STRATEGIC PLAN 2009
Context
The Children’s Sanctuary, Inc. (CSI) Strategic Plan is a dynamic tool for continuous quality improvement and program development. Goals and objectives apply to a single year within a general five-year framework. We revise the plan each year to address the needs of consumers and stakeholders and fluctuations in government funding.
History
Founded in Fort Wayne, Indiana in 1995, Children’s Sanctuary, Inc. provides treatment foster care in state licensed or certified foster homes, case management, counseling, and family reunification services for special needs children and their families. Since February 1996, Children’s Sanctuary, Inc. has provided treatment foster care services for more than 1000 abused and neglected children with mild to severe emotional, behavioral, and medical needs.
Children’s Sanctuary’s, Inc. is a 501-C-3 not-for-profit, IV-E approved treatment foster care agency based in Fort Wayne, Indiana with programs in Indiana, Illinois, and Ohio. Children’s Sanctuary, Inc. is licensed by the Indiana Family and Social Service Administration and the Ohio Department of Job and Family Services. Children's Sanctuary will obtain a license to operate in Illinois in 2009.
Children’s Sanctuary, Inc. is a member of the Indiana Association of Residential Child Care Agencies (IARCCA), the Ohio Association of Child Caring Agencies (OACCA), and the Foster Family-based Treatment Association (FFTA). Children’s Sanctuary Indiana is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). Children’s Sanctuary is managed by ResCare, Inc.
Our Mission
Children’s Sanctuary, Inc. will provide care, treatment, and case management for the special needs child in a safe, nurturing home environment with trained treatment foster parents. We will exert every effort to provide the best care and treatment for the child in the least restrictive environment. We will work with the court, the public custodial agency, the child, the foster parents, and the child’s biological parents to re-unite the child with his or her family as soon as possible.
Our Values
Every child deserves a safe, permanent home with a nurturing, caring family.
Every child should be treated with dignity and understanding.
Every child is an individual with human rights and legal rights.
Every child has a right to participate in the development of his or her treatment plan.
Reunification with the biological family should be the primary goal for a child.
When reunification is not possible, an adoptive home should be found for the child.
Our Vision
Children’s Sanctuary, Inc. strives to provide the child and family a holistic treatment program that includes the child, biological family, foster family, teachers, public agency workers, and other significant individuals in the child’s life. We aspire to focus on the emotional, social, cultural, medical, and academic needs of the child.
STRENGTHS AND ADVANTAGES
Accountability
State Licensing
Children’s Sanctuary, Inc. holds child placing agency licenses in Indiana and Ohio, and placement contracts with West Virginia. The Indiana Division of Family and Children and the Ohio Department of Job and Family Services review Children’s Sanctuary, Inc.’s programs, standards, and policies annually for compliance with state rules and regulations. The agency is in the process of obtaining a license and contract to provide services in Illinois.
Agency
CSI reviews its programs twice a year through surveys with placing agencies, foster parents, foster children and staff. The agency completes a Best in Class review each quarter. The Executive Director completes a comprehensive quality assurance report twice a year and an outcomes management report once a year.
Staff
All staff members at Children’s Sanctuary are employed by ResCare, Inc. Staff members participate in weekly staff meetings and monthly supervision sessions. Staff performance is reviewed annually using the Managed Valued Performance (MVP) tool.
Treatment Staff - Experience and Qualifications
The Executive Director is a master’s level Social Worker with over thirty years experience managing treatment programs for children and adolescents.
Program Directors have graduate or undergraduate degrees in social work or a related field and five or more years of experience with public or private child caring/placing agencies.
Treatment/Clinical Directors have graduate degrees in social work or a related field and five or more years of clinical experience working with troubled children and their families.
Child and Family Therapists have graduate degrees in social work or a related field and five or more years of clinical experience working with troubled children and families.
Foster Care Social Workers have graduate or undergraduate degrees in social work or a related field and two or more years experience with a public or private child placing agency.
Accreditation
Children’s Sanctuary maintains CARF accreditation by an ongoing program of review and improvement of its services and business practices.
Risk Management
Children’s Sanctuary complies with state risk management requirements and the risk management policies and procedures of ResCare, Inc. Children’s Sanctuary and ResCare carry liability insurance on directors and officers, treatment staff, and foster parents. Staff and foster parents undergo stringent background checks including finger prints and driving records. Foster parents must show proof of auto insurance, and homeowners or renters insurance prior to licensing or certification.
