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340:75-1-151. Oklahoma Children's Services (OCS) referral procedure

Revised 7-1-13

    Oklahoma Children's Services (OCS) referrals are requested by Oklahoma Department of Human Services (OKDHS) child welfare specialists and authorized by the OKDHS OCS contract liaison in the service area where the child or family resides.    • 1 through 4

INSTRUCTIONS TO STAFF 340:75-1-151

 Revised 9-16-21

1.  (a) Referral focus for Comprehensive Home-Based Services (CHBS).  Form OCS-1, Oklahoma Children's Services (OCS) Referral, is accessed via KIDS Service Log.  The referring child welfare (CW) specialist chooses the focus of service that corresponds to the family's therapeutic, supportive, and concrete needs directly related to the child's health, safety, and welfare.  CHBS include:

(1) voluntary prevention and intervention-related services to strengthen parental protective capacities to maintain the child safely in the child's own home;

(2) trial adoptive placement maintenance;

(3) kinship placement maintenance;

(4) out-of-home permanent placement maintenance;

(5) reunification; and

(6) post-legal adoption maintenance.

(b) Criteria for CHBS referrals.  CHBS referrals are appropriate for:

(1) a child protective services (CPS) case when:

(A) child abuse or neglect is substantiated, and the child is determined to be safe;

(B) the family is cooperative and likely to modify behaviors or conditions in the home that caused the abuse or neglect to occur through voluntary prevention and intervention-related services;

(C) the family does not require assistance to meet a singular need;

(D) no pervasive safety concerns exist, such as a custodial parent who is habitually unwilling or unable to protect the child; and

(E) other less intensive services within the community are exhausted or it is established that community resources are insufficient to prevent the child's placement in out-of-home care;

(2) family-centered services (FCS) case when:

(A) at least one child in the family is assessed as unsafe;

(B) the family is cooperative and likely to modify behaviors or conditions in the home that caused the abuse or neglect to occur with comprehensive and time-limited prevention and intervention-related services;

(C) the family does not require assistance to meet a singular need;

(D) no pervasive safety concern exists, such as a custodial parent who is habitually unwilling or unable to protect the child; and

(E) other less intensive services within the community are exhausted or it is established that community resources are not sufficient to avert the child's placement in out-of-home care;

(3) an FCS case when:

(A) the criteria in (2) of this subsection are met; and

(B) the child is residing outside of the home as part of the Safety Plan; however, the CW specialist maintains an open FCS case until after the child returns to the parent's home and is considered safe;

(4) reunification services for a family who has an active court case, including cases where the child was removed, may be removed, or was returned to the home;

(5) maintenance services for permanent placement in a kinship, adoptive, or trial adoptive home at risk of disruption due to the child's acting-out behavior.  When the disruption is due to the caregiver's behavior, the referral is discussed with and approved by the resource specialist responsible for maintaining the resource home; or

(6) foster or adoptive home maintenance when the child has an established connection or attachment to the resource family; however, CHBS is not used to maintain therapeutic placements or to rectify paid placement providers' deficient parenting skills.

(c) Exceptions to CHBS criteria.  A formal staffing with the CW supervisor is required for exceptions to the referral criteria.  OCS contract liaisons may request justification for utilizing CHBS and have the authority to reject any referral.

(d) CHBS OCS contract liaison referral guidelines.  Contract liaisons are gatekeepers responsible for priority decisions to ensure OCS resources serve the families most in need.  When the approved referral is incomplete, or a service other than CHBS is more appropriate for the family, the contract liaison contacts the CW specialist and supervisor for additional information or to recommend a more appropriate intervention.  CHBS is not specified as a required service in Form 04KI012E, Individualized Service Plan (ISP).  Contract liaisons use guidelines in (1) through (11) to determine appropriate referrals for CHBS.

(1) Physical abuse.

