Elder Care in the Workplace — Calculate Your Company’s Loss…Then Manage Your Company’s Risk

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

From time-to-time, my research uncovers great perspectives that help illuminate the challenges associated with “Eldercare in the Workplace”. Dan Henry, Chief Human Resources Officer at Bright Horizons, ran the numbers on elder care as it relates to employers and their employees. In September of 2014 he stated the following.

adding up figures concept with modern white calculator in officeSome numbers just hit you over the head. This is how I felt when I read a Gallup poll the other day called the Cost of Caregiving to the U.S. Economy. The study breaks down the cost of elder care in this country. Here are two of the highlights:

  • One-in-six employed Americans are caring for an elder or disabled relative
  • Each of those people miss an average of 6.6 days each year

Thatƒ’s a pretty significant number all by itself. Then I started to do the math. In a company of 1000 people, one-in-six employees missing an average of 6.6 days annually add up to a loss of more than 1,000 days every year. Thatƒ’s 1000 employees who have elder care responsibilities x 6.6 missed workdays = 1,100 lost days.

Calculating Future Business Losses

That kind of time loss isnƒ’t just days — itƒ’s years. So if youƒ’re running a business with 1,000 people, youƒ’re paying literally the equivalent of three years in lost time every year because people have unsolved elder care challenges. And that was just in 2011. The U.S. Census Bureau says our population is aging, which means the number of people caring for aging relatives is only going to go up. Our own Modern Family Index tells us many employees are seeing elder care in their future.

Sobering Statistics for Employers

For employers, these are sobering statistics and proof that elder care is not just a personal problemƒ’itƒ’s a business problem. Like any other trend ƒ’ technology, demographic, scientific ƒ’ itƒ’s altering the business landscape. And smart employers are looking at it exactly that way ƒ’ pragmatically. Theyƒ’re saying to themselves that to preserve their bottom lines theyƒ’re going to have to approach it head on. Theyƒ’re leading a trend of programs that offer both guidance to employees about how to sift through all the options and also actual, tangible care.

The Importance of Solving for Elder Care

The other aspect to this equation that canƒ’t be ignored is the positive performance effect. Being ƒsandwichedƒ between generations is hard. Taking care ofRisk Management children and elder relatives is hard. Taking care of an elder relative and working is stunningly hard. People who get support from the people they work for (in this case, with elder care) are gratefulƒ and relieved. They pay their employers back not just by showing up, but by being great employees. Elder care responsibilities are a fact of life. Numbers donƒ’t lie. That one-in-six number says your company is going to be affected, no matter who you hire, where youƒ’re located, and what business youƒ’re in. Itƒ’s yet another reason conversations about working families are taking on such urgency. Families arenƒ’t only children. As Ellen Galinsky told NPR IN 2014, ƒ”We may choose to have children but we donƒ’t choose to have parents.ƒ” That makes addressing this challenge good business no matter how you look at it. Because itƒ’s a simple equation: solve for elder care, or watch literally years of hard work go down the drain.

Well said Dan! Helping businesses mitigate this risk is what we do here at Caring Concierge. We have been doing it for years and we’ve been able to assist companies large and small.

Determine Your Company’s ‘Sobering Statistics’

Take a moment to apply the ‘one-in-six’ formula above and you can get a feel for how your company is impacted with respect to employee missed workdays due to elder care issues. Then give us a call. Caring Concierge can help to greatly reduce your companies exposure and enable your employees to confidently and proactively address their elder care issues.

I wish each and every one of you a healthy and successful 2015!


Eldercare & The Workplace: A Professional and Personal Conversation!

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

On Thursday, September 18th, Visiting Angels of Cleveland, Ohio will co-sponsor the Health Care Forum sponsored by Crain’s Cleveland Business. I mention this because I am privileged to be a panelist during one of the breakout sessions at the health care forum. The forum will take place in downtown Cleveland at the new Cleveland Convention Center from 7:00AM to 1:00PM. Preceded by networking and breakfast, the morning will begin at 7:30AM with a keynote address.