Financial Stability
Children’s Sanctuary, Inc. maintains surplus revenue to sustain the operation at optimum levels while awaiting per-diem payments from county and state agencies. The aging cycle on receivables is 60 to 90 days. Children’s Sanctuary receives additional reimbursement from its Medicaid approved counseling program.
Children’s Sanctuary's undergoes an independent financial audit each year from a certified public accountant. The audit and other financial information are available on the website: www.childrenssanctuary.org.
Marketing
Marketing revolves around two issues: foster parent recruitment and the agency’s ability to provide optimum services to the clients, their families, public custodial agencies and the courts. In 2009, Children Sanctuary will aggressively market its programs in Indiana, Illinois and Ohio. Children’s Sanctuary will research other states for possible startup programs.
Unity
Children’s Sanctuary and ResCare work together to provide optimum services to clients, families, the state and other stakeholders. ResCare’s Code of Conduct and Best in Class standards are applied across the entire CSI program. In addition, the agency applies CARF standards in its business and professional practice.
Growth
In 2009 Children’s Sanctuary, Inc. will expand its services in Indiana, Ohio and Illinois. The agency will provide additional services to meet the needs of the placing agencies and the community.
Staff Development
In 2009 Children’s Sanctuary, Inc. will maintain competitive salaries and continue the development of its professional staff and contractual foster care providers.
Grants
Children’s Sanctuary, Inc. supports its operations almost entirely with public funds. In 2009, CSI will research and secure grants for specific programs when possible.
Fund Raising
Children’s Sanctuary, Inc. raises funds for scholarships, summer camp, independent living, social and cultural events, and Christmas for the youth in care.
Performance Improvement
Children’s Sanctuary, Inc. will continue to improve its programs and initiate new programs to keep pace with the changing needs of children and families as well as the needs of the public custodial agencies and the courts. CSI and ResCare will provide programs and financial support for the increasing need for intensive treatment services.
Revenue
Through a continuous program of quality improvement and assurance and aggressive marketing, CSI will increase its census by 20% in all programs in 2009.
Margin
A not-for-profit agency must maintain surplus revenue to assure the financial health of the agency. Surplus revenue at CSI is 10 to 15 percent of the annual gross revenue.
Probability
Growth will continue in therapeutic foster care. As budgets decrease, states will look for other alternatives for out-of-home placement of troubled children rather than institutions, group homes, or hospitals where the cost can be prohibitive. Treatment foster care is cost effective, provides treatment in the least restrictive environment, and has a proven record of positive outcomes for the special needs child.
Risks
Tight state fiscal budgets
Decreased federal funding
Increased regulations without additional funding
Increased competition from public and private agencies
Foster Care
Foster care is the care of a child in a private home by a family who is usually unrelated to the child. The child lives in a home environment with a caring family. Public custodial agencies and private placing agencies contract with licensed foster parents to care for the abused, neglected, delinquent, or emotionally disturbed child.
Group Homes
A group home is a residential facility owned and operated by a public or private child care agency. Paid house parents or child care workers provide around the clock care for 8 to 10 children of various levels of needs.
Institutions and Mental Health Hospitals
Institutions and mental health hospitals are residential facilities that provide care, treatment and intensive supervision for ten or more youth in settings that range from open to secure.
Treatment Foster Care
Treatment foster care is a specialized program for the care and treatment of a child with mild to severe behavioral, emotional, or medical problems in a private home by trained foster parents. The child and family receive case management services and clinical services from the private foster care agency and in the community.
EXTERNAL STAKEHOLDERS
Children’s Sanctuary, Inc.’s primary external stakeholders are the children, who deserve a safe, caring, nurturing environment, the foster parents who care for the children, and the biological parents. The children and their families depend on the courts, the public custodial agencies, and the private placing agencies to protect their interests.
The public custodial agencies and the courts are the external stakeholders responsible for acquiring safe, cost effective out-of-home placement for abused, neglected, delinquent, and emotionally disturbed children. They have a fiscal responsibility to the state, the federal government, and the taxpayer. It is prudent for the public custodial agencies and the courts to keep as many children as possible out of institutions and hospitals.