(A) A CHBS referral is appropriate in a physical abuse case when:

(i) the child was injured but the injury is not serious, per Oklahoma Administrative Code (OAC) 340:75-3-120, and the child is safe to remain in the home with a Safety Plan until the specified person responsible for child (PRFC) can protect the child; or

(ii) an older child refuses to return home due to a conflict with a parent that escalated to physical injury, and family members agree to work cooperatively with CHBS to resolve the conflict.

(B) A CHBS referral is not appropriate in a physical abuse case when:

(i) physical abuse to the child is considered serious or life-threatening, per OAC 340:75-3-120;

(ii) a physical abuse history exists and no PRFC is willing or able to protect the child;

(iii) the person responsible for the injury to the child remains in the home and does not accept responsibility or demonstrate a desire to change the abusive behavior; or

(iv) an infant was intentionally injured.

(2) Sexual abuse.

(A) A CHBS referral is appropriate in a sexual abuse case when the:

(i) perpetrator left or no longer frequents the home, in the case of sexual abuse by a household member or frequent visitor, and a Safety Plan is in place;

(ii) perpetrator is incarcerated or a court order exists preventing him or her from accessing the child; or

(iii) the non-offending PRFC verbalizes and demonstrates his or her willingness to protect the child and accepts CHBS.

(B) A CHBS referral is not appropriate in a sexual abuse case when the:

(i) non-offending PRFC places the child at risk of further victimization by allowing a known sexual abuse perpetrator access to the child;

(ii) sexual abuse involves multiple members of the family jointly engaging in sexual activity;

(iii) PRFC denies the child is unsafe and does not agree that treatment is necessary;

(iv) perpetrator of the sexual abuse returns to the home without court approval; or

(v) PRFC's engagement in activities, such as prostitution, extensive involvement with pornography, or association with those who participate in such activities, places the child in continued danger of further sexual abuse victimization.

(3) Neglect.

(A) A CHBS referral is appropriate in a serious neglect case when a Safety Plan controls the safety threats and the PRFC or family is willing and able to participate in CHBS.  Examples include:

(i) a child younger than 12 years of age is left alone or is left in the care of an inappropriate caregiver on a regular basis;

(ii) the PRFC is overwhelmed and neglects the child's physiological needs;

(iii) the child is diagnosed as underweight, or potentially failure to thrive, but the condition is not considered serious or life-threatening and is best addressed by educating the PRFC about emotional nurturing, proper nutrition, and feeding techniques;

(iv) the PRFC medically neglects or fails to address the health needs of an ill child and health care education is likely to strengthen the PRFC's protective capacities.

(v) the PRFC refuses to allow the child with adolescent acting-out behaviors to stay or return home due to serious parent and child conflict that requires a CW response; or

(vi) housing conditions cause the child to be unsafe and relocation or prompt repairs are likely to prevent the need for the child's removal from the home.

(B) A CHBS referral is not appropriate in a neglect case when the:

(i) neglect is long-term, chronic, and was not resolved with multiple prior CW intervention services including CHBS;

(ii) PRFC does not acknowledge a problem exists, does not want assistance, appears to be seriously mentally ill, or exhibits evidence of significant substance use or abuse; or

(iii) neglect is considered life-threatening.

(4) Substance use or abuse.

(A) A CHBS referral is appropriate in a substance use or abuse case when:

(i) the PRFC acknowledges that his or her drug use, abuse, or dependency threatens the child's safety, is willing to enter outpatient treatment for the substance abuse problem, and agrees to cooperate with CHBS to address the child's needs;

(ii) a child in the family is chemically dependent and the family is willing to cooperate with CHBS to initiate treatment options for the child and improve family communication and interaction;

(iii) the PRFC gives birth to a substance-exposed infant who does not have significant health problems, the PRFC is willing to participate in a drug use or abuse treatment program, and cooperate with CHBS to receive parenting education and skills development; or

(iv) the PRFC who completed substance use or abuse treatment services needs help in reconnecting to a healthy support system and overcoming family issues caused by chemical dependency.