• J.B. Silvers, Ph.D. John R. Mannix Medical Mutual of Ohio Professor of Health Care Finance, Professor of Epidemiology & Biostatistics – School of Medicine CWRU, Weatherhead School of Management

Visiting Angels’ Cleveland, Ohio office is also participating in a breakout panel titled Your employees, their eldercare concerns, your bottom line: What’s it Crains Health Care Forumcosting you?” This panel will be moderated by Crain’s Cleveland Business Publisher John Campanelli. I encourage you to attend and participate in this 90-minute panel that begins at 8:45AM. Below is an overview of the content that will be discussed along with the panel participants.

PANEL #1 – “Your employees, their eldercare concerns, your bottom line: What’s it costing you?”
• Eldercare costs U.S. Businesses more than $33 Billion each year in lost productivity
• How can you calculate your company’s risk?
• What resources are available to help your employees handle their caregiving duties?
• How can businesses build support systems for employees who have significant caregiving duties?

• Richard Browdie, president & CEO, Benjamin Rose Institute on Aging
• Eiran Z. Gorodeski, director, Cleveland Clinic Center for Connected Care
• Kevin Johnson, managing director, Visiting Angels
• Claire Zangerle, president and CEO, Visiting Nurse Association of Ohio

As readers and subscribers of this blog know, Eldercare and the Workplace is an important topic. So much so, that Visiting Angels of  Cleveland, an independent company that specializes in providing home care for seniors, works with Caring Concierge to extend the assistance available for their clients who are caring for seniors. As a Certified Senior Advisor, and as co-owner of Visiting Angels’ Cleveland, Ohio office, I provide content and subject matter awareness to both company’s.

The health care forum will conclude with a keynote presentation featuring some of northeast Ohio’s national leaders in health care. An overview of the closing keynote presentation and the panel participants are below:

FORUM KEYNOTE PRESENTATION: “Checking the pulse: A conversation with Northeast Ohio’s health care leaders”

• Akram Boutros, MD, President & CEO, The MetroHealth System
• Delos M. “Toby” Cosgrove, MD, President & CEO, Cleveland Clinic
• Terrence P. Kessler, President & CEO, The Sisters of Charity Health System
• Thomas “Tim” Stover, MD, President & CEO, Akron General Health System
• Thomas F. Zenty III, CEO, University Hospitals

I hope you will be able to attend this informative event. We look forward to speaking with you. For all of the information regarding the Forum, please access the following hypertext link, Crain’s Health Care Forum.


Note: Visiting Angels (at Fairhill Partners) is an award wining, full-service senior home care agency providing a comprehensive range of non-medical services. Our experienced caregivers are bonded and insured. We are in our 12th year of operation  and are honored to have served hundreds of seniors in the Greater Cleveland area and surrounding suburban communities.

Employers: Improve Employee Loyalty in the Post ACA World

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

As the Affordable Care Act was coming on line last year, I spoke to a number of employers who suggested that the health benefit plans they offered to their employees were really instruments of competitive advantage. These employers felt that their employees selected to work for their respective company’s, in part, based upon the quality of the health care plan. I thought that was extremely interesting. In my experience, the only employees that actually compare benefits prior to applying to or accepting a job, are those employees that had to address a ‘special-needs’ situation in their immediate family. By far this is a much smaller subset of employees.

Well with the running implementation of the Affordable Care Act, employers might consider another benefit that will provide real value to the majority of their employees. This one has application to a broader employee base and can provide comparative competitive advantage versus other companies that might be competing for great employees.

Addressing the Primary Needs of Working Caregivers

Managing both work life and family life has become a major issue for a large and growing number of family caregivers and their employers. With the aging of the Baby Boom generation will come a dramatic increase in the long-term care needs of our population. As policy-makers consider our options for meeting these needs, supporting working caregivers takes on national importance.” – Margaret Neal and Donna Wagner

There are four areas of need that have implications for structuring workplace settings and providing support for caregivers:Exhausted Business Woman_PM2

  1. Flexibility
  2. Information and assistance
  3. Emotional Support and
  4. Tangible assistance

Employed caregivers routinely note the importance of both flexible work hours and being able to take unscheduled time off to handle caregiving responsibilities when needed. A recent study of working “sandwich generation” couples (e.g. those raising depending children and caring for aged parents) found that couples who felt they had work schedule flexibility experienced less work-family conflict. Work schedule flexibility and other work-based supports offered by employers to their employed caregivers have generally been perceived positively on the part of the caregivers. This, in turn, has led to increased loyalty and satisfaction with those employers.