The federal government provides funding and establishes policies for out-of-home placement of children through block grants and entitlement programs. Attention to governmental trends in public welfare is critical to long range planning.
Other external stakeholders are the state mental health entities, community mental health providers, police departments, probation departments, the courts, and the community.INTERNAL STAKEHOLDERS
Internal stakeholders are the agency’s clinical directors, therapists, social workers, case managers, and home resource coordinators who provide treatment, case management, training, and support to the children, foster parents, and biological families.
Other internal stakeholders are the executive directors and program directors who oversee the agency’s operations; business managers and human resources managers who manage the financial and personnel systems; the Board of Directors who represent the community's interest in the provision of services to the children and families, and ResCare.
ENVIRONMENTAL SCAN
External
Public custodial agencies throughout the country are moving away from institutional and group home models for out-of-home care and towards the family foster home model. Hospitalization and institutional care are still used in the short term for the seriously disturbed child. Group home care has declined since the early 1990s. The group home can neither compete with the less expensive foster home, nor provide the structure and services available in the larger institutions and hospitals, i.e., specialized units, on-grounds schools, and medical support and treatment. Placement of children in treatment foster homes is cost effective and meets state and federal criteria for optimal care and treatment in the least restrictive environment. Foster children tend to do better behaviorally, emotionally, and academically. Foster care is more likely to lead to permanency, i.e., adoption, reunification, and emancipation.
In the United States, public custodial agencies contract with private foster care agencies to provide specialized services including intensive case management, treatment, and daily care in private homes with skilled foster caregivers. Troubled children, who once lingered indefinitely in psychiatric hospitals and institutions, now receive services in private family homes.
Treatment foster care has grown consistently since 1985. Many agencies that provided group home or institutional care have developed foster care programs. Today, there is an extensive network of treatment foster homes operated by public and private social service agencies.Ohio
In 2007, Ohio revised the rules governing traditional, therapeutic, and medical needs foster care. Ohio’s policies are among the most comprehensive in the nation. Children’s Sanctuary has designed its programs to meet Ohio’s requirements for traditional, treatment, and medically fragile foster care services.
Indiana
In 2009, Indiana will develop a regional system for contracting services for foster care. The state plans to initiate standardization of documentation, state contracts, and rates based on a level of care formula. In 2009, the state will become the single payer for foster care services.
Illinois
In 2008, Children’s Sanctuary completed a needs assessment and developed a business plan to initiate a treatment foster care program in southern Illinois. In 2009, Children's Sanctuary will obtain a license and a contract from the state and begin providing services in Carbondale and Danville by July 1.
ENVIRONMENTAL SCAN
Internal
The Agency
Children’s Sanctuary and ResCare possess the experience and resources to provide care and treatment for the abused, neglected child with serious behavioral, emotional, and medical needs. The agency has experienced professional staff and a multi-state network of skilled foster caregivers.
Northern Indiana
The Northern Indiana program based in Fort Wayne covers the northern half of the state. The agency has a track record of positive outcomes such as reunification, adoption, and emancipation from its self-sufficiency program.
Southern Indiana
The Southern Indiana program based in New Albany, Indiana covers the southern half of the state. The program grew substantially in 2008. In 2009, CSI will double the number of foster homes in this region.
Ohio
The Ohio program, based in Ironton, accepts placements from counties in southern Ohio and West Virginia. Census declined in the first half of 2008, but improved during the last three months of the year. In 2009, CSI will continue to provide services in southeastern Ohio, but will move the main office to Dayton. The agency will develop new foster homes in Dayton and Lima, Ohio.
Illinois
CSI started a new program in Southern Illinois in 2008. State licensing has approved the program and will issue a license in early 2009. CSI will obtain a contract by June 2009. The agency will license 10 foster homes and provide services to 20 clients by December 2009.
See Attached Action Plan
Children’s Sanctuary, Inc. will continue to develop its programs and management systems to ensure ongoing quality improvement. We will provide the children, the families, the courts, the public custodial agencies, the foster caregivers and the community care and treatment programs that are effective and efficient. We will monitor and develop our programs and management systems to ensure ongoing quality control and improvement. We will provide the children and families, the courts, the public placing agencies, the foster caregivers, and the community a treatment program that assures positive, measurable outcomes.