(B) A brief self-assessment of drug and alcohol use or abuse and dependency is included in the CHBS multi-level assessments but there is no provision for ongoing drug and alcohol treatment services.  A CHBS referral is not appropriate in a substance use or abuse case when the PRFC:

(i) is not available for substance use or abuse treatment;

(ii) is not willing to enter treatment for a substance use or abuse problem;

(iii) has a chronic history of failing to enter or successfully complete substance use or abuse treatment;

(iv) requests that the child with a substance use or abuse problem be placed outside of the home and the PRFC does not verbalize or demonstrate a sense of commitment and responsibility to the child; or

(v) has a behavioral health condition or developmental delays that will likely result in unsuccessful and unachievable substance use or abuse treatment and cooperation.

(5) Behavioral health.

(A) A CHBS referral is appropriate when the PRFC or child has a behavioral disorder or emotional disturbance that may be stabilized by appropriate medication or therapy, and the PRFC is willing to comply with recommended treatment when:

(i) the PRFC has a behavioral health impairment that does not significantly impede the PRFC's potential ability to make necessary changes; and

(ii) the child has a serious behavioral health condition but recommended treatment is expected to stabilize the child within the family.

(B) A CHBS referral is not appropriate when the PRFC or child has a behavioral disorder or emotional disturbance when the:

(i) PRFC or child's behavioral disorder or emotional disturbance requires hospitalization;

(ii) PRFC has a significant cognitive impairment that renders the PRFC unable to learn to provide minimal care for the child and no other family member or person is available to provide long-term support or care;

(iii) PRFC has a chronic behavioral health condition with unsuccessful treatment; or

(iv) sole purpose of the referral is to purchase a psychological evaluation of the PRFC.

(6) Physical illness or limitation.

(A) A CHBS referral is appropriate when physical illness or limitation concerns the:

(i) child with a life-threatening illness and the PRFC requires support to learn to provide or obtain the necessary health care to prevent the child's out-of-home placement; or

(ii) PRFC with a severe physical illness or limitation that threatens his or her ability to meet the child's minimal needs but could provide appropriate care if help is available.

(B) A CHBS referral is not appropriate when:

(i) the child has a life-threatening illness;

(ii) the PRFC does not have the intellectual capacity to learn to provide or obtain the necessary health care; and

(iii) a homemaker, public health nurse, or family member is not available to provide the care; or

(iv) there is a low probability that adequate resources can be obtained to supplement or provide proper physical or medical care of the child.

(7) Domestic violence.

(A) A CHBS referral is appropriate when domestic or intimate partner violence occurred and:

(i) the person responsible for the physical violence left the home or is willing to participate in a certified batterers' program to address the issue;

(ii) the victim is willing to take action to protect himself or herself and ensure child safety; or

(iii) all parties to the violence acknowledge a problem exists and are willing to engage in services to address the problem.

(B) A CHBS referral is not appropriate when domestic or intimate partner violence exists and:

(i) violence is a long-term and chronic dynamic in the relationship with a repeated pattern of separation and reconciliation;

(ii) the PRFC denies violence is an issue that is detrimental to the PRFC or the child; or

(iii) violence intervention services were provided in the past, but the violence continues.

(8) Voluntary prevention and intervention-related services.

(A) A family who receives voluntary prevention and intervention-related services commonly exhibits issues of parental neglect or a combination of environmental factors that are likely to result in serious harm to the child when unresolved. To determine priority for service, the contract liaison may defer or decline a referral to CHBS or offer a shortened period of service, particularly when the family failed to cooperate with CHBS in the past.

(B) A CHBS referral is not appropriate in an FCS case, unless an exception is approved, per OAC 340:75-1-151 Instructions to Staff (ITS) # 1, when the child is determined to be safe after Form 04KI030E, Assessment of Child Safety, is completed or safety threats may be controlled with the use of contingency funds or other community resources.

(9) Reunification.  Refer to OAC 340:75-6-31.