The needs of employed caregivers vary according to the care situation and the needs of the care recipient. Regardless, however, just as do their non-employed counterparts, employed caregivers need information on the community services that are available to support the needs of elders. Most caregivers of elders have had little or no previous experience either with providing care to an elder or with negotiating the aging services system. Thus, information about caregiving, health conditions, and where to turn for help is a critical need for employed caregivers. Because of the complexity of many elders’ health care situations, employed caregivers, like other caregivers, can find it difficult to know even what is needed, let alone decide which service approach is best for their elder. Professional expertise can be invaluable for assessing the elder’s needs, providing referrals and advice, determining eligibility and payment options, and packaging the needed services.

Emotional support for employed caregivers can come in the form of support from co-workers and supervisors at the workplace, support from other family members, and support from friends. A recent study found that, not surprisingly, lower levels of family related supervisor support were associated with higher levels of work-family conflict. Similarly, a less supportive workplace culture was also associated with work-family

Employed caregivers need help with legal, financial, and health insurance matters and the paperwork associated with these. Helping an elder manage the paperwork associated with his or her medical care is a daunting task. Similarly, securing and completing the legal forms for durable power of attorney, wills, reverse mortgages, and the like can be frustrating and time-consuming.

Adding assistance with eldercare benefits that apply to most of your employee base can provide real competitive advantage versus other companies that are competing for great employees; including employees that are currently on your staff. In the process you can differentiate your company from your competition in a way that is really important to your workforce. Caring Concierge can help you create an affordable, elder care benefit program that makes sense for your company.

Referral: University of Wisconsin

Employer Wellness Programs — Well Worth It But Consider This!

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

As the mounting cost of health insurance continues to strain corporate and household budgets, both employers and policy makers are increasingly turning to wellness programs as a way to help bring them under control. Evidence indicates that carefully executed wellness programs can save employers as much as $7 for every $1 spent, according to a new study by the Massachusetts Business iStock_WomanWorkingWellness_PMRoundtable, a public policy group that represents top executives at some of the state’s biggest companies. Such programs can lower health care costs over the long term, but more immediate savings can come from higher employee morale, reduced absenteeism, and increased productivity and retention.


According to a new study of more than 1,000 small-business owners by Humana and the National Small Business Association (NSBA), 93 percent of small businesses consider their employees’ physical and mental health to be important to their bottom line, and 54 percent say it’s “extremely important.” But despite that, only a third of respondents are confident they can manage employee health care needs, citing gaps in information and employee interest.

(Note: This survey defined health and wellness programs as initiatives to encourage employees to make healthier choices, such as getting preventative care, eating right and exercising.)

So what health and wellness issues are small business owners concerned about?

  • High employee stress is the number one concern for small business decision-makers, especially at smaller companies, with stress levels rating more than triple other employee well-being concerns.
  • Employees working when they are sick is second – 57 percent reported that their employees show up for work when they should be taking a sick day.

As this study shows, health and wellness programs can be a win-win situation for small businesses, fostering healthier people and healthier profits. So what’s holding small business owners back from implementing programs?

So what does it take to create an effective wellness program? The roundtable’s report examined programs and experiences of eight companies and identified elements that made them successful. They included careful planning, the ability to measure progress, and respect for the attitudes, practices, and values that make up a company’s culture. “There are best practices that could be shared broadly for folks that are thinking about doing a wellness program,” said JD Chesloff, executive director of the Massachusetts Business Roundtable.

Employers should not necessarily provide an exhaustive range of wellness options, said Kelly Dougherty, executive director of the CardioVascular Center at Tufts Medical Center and part of the group that drafted the report. Successful plans instead focus their offerings on their particular audience, she said: A workplace dominated by young men could have different needs than an office staffed largely by middle-aged parents. “The folks we talked to who really had a handle on this really seemed to understand their workforce,” Dougherty said.

Consigli Construction, for example, shaped a program that complements its competitive company culture, with group exercise classes and workplace contests that encourage employees to push each other to adopt healthier lifestyles.