Objectives
Maintain successful program completion for clients through family reunification, adoption, or graduation. CSI professionals will work with clients, foster parents, biological parents and others for positive outcomes on discharge from the program. CSI will provide independent living training for youth 14 and older. CSI will maintain a transitional living program in scattered site housing for youth 18 to 21.
Minimize the rate of clients moving to other foster care agencies. On completion of treatment or failure of client to complete treatment in a CSI foster home, the custodial agency may place the child in foster care in a county foster home or with another private foster care agency. This may be a positive outcome: a child moves from treatment foster care to traditional foster care, or negative: disruption or allegation of abuse causing the child to be moved from the CSI foster home.
Decrease the number of clients released to more restrictive placements. Failure to meet emotional, behavioral, and medical needs of the client may result in the client being sent to detention, residential treatment, or a mental health hospital. The goal for each discharge client is permanency, either by adoption, reunification or graduation.
Reduce the number and frequency of critical incidents. A critical incident endangers the client, the foster parent, a staff member, or the program. While some critical incidents are caused by acts of nature, most are caused by error, negligence, actions or activities. CSI reduces the number and frequency of critical incidents through close monitoring and professional intervention. Incidents are reviewed by the CSI Safety Committee and ResCare.
Reduce the length of time a client resides in out-of-home placement. Children’s Sanctuary, Inc. will assist the public custodial agency in finding a permanent placement for a client through concurrent planning with the agency, the foster family, the biological family, the adoptive family and other involved parties.
Maximize the satisfaction of clients with the program. CSI will survey youth in CSI foster care twice a year to determine their degree of satisfaction with staff and foster parents, the benefits they received from placement and their overall feelings concerning the services they received from the agency. We will use this information to improve our quality and delivery of services.
Maximize satisfaction of targeted stakeholders. CSI will survey its foster parents and the public custodial agency caseworkers twice each year to determine their satisfaction with the agency’s program and services. CSI will use this information to improve quality and delivery of services to the foster parents, the public custodial agencies and the children in care.
Maximize satisfaction of CSI employees. DEYTA, LLC provides independent satisfaction surveys of all Children’s Sanctuary/ResCare employees. CSI will use the results of this survey to meet employee needs and improve overall job satisfaction with the agency and ResCare.
Maintain continuous quality improvement in service delivery. ResCare’s “Best in Class” reviews will be conducted Four times a year. The CSI Executive Director and Director of Quality Assurance will prepare a Quality Control Initiatives report twice a year.
GOAL TWO: BUSINESS PRACTICES
See Attached Action Plan
Objectives
Maintain Best in Class in program performance and consistency as measured by ResCare's Best in Class evaluation tool.
Maintain census at budgeted level: CSI will review its placements each month for changes in number of children in placement. The agency will continue to improve its services and market its programs to maintain census at or above budget.
Maintain operational expenses at or below budgeted levels. The agency will track monthly expenses to maintain solvency.
Achieve and maintain accreditation and accreditation standards. Children’s Sanctuary, Inc. Indiana is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). CSI will seek accreditation for its Ohio and Illinois programs in 2010.
Maintain effective employee retention. CSI will monitor employee turnover and investigate and utilize strategies to retain its employees. Employee retention will be addressed in the quality control initiatives reports and in strategic planning.
Implement Staff Development Activities. The agency will implement general and job specific training activities for all staff in 2009. Treatment staff will attend weekly staff meetings and monthly supervision meetings. They will receive 30 hours job related training annually. The agency will encourage staff to attend job related educational programs, conferences, and seminars. All staff will have an annual MVP evaluation.
GOAL THREE: RESEARCH AND DEVELOPMENT
See Attached Action Plan
Children’s Sanctuary, Inc. will focus on support and enhancement of programs demonstrating success and growth, assess needs in other states, start new programs where needed, and discontinue programs which are failing or too costly to operate.
Objectives
Continue development of programs in Indiana, Ohio and Illinois: In 2009, CSI will aggressively market its services in Indiana, Illinois and Ohio to develop its programs, increase census and become the service provider of choice.
Indiana
CSI will increase census by 20% in 2009. The agency presently receives most of its referrals and placements from Allen County, but is rapidly expanding its foster home base into surrounding counties. The Southern Indiana program continues to grow in central and southern Indiana.