(A) A CHBS referral is appropriate during reunification when:

(i) the child can safely return to the home, the PRFC(s) made or commits to make the changes that provide the safety and stability prescribed by Form 04KI012E; or

(ii) the family is highly motivated to cooperate with CHBS to work through barriers to have the child returned to the home; and

(iii) the family is willing to collaborate with the OCS contract staff to set goals and participate in treatment to affect the child's rapid, safe return to the home; and

(iv) at least one PRFC is available to participate with the contractor.

(B) A CHBS referral is not appropriate to facilitate reunification when:

(i) the permanency plan is not reunification;

(ii) no PRFC is willing to work with the contractor;

(iii) other, less intensive services are sufficient to enable the PRFC to achieve family reunification by completing the requirements prescribed by Form 04KI012E; or

(iv) the referral is prompted by a need for a single focus service, such as a mentor, tutor, psychological evaluation of a PRFC, or a similar service.

(10) Permanent placement.

(A) A CHBS referral is appropriate when a child is in a permanent placement when the:

(i) permanent placement is at risk of disruption and the child has established ties to the family that afford the child a permanent connection;

(ii) kinship, trial adoptive family, or the child needs assistance with learning behavior management techniques; or

(iii) kinship or trial adoptive family is willing to cooperate with CHBS to address the social or behavioral issues creating conflict.

(B) A CHBS referral is not appropriate when a child is in a permanent placement when the:

(i) resource parent refuses to accept services;

(ii) resource parent has endangered the child or other children in the resource parent's care;

(iii) child has not bonded with the resource family, but no other placement is available; or

(iv) CW specialist determines the permanent placement no longer meets the child's needs and the child will be moved.

(11) Adoption disruption.

(A) A CHBS referral is appropriate when a trial adoption disrupts or is at risk of disruption when:

(i) the child is placed in substitute care and the goal is to reunify the child with the adoptive family;

(ii) the child presents emotional or behavioral problems the adoptive parent believes may result in disruption;

(iii) the child is experiencing grief or loss issues that were not addressed;

(iv) the adoptive family may benefit from enhanced parenting skills to manage the child's special needs; or

(v) there are situational stressors to the family, such as death, divorce, or the addition of a new family member.

(B) A CHBS referral is not appropriate when a trial adoption disrupts and the:

(i) adoptive parent does not want the child returned to the home;

(ii) adoptive parent refuses to accept services; or

(iii) child, 12 years of age and older, threatened family members with physical harm.

(e) CHBS reunification referrals.

(1) The CHBS reunification referral is timed to allow the child in out-of-home care to be returned to the home no later than midpoint in the CHBS service period allowing the contractor time to observe family interactions and reinforce safe parenting behaviors.

(2) The contractor and the CW specialist develop the plan for the child's return to the home that includes the tentative return date and a schedule for overnight, unsupervised family time prior to the actual return.  Sibling integration is strategically planned.

(3) When the child is not authorized by the court to return home as anticipated and the permanency plan remains reunification, the CHBS case is closed and a new referral made when reunification is imminent.

(4) Reunification is selected as the focus of service if services are required when the court grants custody to a parent who was not previously the custodial parent, or an intact family requires services and a court case exists.

(f) CHBS kinship placement maintenance referrals.  The CW specialist consults with the resource specialist when a kinship parent's behavior jeopardizes the placement.  Prior to submitting an OCS Referral in KIDS, the CW specialist determines whether another course of action is more appropriate to correct issues with the kinship parent's behavior.  The resource specialist initiates an OCS referral to signify to the OCS contract liaison that the specialist concurs with the referral decision.