Northmark Bank, on the other hand, takes a more relaxed approach at its three locations in Andover, North Andover, and Winchester. The company’s goal is to get employees out of their seats and walking around for at least five minutes every day, said chief executive Jane Walsh. Participants are recognized with stars for each day they walk and small gifts for longer streaks.

Some employees are so dedicated to maintaining the habit that they will circle the boardroom or pace the stairs when weather keeps them indoors, Walsh said. “It ends up building camaraderie,” Walsh said. “I think the company’s better for it.”

The Roundtable report also pointed to the need to quantify the impact of wellness programs.

Starting last year, Consigli Construction employees were offered up to $400 off their annual health insurance payments if they completed an assessment including blood pressure and cholesterol testing. To earn the same discount next year participants will have to show they have maintained or improved their health stats. The measurements let the 62 percent of Consigli employees who participate track their progress while giving the company solid metrics to determine whether its program is working.

“After we do this for a few years, we’ll be able to look back and take an average and see where it saves us money,” Brogioli said.

Blue Cross and Blue Shield of Massachusetts uses data to target its wellness programs. After an initial assessment, employees are classified as low, medium, or high risk and directed to resources most appropriate to their needs, explained Cathy Hartman, vice president of prevention and wellness for the insurer. A low-risk employee might be advised on maintaining healthy habits; a higher-risk person might be counseled on increasing physical activity

But there is still much to learn about the impact of wellness programs. For one, the definition of what exactly constitutes a“wellness program” remains up in the air. The report found that some companies do no more than provide access to online nutrition and exercise tips, while others, like Consigli, have invested in comprehensive initiatives.

Further, the growth in wellness initiatives — 74 percent of employers nationally reported offering such programs in 2010, up from 54 percent in 2008 — has outpaced research into their effectiveness, Hartman said. Still to be discovered is how, why, and where specific interventions work and others do not, she said.

At Consigli Construction, the results from the first year of the health metrics program are not yet in, but Brogioli expects the numbers to show success.

“You’re getting rewarded for positive results,” he said. “Common sense dictates that it is going to be very effective.”



  • SBA.gov
  • Sarah Shemkus, Globe Correspondent

The Duality of Employers and Their Employees Providing Eldercare!

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

We do indeed ‘live in interesting times’! Increasing numbers of older adults are involved in caregiving and financial support of their parents their spouses, their older children and their grandchildren. Many older adults today find that they need to continue to work in order to help family members financially, while others need flexibility in their work schedules to meet caregiving demands.

The preceding five blog post series addressed ‘best practices’ employers should consider regarding ‘eldercare and the workplace’. They were presented for employer awareness and for employer action planning based on precedent and good management practice. So why is this so important to employers.

iStock_YinYangDemographic trends indicate a greater number of employees of all ages will assume the role of family caregiver with an increasingly older population.  This trend will no doubt impact employee caregivers ages 18 to 39, as much as those ages 50 and older.  These caregivers will be affected in many ways including their physical and mental well-being as well as their health care costs.

In fact, a January 2010 MetLife survey – Working Caregivers and Employer Health Care Costs – shows an eight percent differential in health care costs for caregiving employees, conservatively estimated to cost US employers $13.4 billion per year.  Beyond medical costs, another cost to employers is absenteeism and work productivity, estimated to cost US businesses $33.6 billion per year. [1]

Consider New Hampshire. Thirteen percent (170,000) of New Hampshire’s population is age 65+, with 24,480 residents age 85+. New Hampshire’s 85+[2]  population – the age group that is most likely to need caregiving services – will nearly double from 2007 to 2030.[3] With such an aging population, the percentage of family caregivers in the workplace will only rise over time.  All stakeholders need to recognize that supporting working caregivers can improve their health and productivity, not just in their personal lives but in their corporate lives as well.

Caring Concierge provides employers with a comprehensive solution set to manage their risk relative to this specific eldercare related employee productivity loss. As you can bet, we stay pretty busy helping the duality that is our employer clients and their respective employees who must also provide eldercare to their loved ones while performing with excellence in the workplace.