Ohio
CSI will develop homes in Lima and Dayton and increase census by 50% in 2009. We will work with the custodial agencies and foster parents to provide optimum services to youth and families. Training, reorganization, and accreditation are integral to the success of CSI Ohio.
Illinois
CSI will obtain a license and contract by June 2009. The agency will recruit, train, and certify ten homes in the Carbondale and Danville area and provide services to 20 clients by December 2009.
Other
Children’s Sanctuary and ResCare will expand its treatment foster care programs based on the needs of neglected and abused children and the public custodial agencies. This will include individual, family and group therapy, supervised visitation, and use of advanced technology, i.e., Rest Assured, to optimize care and treatment of troubled children. Future funding streams will include grants and Medicaid. As directed by ResCare, the agency will conduct assessments in other states to determine needs, costs, and feasibility of providing services
CONCLUSION
Children’s Sanctuary, Inc. has grown steadily since 1995. The agency has demonstrated continuous quality improvement through ongoing assessments of programs and service delivery, Best in Class reviews, and accreditation. CSI foster parents and staff are skilled professionals in the care and treatment of the neglected, abuse, emotionally disturbed child.
Children’s Sanctuary and ResCare will continue to expand its services in Indiana, Ohio and Illinois. CSI will continue to utilize a service model based on the needs of the child and family. We will improve current programs and develop new programs. To accomplish our goals, we will market our programs strategically and aggressively, increase fund-raising, and continue to monitor, review and improve program quality. We will seek additional funding sources where available to provide the best possible services for the child, the family, and the public custodial agency.
Each year, Children’s Sanctuary, Inc. will develop action plans for Service Delivery, Business Practices, and Program Development. The plans will contain specific goals and objectives based on the Annual Outcomes Report and the changing needs of children, families and the public custodial agencies. The Children’s Sanctuary Strategic Plan will be available for review on the website: www.childrenssanctuary.org.Children's Sanctuary, Inc. Service Delivery
| GOAL | OBJECTIVE MEASURE | RESPONSIBILITY | TOOL | PERIOD | 2008 TARGET | INDIANA OUTCOME | OHIO OUTCOME | 2009 TARGET |
| Maintain successful program completion rate. | Client planned discharge rate: adoption, reunification, relative, guardian or graduation. | Clinical Director & foster care social work staff | CSI Release Log & Demographic Data | Annual | > 75% | 70% | 82% | > 75% |
| Minimize rate of clients moving to foster care placement with other agencies. | Clients discharged to a foster care placement with another agency. | Clinical Director & foster care social work staff | CSI Release Log & Demographic Data | Annual | < 10% | 14% | 4% | < 10% |
| Minimize the rate of clients discharged to more restrictive placements | Clients discharged to more restrictive placement (detention, Institution, hospital) | Clinical Director & foster care social work staff | CSI Release Log & Demographic Data | Annual | < 15% | 16% | 14% | < 15% |
| Maintain appropriate standards of care as measured by an independent review. | Percentage of services regions in compliance with state regulations | The State Licensing Agency | Regulations for Child Placing Agencies | Annual | 100% | 96% | 96% | 100% |
| Reduce number and frequency of critical incidents | The total number of reportable critical incidents. | Clinical Director & foster care social work staff | Critical Incident Reports | Annual | < 25 | 22 | 14 | < 25 |
| Reduce time youth resides in foster care placement | Median length-of-stay in days of discharged clients. | Clinical Director & foster care social work staff | CSI Release Log & Demographic Data | Annual | < 365 | 474 | 163 | < 365 |
| Maximize satisfaction of clients (Youth) in CSI Foster Care Program | % score of clients' expressing overall satisfaction with CSI foster care services. | Clinical Director & foster care social work staff | CSI Satisfaction Surveys | 2X Year | 95% | 88% | 85% | > 90% |
| Maximize satisfaction of Foster Parents with CSI Foster Care Program | % score of foster parents expressing satisfaction with the agency. | Clinical Director & foster care social work staff | CSI Satisfaction Surveys | 2X Year | 95% | 89% | 85% | > 90% |
