Bill Amendment: IL HB0763 | 2017-2018 | 100th General Assembly
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: HEALTH FACILITIES-STATE BOARD
Status: 2017-09-22 - Public Act . . . . . . . . . 100-0518 [HB0763 Detail]
Download: Illinois-2017-HB0763-Senate_Amendment_002.html
Bill Title: HEALTH FACILITIES-STATE BOARD
Status: 2017-09-22 - Public Act . . . . . . . . . 100-0518 [HB0763 Detail]
Download: Illinois-2017-HB0763-Senate_Amendment_002.html
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1 | AMENDMENT TO HOUSE BILL 763
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2 | AMENDMENT NO. ______. Amend House Bill 763 on page 35, | ||||||
3 | immediately below line 9, by inserting the following:
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4 | "Section 10. The Alternative Health Care Delivery Act is | ||||||
5 | amended by changing Section 35 as follows:
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6 | (210 ILCS 3/35)
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7 | Sec. 35. Alternative health care models authorized. | ||||||
8 | Notwithstanding
any other law to the contrary, alternative | ||||||
9 | health care models
described in this Section may be established | ||||||
10 | on a demonstration basis.
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11 | (1) (Blank).
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12 | (2) Alternative health care delivery model; | ||||||
13 | postsurgical recovery care
center. A postsurgical recovery | ||||||
14 | care center is a designated site which
provides | ||||||
15 | postsurgical recovery care for generally healthy patients
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16 | undergoing surgical procedures that potentially require |
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1 | overnight nursing care, pain
control, or observation that | ||||||
2 | would otherwise be provided in an inpatient
setting. | ||||||
3 | Patients may be discharged from the postsurgical recovery | ||||||
4 | care center in less than 24 hours if the attending | ||||||
5 | physician or the facility's medical director believes the | ||||||
6 | patient has recovered enough to be discharged. A | ||||||
7 | postsurgical recovery care center is either freestanding | ||||||
8 | or a
defined unit of an ambulatory surgical treatment | ||||||
9 | center or hospital.
No facility, or portion of a facility, | ||||||
10 | may participate in a demonstration
program as a | ||||||
11 | postsurgical recovery care center unless the facility has | ||||||
12 | been
licensed as an ambulatory surgical treatment center or | ||||||
13 | hospital for at least 2
years before August 20, 1993 (the | ||||||
14 | effective date of Public Act 88-441). The
maximum length of | ||||||
15 | stay for patients in a
postsurgical recovery care center is | ||||||
16 | not to exceed 48 hours unless the treating
physician | ||||||
17 | requests an extension of time from the recovery center's | ||||||
18 | medical
director on the basis of medical or clinical | ||||||
19 | documentation that an additional
care period is required | ||||||
20 | for the recovery of a patient and the medical director
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21 | approves the extension of time. In no case, however, shall | ||||||
22 | a patient's length
of stay in a postsurgical recovery care | ||||||
23 | center be longer than 72 hours. If a
patient requires an | ||||||
24 | additional care period after the expiration of the 72-hour
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25 | limit, the patient shall be transferred to an appropriate | ||||||
26 | facility. Reports on
variances from the 24-hour or 48-hour |
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1 | limit shall be sent to the Department for its
evaluation. | ||||||
2 | The reports shall, before submission to the Department, | ||||||
3 | have
removed from them all patient and physician | ||||||
4 | identifiers. Blood products may be administered in the | ||||||
5 | postsurgical recovery care center model. In order to handle
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6 | cases of complications, emergencies, or exigent | ||||||
7 | circumstances, every
postsurgical recovery care center as | ||||||
8 | defined in this paragraph shall maintain a
contractual | ||||||
9 | relationship, including a transfer agreement, with a | ||||||
10 | general acute
care hospital. A postsurgical recovery care | ||||||
11 | center shall be no larger than 20
beds. A postsurgical | ||||||
12 | recovery care center shall be located within 15 minutes
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13 | travel time from the general acute care hospital with which | ||||||
14 | the center
maintains a contractual relationship, including | ||||||
15 | a transfer agreement, as
required under this paragraph.