[1] The Metlife Study of Working Caregivers and Employer Health Care Costs, January 2010.  http://www.metlife.com/assets/cao/mmi/publications/studies/2010/mmi-working-caregivers-employers-health-care-costs.pdf

[2] U.S. Census Bureau, Population Division.  Estimates of the Resident Population by Selected Age Groups for the United States and Puerto Rico: July 1, 2008.  Released May 14, 2009.  URL:  http://www.census.gov/popest/states/asrh/SC-EST2008-01.html

[3] Gibson, Mary Jo, Fox-Grage, Wendy, Houser, Ari.  Across the States 2009:  Profiles of Long-Term Care and Independent Living:  Executive Summary, State Data, and Rankings.  Page 34.  AARP Public Policy Institute.  Washington, D.C.  URL:  http://www.aarp.org/research/ppi/ltc/Other/articles/across_the_states_2009__profiles_of_long-term_care_and_independent_living.html

Employers Can Help Employees…and Help Themselves When it Comes to Eldercare!

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

Part 2: Family Responsibilities Discrimination (FRD)

This post is a continuation of a discussion about how employers can avoid not only lost productivity costs, but also avoid employment discrimination issues that could arise from employees that are family caregivers. In our previous post we shaped the issue. Now let’s discuss the legal issues companies face.

iStock_000014696872XSmall_PMFamily Responsibilities Discrimination is discrimination against workers caring for children, older adults, or ill or disabled family members. FRD comes about from treating employees with caregiving responsibilities less favorably that other employees due to unexamined assumptions that their family obligations may mean that they are not committed to their jobs. For detailed information regarding employer history with FRD issues, consider reviewing the database of the Center for WorkLife Law. It contains over 3,000 cases involving some form of FRD. The include examples such as:

  • An employee is fired when he asks for leave to care for his chronically ill father.
  • After being told that his employer has “paid enough” for his ailing wife already, an employee is terminated when he refuses to take his wife off of the employer’s insurance plan.
  • An employee is denied leave when her employer asserts that it is not her responsibility to care for her ailing mother as long as her father is still alive.
  • An employee is called lazy and then fired after taking leave to care for his mother, who is near death.

For a frame of reference, take a look at my blog posts of July 9, 2012 and January 8, 2013, where I’ve quantified the number of employees that ask for some employer provision in order to provide eldercare for a spouse, parent, grandparent, etc…

Claims of FRD in eldercare include denial of leave and retaliation for taking leave. They usually involve employees’ needs for periodic time off to take an aging parent to medical or other appointments, to administer medications, or to perform other health care tasks in the home, such as wound care. Blocks of time off may be requested to care for an older family member who is hospitalized unexpectedly. Flexible schedules may be requested to help a grandparent who may need personal care at home (such as dressing, bathing, eating), or need advanced illness care. In addition, some employees have brought claims related to leave requests to take care of their own health problems caused by the strain of being a caregiver for a frail older parent.

FRD has caught the attention not only of attorneys and human resources professionals, but also of unions, employers, courts, policymakers, caregiver advocates, and the press.

The number of FRD lawsuits grew from about 444 cases in 1989 to about 2,207 cases in 2008, an increase of nearly 400 percent over the two decades. The dramatic rise in the number of FRD cases heightens attention to the extent of this type of discrimination, during an era in which the number of employment discrimination lawsuits heard by federal courts overall has been decreasing.

To date, only a small—but growing—number of FRD cases involve workers caring for older family members, because current public policy does not offer as much protection for workers with eldercare responsibilities as they need. An analysis of 204 eldercare cases found that only 23 cases were filed before 2000. The other 181 cases were filed between 2000 and 2009.

Lawsuits show the kinds of problems that American workers with eldercare responsibilities face.

The largest individual jury verdict in an FRD case to date ($11.65 million) involved a hospital maintenance worker, Chris Schultz, who was fired while caring for his father with Alzheimer’s disease and mother with congestive heart problems and severe diabetes. To help manage his parents’ care, he asked to take intermittent leave, to which he was entitled under the federal Family and Medical Leave Act (FMLA). While he was on leave to care for his parents, his supervisor suddenly instituted a new quota system that was impossible for Schultz to meet (and may have been designed to drive Schultz out). As a result, Schultz was fired for poor performance after 26 years as a dedicated employee with a record of excellent evaluations—the year before he began taking leave, his picture hung in the lobby as the hospital’s outstanding worker of 1999.

