurrentTaxYearAmt>
        <TotalAmt>4325081</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.61210</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.53200</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.02600</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.01180</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </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">
      <TotalBookValueLandBuildingsAmt>0</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Refundable advance</Desc>
        <Amt>225000</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>225000</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>946221</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>946221</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>946221</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>616862</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>616862</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>616862</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleF documentId="RetDoc1040500001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>North America</RegionTxt>
        <OfficesCnt>0</OfficesCnt>
        <EmployeeCnt>0</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>Program Service</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>Fellowship Grants</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>62407</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>South America</RegionTxt>
        <OfficesCnt>0</OfficesCnt>
        <EmployeeCnt>0</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>Program Service</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>Fellowship Grants</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>17820</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <SubtotalOfficesCnt>0</SubtotalOfficesCnt>
      <SubtotalEmployeesCnt>0</SubtotalEmployeesCnt>
      <ContinuationTotalOfficeCnt>0</ContinuationTotalOfficeCnt>
      <ContinuationTotalEmployeeCnt>0</ContinuationTotalEmployeeCnt>
      <TotalOfficeCnt>0</TotalOfficeCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <SubtotalSpentAmt>80227</SubtotalSpentAmt>
      <ContinuationSpentAmt>0</ContinuationSpentAmt>
      <TotalSpentAmt>80227</TotalSpentAmt>
      <GrantsToOrgOutsideUSGrp>
        <RegionTxt>North America</RegionTxt>
        <PurposeOfGrantTxt>Fellowship Grant</PurposeOfGrantTxt>
        <CashGrantAmt>62407</CashGrantAmt>
        <MannerOfCashDisbursementTxt>Wire transfer from bank</MannerOfCashDisbursementTxt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
      </GrantsToOrgOutsideUSGrp>
      <GrantsToOrgOutsideUSGrp>
        <RegionTxt>South America</RegionTxt>
        <PurposeOfGrantTxt>Fellowship Grant</PurposeOfGrantTxt>
        <CashGrantAmt>17820</CashGrantAmt>
        <MannerOfCashDisbursementTxt>Wire transfer from bank</MannerOfCashDisbursementTxt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
      </GrantsToOrgOutsideUSGrp>
      <Total501c3OrgCnt>2</Total501c3OrgCnt>
      <TransferToForeignCorpInd>0</TransferToForeignCorpInd>
      <InterestInForeignTrustInd>0</InterestInForeignTrustInd>
      <ForeignCorpOwnershipInd>0</ForeignCorpOwnershipInd>
      <PassiveForeignInvestmestCoInd>0</PassiveForeignInvestmestCoInd>
      <ForeignPartnershipInd>0</ForeignPartnershipInd>
      <BoycottCountriesInd>0</BoycottCountriesInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Fellowship recipients are required to submit two evaluations: one at the midpoint and one at the conclusion of the fellowship.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleF>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization utilizes the services of a management firm, Status Plus, LLC. Management fees represent amounts paid to Status Plus, LLC for meeting management services and the performance of duties commonly performed by management and staff of a non-profit association.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>ISA has the following types of members: full members, student members, emeritus members, affiliate members, and patient/care partner members. Full members have the ability to attend meetings, to vote during elections and on other matters requiring member votes, to hold office, to nominate candidates for office and to serve on committees and working groups. Student members have the ability to attend meetings and to serve on committees and working groups, but not to vote, nominate candidates for office or hold office. Emeritus members have the ability to attend meetings, to vote during elections and on other matters requiring member votes, to nominate candidates for office and to serve on committees and working groups. Emeritus members may serve on the Board, but not in Officer positions. Affiliate members have the ability to attend meetings but may not vote during elections and on other matters requiring member votes, and may not serve on the Board, committees or working groups. Patient/Care Partner members are not eligible to attend symposia or ISA business meetings (unless otherwise allowed by the Board or its delegate as to the particular symposium or meeting), vote during elections or other matters requiring member votes, or nominate candidates for office. Upon appointment by the President, they may serve on committees and working groups.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>Full members have the right to vote in elections, nominate candidates, hold office, and serve on committees and working groups.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>A review of the 990 is conducted either in person or via a conference call before the return is filed.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The society's board reviews the directors statement of disclosure for any sets of facts or circumstances that may reflect an actual, potential or apparent conflict of interest. The board will review each circumstance individually, taking into account various factors that might indicate a potential conflict of interest and determine whether an actual conflict of interest exists. The board reserves final authority over the resolution of the conflict of interest and may require the director to recuse themselves from deliberations or, in certain scenarios, resign from their service.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The society makes its governing documents and financial statements available to the public upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 2c:</FormAndLineReferenceDesc>
        <ExplanationTxt>The process has not changed from the prior year.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>