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16 | No postsurgical recovery care center shall | ||||||
17 | discriminate against any patient
requiring treatment | ||||||
18 | because of the source of payment for services, including
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19 | Medicare and Medicaid recipients.
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20 | The Department shall adopt rules to implement the | ||||||
21 | provisions of Public
Act 88-441 concerning postsurgical | ||||||
22 | recovery care centers within 9 months after
August 20, | ||||||
23 | 1993. Notwithstanding any other law to the contrary, a | ||||||
24 | postsurgical recovery care center model may provide sleep | ||||||
25 | laboratory or similar sleep studies in accordance with | ||||||
26 | applicable State and federal laws and regulations.
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1 | (3) Alternative health care delivery model; children's | ||||||
2 | community-based
health care center. A children's | ||||||
3 | community-based health care center model is a
designated | ||||||
4 | site that provides nursing care, clinical support | ||||||
5 | services, and
therapies for a period of one to 14 days for | ||||||
6 | short-term stays and 120 days to
facilitate transitions to | ||||||
7 | home or other appropriate settings for medically
fragile | ||||||
8 | children, technology
dependent children, and children with | ||||||
9 | special health care needs who are deemed
clinically stable | ||||||
10 | by a physician and are younger than 22 years of age. This
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11 | care is to be provided in a home-like environment that | ||||||
12 | serves no more than 12
children at a time , except that a | ||||||
13 | children's community-based health care center in existence | ||||||
14 | on the effective date of this amendatory Act of the 100th | ||||||
15 | General Assembly that is located in Chicago on grade level | ||||||
16 | for Life Safety Code purposes may provide care to no more | ||||||
17 | than 16 children at a time . Children's community-based | ||||||
18 | health care center
services must be available through the | ||||||
19 | model to all families, including those
whose care is paid | ||||||
20 | for through the Department of Healthcare and Family | ||||||
21 | Services, the Department of
Children and Family Services, | ||||||
22 | the Department of Human Services, and insurance
companies | ||||||
23 | who cover home health care services or private duty nursing | ||||||
24 | care in
the home.
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25 | Each children's community-based health care center | ||||||
26 | model location shall be
physically separate and
apart from |
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1 | any other facility licensed by the Department of Public | ||||||
2 | Health under
this or any other Act and shall provide the | ||||||
3 | following services: respite care,
registered nursing or | ||||||
4 | licensed practical nursing care, transitional care to
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5 | facilitate home placement or other appropriate settings | ||||||
6 | and reunite families,
medical day care, weekend
camps, and | ||||||
7 | diagnostic studies typically done in the home setting.
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8 | Coverage for the services provided by the
Department of | ||||||
9 | Healthcare and Family Services
under this paragraph (3) is | ||||||
10 | contingent upon federal waiver approval and is
provided | ||||||
11 | only to Medicaid eligible clients participating in the home | ||||||
12 | and
community based services waiver designated in Section | ||||||
13 | 1915(c) of the Social
Security Act for medically frail and | ||||||
14 | technologically dependent children or
children in | ||||||
15 | Department of Children and Family Services foster care who | ||||||
16 | receive
home health benefits.
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17 | (4) Alternative health care delivery model; community | ||||||
18 | based residential
rehabilitation center.
A community-based | ||||||
19 | residential rehabilitation center model is a designated
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20 | site that provides rehabilitation or support, or both, for | ||||||
21 | persons who have
experienced severe brain injury, who are | ||||||
22 | medically stable, and who no longer
require acute | ||||||
23 | rehabilitative care or intense medical or nursing | ||||||
24 | services. The
average length of stay in a community-based | ||||||
25 | residential rehabilitation center
shall not exceed 4 | ||||||
26 | months. As an integral part of the services provided,
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1 | individuals are housed in a supervised living setting while | ||||||
2 | having immediate
access to the community. The residential | ||||||
3 | rehabilitation center authorized by
the Department may | ||||||
4 | have more than one residence included under the license.