Not only is FMLA coverage limited, the protections it provides also are limited: Employers often treat employees with caregiving responsibilities differently for reasons that relate more to their need to alter (or keep) their schedule than to take a period of leave.

Why is Family Responsibilities Discrimination (FRD) a Policy Matter? — With very few exceptions, most federal and state statutes do not expressly prohibit FRD. No laws protect working caregivers of older adults or people with family responsibilities asiStock_SeriousSeniorExecutive_PM a specific group or class from discrimination. Rather, FRD-related claims in the workplace have been framed from other legal theories in federal and state law—for example, as sex discrimination, discrimination based on association with a person with a disability, or a violation of state or federal family and medical leave laws.

While the majority of American workers have to balance work with family responsibilities, today’s workplaces are still designed around the breadwinner-homemaker workforce of the 1950s. This outdated workplace model assumes that workers have someone at home to take care of family caregiving and domestic responsibilities. Changing workplace demographics have led to more working parents and more workers with eldercare responsibilities.

New research shows that workers who make their caregiving responsibilities known on the job, for example by requesting family leave or a flexible work schedule, often encounter bias based on assumptions that they are less competent than other workers or not committed to their jobs.

This mismatch between today’s workplace and today’s workforce is an important public policy issue. Americans rely heavily on family members to provide care for children, relatives with disabilities, and older adults—without the kinds of leaves or subsidies available in most other industrialized countries. In addition, the American health care and  Long Term Services & Support (LTSS) systems rely on family members to provide substantial, complex, and often time-consuming care for adult relatives or friends with chronic conditions or disabilities. The estimated value of their unpaid contributions was approximately $450 billion in 2009, more than total Medicaid spending ($361 billion) that year.

For many workers experiencing FRD, “opting out” of the workforce is not a viable option, and for some, losing their job may mean living in poverty. In this context, it is imperative that employers not impose job penalties and job loss on workers who have eldercare responsibilities. This imperative is all the more important in an era of high unemployment. It may no longer be an option, for someone who lost a job due to workplace bias, to simply get another job.

Next Post — Protections that exist for employees under Federal Employment Laws.

Reference: AARP Public Policy Institute

Employers Can Help Employees…and Help Themselves When it Comes to Eldercare!

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

Part 1 — The Problem Employees Face

I thought I’d use a multi-post format to talk about how employers can avoid not only lost productivity costs, but also avoid employment discrimination issues that could arise from employees that are family caregivers. Here in Part 1, I’ll shape the issue.

You’re at work. You receive news that your mother just fell and broke her hip. What do you do? As a Senior Care Advisor who helps  adult children care for their aging parents, this is a typical scenario I receive from an employee at a client company.

Here’s the key. If the employee doesn’t have someone like Caring Concierge to call, they’re going to close their office door and make call after call during the work day. Employees are often feeling overwhelmed as caregivers. They are trying to get educated on their options; trying to learn the ‘industry’ of eldercare, usually from scratch, and all while under duress. Various versions of this scenario play out everyday in the workplace. This is what causes the +$30 billion in lost productivity that employers in the United States absorb every year as a result of employees and adult caregiving.

With one call, we are able to work with an employee to provide eldercare education and to give them options that will bring about informed decisions regarding the care for their loved one. We help with developing a plan of  care. This saves the employer from incurring so much lost employee productivity.

It’s linear! Family caregiving responsibilities at home can lead to negative consequences at work. According to the “Caregiving in the U.S. 2009” survey, 68% of family caregivers of adults age 50 and older report making plans to support their care recipient while at work. Workers with eldercare responsibility report the kinds of workplace effects that open up employees to discrimination. These include, arriving to work late, leaving work early, or taking time off during the day to provide care. These together comprise approximately 64% of the issues. Approximately 17% take a leave of absence, while another 9% reduce their work hours from full-time to part-time. An estimated 10% of the family caregivers in this survey  actually quit their jobs to give care or choose early retirement in order to support their eldercare recipients.

To a U.S. employer based that has been right-sized to optimize costs and efficiencies. these numbers are absolutely staggering. This is true when considering the blue-collar work force or the white-collar work force.  

Next Post — Part 2: Family Responsibilities Discrimination

Reference: AARP Public Policy Institute

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