(g) OCS referral completion.  The OCS referral includes:

(1) identifying information for service participants.  The CW specialist prints a copy of the referral to ensure the address and other populated information is correct before submitting the CHBS referral to the supervisor for approval.  CHBS referrals require:

(A) identifying information for the custodial and noncustodial parent or placement provider, as applicable, and each child participating in services; and

(B) two referrals when the parents will receive services in separate households listing a different child's name on each referral, and more than one child will receive services; 

(2) the reason for the CHBS referral.  A request for CHBS identifies the specific reason for the referral, such as physical abuse, child's behavior, or environmental conditions;

(3) documentation that CHBS is the most appropriate type of service for the family.  The CW specialist documents the:

(A) specific conditions that put the child at risk of:

(i) out-of-home placement; or

(ii) placement disruption;

(B) reasons for the child's placement;

(C) prior history of abuse and neglect, explanation of safety threats, impending or present danger, and the in-home or out-of-home Safety Plan;

(D) outcomes expected from services including the specific behaviors that must change for the child to be safe;

(E) tentative date the child will be returned to the family home when reunification is the case goal or the date the child was returned.  The CW specialist:

(i) selects a date prior to the referral to signify the child resides in the home; and

(ii) selects reunification as the service focus when:

(I) the child will be or was returned home from the custody or supervision of Oklahoma Human Services; or

(II) services are required after the court grants custody to a parent who was not previously the custodial parent; or

(III) for a supervision only case;

(4) supporting documentation from the court-involved case that includes:

(A) Form 04KI030E, Assessment of Child Safety;

(B) Form 04MP046E, Family Meeting Report, when applicable; and

(C) Form 04KI012E, Individualized Service Plan (ISP) and most recent Form 04KI014E, Progress Report;

(5) supporting documentation for FCS cases referred more than 15-business days after Form 04MP078E, Family Service Agreement (FSA)/Safety Plan, is signed, includes:

(A) Form 04MP078E;

(B) Form 04KI030E;

(C) Form 04MP046E, when applicable; and

(D) Form 04KI012E; and

(6) a full description of the safety threats and conditions that must be addressed to make the child safe.

(A) A CPS specialist may initiate the referral as soon as CHBS is determined appropriate.  If at that time, Form 04KI030E was not finalized, a referral may be submitted using only Form 04MP078E, and a full description of the safety threats and conditions that need to be changed to make the child safe.

(B) A completed Form 04KI030E is forwarded to the OCS contract liaison within seven-business days of the referral date.

2. (a) Parent Aide Services (PAS) referrals.  The OCS referral is accessed via KIDS Service Log.  The referring CW specialist selects the services needed.  PAS is non-therapeutic services provided by trained paraprofessionals to encourage parenting skill development.

(b) PAS criteria.  PAS is appropriate for the PRFC who:

(1) is new to parenting and unfamiliar with how to access available resources;

(2) is likely to benefit from time-limited, non-therapeutic services;

(3) does not have a singular need, such as transportation;

(4) does not have pervasive safety concerns that require the attention of a CW specialist, such as a PRFC who:

(A) is chronically unwilling or unable to protect his or her young child;

(B) does not acknowledge a problem exists;

(C) appears to be seriously mentally ill; or

(D) exhibits evidence of significant substance abuse; and

(5) has an open CW case and would benefit from in-home parent skill-based services, while the CW specialist assesses safety.

(c) PAS exceptions.  A formal staffing with the CW supervisor is required for exceptions to the PAS referral guidelines.  OCS contract liaisons may request justification for utilizing PAS outside of the referral guidelines, deny the referral, or suggest the referral be redirected to another service.

(d) PAS OCS liaison referral guidelines.

(1) The CPS specialist may determine that a PRFC requires parenting education or assistance with maintaining a safe home environment although the child is currently deemed safe and does not require ongoing CW services.  PAS may assist the PRFC eliminate safety hazards in the home and learn sufficient parenting skills to avoid re-entry into the CW system.

(2) When the case is transferred to FCS or there is a need for PAS in the court-involved case, a parent aide may be assigned to assist the CW specialist with hands-on parenting education, transportation, budgeting, home management, and other tasks appropriate for the paraprofessional under the CW specialist's guidance.

(A) In the case with more serious threats to child health or safety, the CW specialist ensures the parent aide is provided a copy of Form 04MP078E, Safety Plan to help with ensuring compliance to the family's in-home Safety Plan, and is not assigned responsibility for assessing safety or case planning.