A | ||||||
5 | residence may be no larger than 12 beds and shall be | ||||||
6 | located as an integral
part of the community. Day treatment | ||||||
7 | or
individualized outpatient services shall be provided | ||||||
8 | for persons who reside in
their own home. Functional | ||||||
9 | outcome goals shall be established for each
individual. | ||||||
10 | Services shall include, but are not limited to, case | ||||||
11 | management,
training and assistance with activities of | ||||||
12 | daily living, nursing
consultation, traditional therapies | ||||||
13 | (physical, occupational, speech),
functional interventions | ||||||
14 | in the residence and community (job placement,
shopping, | ||||||
15 | banking, recreation), counseling, self-management | ||||||
16 | strategies,
productive activities, and multiple | ||||||
17 | opportunities for skill acquisition and
practice | ||||||
18 | throughout the day. The design of individualized program | ||||||
19 | plans shall
be consistent with the outcome goals that are | ||||||
20 | established for each resident.
The programs provided in | ||||||
21 | this setting shall be accredited by the
Commission
on | ||||||
22 | Accreditation of Rehabilitation Facilities (CARF). The | ||||||
23 | program shall have
been accredited by CARF as a Brain | ||||||
24 | Injury Community-Integrative Program for at
least 3 years.
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25 | (5) Alternative health care delivery model; | ||||||
26 | Alzheimer's disease
management center. An Alzheimer's |
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1 | disease management center model is a
designated site that | ||||||
2 | provides a safe and secure setting for care of persons
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3 | diagnosed with Alzheimer's disease. An Alzheimer's disease | ||||||
4 | management center
model shall be a facility separate from | ||||||
5 | any other facility licensed by the
Department of Public | ||||||
6 | Health under this or any other Act. An Alzheimer's
disease | ||||||
7 | management center shall conduct and document an assessment | ||||||
8 | of each
resident every 6 months. The assessment shall | ||||||
9 | include an evaluation of daily
functioning, cognitive | ||||||
10 | status, other medical conditions, and behavioral
problems. | ||||||
11 | An Alzheimer's disease management center shall develop and | ||||||
12 | implement
an ongoing treatment plan for each resident. The | ||||||
13 | treatment
plan shall have defined goals.
The
Alzheimer's | ||||||
14 | disease management center shall treat behavioral problems | ||||||
15 | and mood
disorders using nonpharmacologic approaches such | ||||||
16 | as environmental modification,
task simplification, and | ||||||
17 | other appropriate activities.
All staff must have | ||||||
18 | necessary
training to care for all stages of Alzheimer's | ||||||
19 | Disease. An
Alzheimer's disease
management center shall | ||||||
20 | provide education and support for residents and
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21 | caregivers. The
education and support shall include | ||||||
22 | referrals to support organizations for
educational | ||||||
23 | materials on community resources, support groups, legal | ||||||
24 | and
financial issues, respite care, and future care needs | ||||||
25 | and options. The
education and support shall also include a | ||||||
26 | discussion of the resident's need to
make advance |
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1 | directives and to identify surrogates for medical and legal
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2 | decision-making. The provisions of this paragraph | ||||||
3 | establish the minimum level
of services that must be | ||||||
4 | provided by an Alzheimer's disease management
center. An | ||||||
5 | Alzheimer's disease management center model shall have no | ||||||
6 | more
than 100 residents. Nothing in this paragraph (5) | ||||||
7 | shall be construed as
prohibiting a person or facility from | ||||||
8 | providing services and care to persons
with Alzheimer's | ||||||
9 | disease as otherwise authorized under State law.
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10 | (6) Alternative health care delivery model; birth | ||||||
11 | center. A birth
center shall be exclusively dedicated to | ||||||
12 | serving the childbirth-related needs of women and their | ||||||
13 | newborns and shall have no more than 10 beds. A birth | ||||||
14 | center is a designated site
that is away from the mother's | ||||||
15 | usual place of residence and in which births are
planned to | ||||||
16 | occur following a normal, uncomplicated, and low-risk | ||||||
17 | pregnancy. A
birth center shall offer prenatal care and | ||||||
18 | community education services and
shall coordinate these | ||||||
19 | services with other health care services available in
the | ||||||
20 | community.