| Maximize satisfaction of public agency workers with CSI Foster Care Program | % score of public agency workers expressing satisfaction with CSI foster care services. | Clinical Director & foster care social work staff | CSI Satisfaction Surveys | 2X Year | 95% | 87% | Not Reported | > 90% |
| Maximize satisfaction of CSI employees providing services. | % score of staff expressing satisfaction with CSI and its programs. | Human Resources Manager & Executive Director | DEYTA Survey (Note: Indiana and Ohio is a combined score | 2X Year | 95% | 89% | 64% | > 95% |
| Maintain continuous quality improvement in service delivery | Combined % score of Quality Control Initiative reviews, surveys, and evaluations | Director of Training & Quality Assurance & Executive Director | Best in Class, Best Practices, Satisfaction surveys and | 2X Year | > 95% | 93% | 90% | > 95% |
Children's Sanctuary, Inc. Business Practices
| GOAL | OBJECTIVE MEASURE | RESPONSIBILITY | TOOL | TIME FRAME | 2008 TARGET | INDIANA OUTCOME | OHIO OUTCOME | 2009 TARGET |
| Maintain continuous quality improvement in business practices, foster homes and case management | Percentage of Compliance with ResCare-Care's Best in Class standards | Director of Financial Operations & Executive Director | ResCare-Care's Best in Class Review | 4X Year | 100% | 97% | 97% | 100% |
| Maintain census at or above budgeted levels | Percentage of clients according to annual budget. | Clinical Director & foster care social work staff | Monthly HCS Census | Annual | > 100% | 106% | 63% | > 100% |
| Maintain operational expenses at or below budgeted levels (Note: Expenses increase with growth as does revenue) | Percentage operational expenses above reported revenue. | Director of Financial Operations & Executive Director | Operational Budget & monthly financial reports | Annual | < 5% | 0% | 7% | 0% |
| Obtain 3 year CARF accreditation for CSI Ohio. | Ongoing preparation of all CSI programs for accreditation | Director of Training & Quality Assurance and Executive Director | CARF Standards Manual | 1 year | Ohio | N/A | No | Ohio |
| Maintain effective employee retention | Percentage turnover rate for all CSI staff. | Human Resources Manager & Executive Director | Employee Turnover report | Annual | < 20% | 11% | 33% | < 20% |
| Implementation of General staff Development Activities | Staff will receive at least 8 hours in-house training in compliance with regulatory requirements. | Dir. of Training and Quality Assurance | CSI Staff Training Curriculum | Annual | 100% | 100% | 100% | 100% |
| Implementation of job specific staff development activities | Staff will receive at least 22 hours training specific to their job. | Dir. of Training and Quality Assurance | CSI Staff Training Curriculum | Annual | 100% | 75% | 75% | 100% |
| 100 % of employees will receive an annual performance evaluation | % of employees who receive a performance evaluation at least once a year | Directors and Supervisors | Managing Values Performance (MVP) evaluation tool | Annual | 100% | 100% | 100% | 100% |
Children's Sanctuary, Inc. Research and Development
| GOAL | OBJECTIVE MEASURE | RESPONSIBILITY | TOOL | TIME FRAME | 2008 TARGET | INDIANA OUTCOME | OHIO OUTCOME | 2009 TARGET |
| Continued development of programs in Indiana and Ohio | Growth in census above budgeted levels for Indiana and Ohio | Dir. Of Training and Quality Assurance & Executive Director | Daily census reports | Annual | > 20% | 6% | 0.37% | 20% |
| Continued development of foster homes in Indiana and Ohio. | Number of new certified/licensed foster homes available for placements. | Home Resource Coordinators | Media advertisements and recruitment bonuses for foster parents. | Annual | 50% | 21% | 65% | 20% |
| Develop program in other states according to need. and feasibility. | Growth in foster homes and census for new states and regions. | Dir.Training & Quality Assurance & Executive Director | Needs Assessment, Census Report, Foster Home Log | Ongoing | Illinois | Permit to operate in Illinois | N/A | State contract & 20 clients |
| Develop new programs and sources of funding | Successful program startup. RFP, Grant, Medicaid funded | Clinical Director, Dir. Quality Assurance, Executive Director | Monthly AR report for new programs | Ongoing | Ongoing | Medicaid funded therapy program | NO | Ongoing |
If you would like more information about Children's Sanctuary, would like to refer a child for placement, or you are interested in becoming a foster parent, please clicks CONTACTS.
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