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21 | (A) A birth center shall not be separately licensed | ||||||
22 | if it
is one of the following: | ||||||
23 | (1) A part of a hospital; or | ||||||
24 | (2) A freestanding facility that is physically
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25 | distinct from a hospital but is operated under a
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26 | license issued to a hospital under the Hospital
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1 | Licensing Act. | ||||||
2 | (B) A separate birth center license shall be | ||||||
3 | required if the birth center is operated as: | ||||||
4 | (1) A part of the operation of a federally
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5 | qualified health center as designated by the | ||||||
6 | United
States Department of Health and Human | ||||||
7 | Services; or | ||||||
8 | (2) A facility other than one described in | ||||||
9 | subparagraph (A)(1), (A)(2), or (B)(1) of this | ||||||
10 | paragraph (6) whose costs are
reimbursable under | ||||||
11 | Title XIX of the federal Social
Security Act. | ||||||
12 | In adopting rules for birth centers, the Department | ||||||
13 | shall consider:
the American Association
of Birth Centers' | ||||||
14 | Standards for Freestanding Birth Centers; the American | ||||||
15 | Academy of Pediatrics/American College of Obstetricians | ||||||
16 | and Gynecologists Guidelines for Perinatal Care; and the | ||||||
17 | Regionalized Perinatal Health Care Code. The Department's | ||||||
18 | rules shall stipulate the eligibility criteria for birth | ||||||
19 | center admission. The Department's rules shall
stipulate | ||||||
20 | the necessary equipment for emergency care
according to the | ||||||
21 | American Association of Birth Centers'
standards and any | ||||||
22 | additional equipment deemed necessary by the Department. | ||||||
23 | The Department's rules shall provide for a time
period | ||||||
24 | within which each birth center not part of a
hospital must | ||||||
25 | become accredited by either the Commission for the
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26 | Accreditation of Freestanding Birth Centers or The Joint |
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1 | Commission. | ||||||
2 | A birth center shall be certified to participate in the | ||||||
3 | Medicare and Medicaid
programs under Titles XVIII and XIX, | ||||||
4 | respectively, of the federal Social
Security Act.
To the | ||||||
5 | extent necessary, the Illinois Department of Healthcare | ||||||
6 | and Family Services shall apply for
a waiver from the | ||||||
7 | United States Health Care Financing Administration to | ||||||
8 | allow
birth centers to be reimbursed under Title XIX of the | ||||||
9 | federal Social Security
Act. | ||||||
10 | A birth center that is not operated under a hospital | ||||||
11 | license shall be located within a ground travel time | ||||||
12 | distance from the general acute care hospital with which
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13 | the birth center maintains a contractual relationship,
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14 | including a transfer agreement, as required under this
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15 | paragraph, that allows for an emergency caesarian delivery | ||||||
16 | to be started within 30 minutes of the decision a caesarian | ||||||
17 | delivery is necessary. A birth center operating under a | ||||||
18 | hospital license shall be located within a ground travel | ||||||
19 | time distance from the licensed hospital that allows for an | ||||||
20 | emergency caesarian delivery to be started within 30 | ||||||
21 | minutes of the decision a caesarian delivery is necessary. | ||||||
22 | The services of a
medical director physician, licensed | ||||||
23 | to practice medicine in all its branches, who is certified | ||||||
24 | or eligible for certification by the
American College of | ||||||
25 | Obstetricians and Gynecologists or the
American Board of | ||||||
26 | Osteopathic Obstetricians and Gynecologists or has |
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1 | hospital
obstetrical privileges are required in birth | ||||||
2 | centers. The medical director in consultation with the | ||||||
3 | Director of Nursing and Midwifery Services shall | ||||||
4 | coordinate the clinical staff and overall provision of | ||||||
5 | patient care.
The medical director or his or her physician | ||||||
6 | designee shall be available on the premises or within a | ||||||
7 | close proximity as defined by rule. The medical director | ||||||
8 | and the Director of Nursing and Midwifery Services shall | ||||||
9 | jointly develop and approve policies defining the criteria | ||||||
10 | to determine which pregnancies are accepted as normal, | ||||||
11 | uncomplicated, and low-risk, and the anesthesia services | ||||||
12 | available at the center. No general anesthesia may be | ||||||
13 | administered at the center. | ||||||
14 | If a birth center employs
certified nurse midwives, a | ||||||
15 | certified nurse midwife shall be the Director of
Nursing | ||||||
16 | and Midwifery
Services who is responsible for the | ||||||
17 | development of policies and procedures for
services as | ||||||
18 | provided by Department rules. | ||||||
19 | An obstetrician, family
practitioner, or certified | ||||||
20 | nurse midwife shall attend each woman in labor from
the | ||||||
21 | time of admission through birth and throughout the | ||||||
22 | immediate postpartum
period. Attendance may be delegated | ||||||
23 | only to another physician or certified
nurse
midwife. | ||||||
24 | Additionally, a second staff person shall also be present | ||||||
25 | at each
birth who is licensed or certified in Illinois in a | ||||||
26 | health-related field and under the supervision of the |
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1 | physician or certified nurse midwife
in attendance, has | ||||||
2 | specialized training in labor and delivery techniques and
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3 | care of newborns, and receives planned and ongoing training | ||||||
4 | as needed to
perform assigned duties effectively. | ||||||
5 | The maximum length of stay in a birth center shall be
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6 | consistent with existing State laws allowing a 48-hour stay | ||||||
7 | or appropriate
post-delivery care, if discharged earlier | ||||||
8 | than 48 hours. | ||||||
9 | A birth center shall
participate in the Illinois | ||||||
10 | Perinatal
System under the Developmental Disability | ||||||
11 | Prevention Act. At a minimum, this
participation shall | ||||||
12 | require a birth center to establish a letter of agreement
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13 | with a hospital designated under the Perinatal System. A | ||||||
14 | hospital that
operates or has a letter of agreement with a | ||||||
15 | birth center shall include the
birth center under its | ||||||
16 | maternity service plan under the Hospital Licensing Act
and | ||||||
17 | shall include the birth center in the hospital's letter of | ||||||
18 | agreement with
its regional perinatal center. | ||||||
19 | A birth center may not discriminate against any patient | ||||||
20 | requiring treatment
because of the source of payment for | ||||||
21 | services, including Medicare and Medicaid
recipients. | ||||||
22 | No general anesthesia and no surgery may be performed | ||||||
23 | at a birth center.
The Department may by rule add birth | ||||||
24 | center patient eligibility criteria or standards as it | ||||||
25 | deems necessary.
The Department shall by rule require each | ||||||
26 | birth center to report the information which the Department |
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1 | shall make publicly available, which shall include, but is | ||||||
2 | not limited to, the following: | ||||||
3 | (i) Birth center ownership. | ||||||
4 | (ii) Sources of payment for services. | ||||||
5 | (iii) Utilization data involving patient length of | ||||||
6 | stay. | ||||||
7 | (iv) Admissions and discharges. | ||||||
8 | (v) Complications. | ||||||
9 | (vi) Transfers. | ||||||
10 | (vii) Unusual incidents. | ||||||
11 | (viii) Deaths. | ||||||
12 | (ix) Any other publicly reported data required | ||||||
13 | under the Illinois Consumer Guide. | ||||||
14 | (x) Post-discharge patient status data where | ||||||
15 | patients are followed for 14 days after discharge from | ||||||
16 | the birth center to determine whether the mother or | ||||||
17 | baby developed a complication or infection. | ||||||
18 | Within 9 months after the effective date of this | ||||||
19 | amendatory Act of the 95th
General Assembly, the Department | ||||||
20 | shall adopt rules that are developed with consideration of: | ||||||
21 | the American Association of Birth Centers' Standards for | ||||||
22 | Freestanding Birth Centers; the American Academy of | ||||||
23 | Pediatrics/American College of Obstetricians and | ||||||
24 | Gynecologists Guidelines for Perinatal Care; and the | ||||||
25 | Regionalized Perinatal Health Care Code. | ||||||
26 | The Department shall adopt other rules as necessary to |
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1 | implement the provisions of this
amendatory Act of the 95th | ||||||
2 | General Assembly within 9 months after the
effective date | ||||||
3 | of this amendatory Act of the 95th General Assembly. | ||||||
4 | (Source: P.A. 97-135, eff. 7-14-11; 97-987, eff. 1-1-13.)".
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