(B) The PAS case with complex safety issues requires coordination and guidance from the CW specialist that includes the CW specialist attending the intake staffing and regular case staffings to ensure services are effectively meeting the family's needs and controlling child safety.

(C) The CW specialist communicates the desired parent skill-based needs and behaviors directly related to the child's safety, permanency, or well-being or to preventing the child from entering foster care to enhance protective capacities that address specific conditions that caused the child to be unsafe.

(D) The parent aide is not responsible for or assigned responsibility for ensuring child safety during supervised family time.

(E) PAS is appropriate when the parent and child have unsupervised family time, are in trial reunification, or are reunified.

(e) PAS referrals.  PAS referrals contain the:

(1) identifying information for each parent and child participating in services and, information regarding the non-custodial parent who maintains a relationship with the child participating in services, when applicable;

(2) reason for the PAS referral.  The PAS referral identifies the type of maltreatment alleged in the initial referral and the parent skill-based needs to be addressed, or for permanency planning cases, the PRFC's remaining court-related requirements related to parent skill-based needs and behaviors that need to be modified to ensure the child's health, safety, and welfare;

(3) expected service outcomes.  The referring specialist documents the specific behavioral changes that demonstrate improved protective capacities expected as a result of PAS; and

(4) supporting documentation.

(A) The supporting documentation for a PAS referral in an FCS case requires:

(i) Form 04MP078E, Family Service Agreement, in conjunction with a Safety Plan, when applicable; and

(ii) Form 04KI030E, Assessment of Child Safety.  When the Form 04KI030E is not completed at the time of the PAS referral, the CW specialist may submit the referral with Form 04MP078E, and provide completed Form 04KI030E within seven-business days.

(B) The supporting documentation for a PAS referral in a court-involved case requires:

(i) Form 04KI012E; and

(ii) Form 04KI030E.

3.  (a) Title IV-E prevention services referrals.  The OCS referral is accessed via KIDS Service Log.  The referring CW specialist selects the services that correspond to the Title IV-E Prevention Plan, Form 04MP078E, Family Service Agreement (FSA)/Safety Plan, and Form 04KI030E, for a child who is a candidate for foster care or Form 04KI005E, Child's Individualized Service Plan (ISP), and Form 04KI012E, Individualized Service Plan (ISP) for a pregnant or a parenting foster youth.  Title IV-E prevention services are limited to up to 12-months for prevention and treatment rated and approved by the Title IV-E Prevention Services Clearinghouse and identified in the state's five-year Title IV-E Prevention Program Plan for:

(1) mental health;

(2) substance abuse; and

(3) in-home parent skill-based programs.

(b) Criteria for Title IV-E prevention services referrals.  Title IV-E prevention services referrals are appropriate for:

(1) an FCS case when:

(A) a child eligible for the Title IV-E Prevention Program, per OAC 340:75-3-120, 340:75-3-300, and 340:75-3-500, is identified as a candidate for foster care, per OAC 340:75-1-9 ITS; and

(B) the needs of the child, parent, or kin caregiver for Title IV-E prevention services are directly related to the safety, permanency, or well-being of the child or to preventing the child from entering foster care; or

(2) a court-involved case only when:

(A) a pregnant or parenting foster youth is in need of Title IV-E prevention

services to ensure that he or she is prepared to be a parent; and

(B) for any child born to the foster youth, the foster care prevention strategy is directly related to the safety, permanency, or well-being of the child or to preventing the child from entering foster care.

(c) Title IV-E prevention services referral documentation.  Title IV-E prevention services referrals contain the:

(1) identifying information for each parent or kin caregiver and child, or pregnant or parenting foster youth participating in services, and information regarding the non-custodial parent who maintains a relationship with the child participating in services, when applicable;

(2) reason for the Title IV-E prevention services referral.  A Title IV-E prevention services referral identifies:

(A) needs directly related to the child's safety, permanency, or well-being or to preventing the child from entering foster care, including for any child born to a foster youth;

(B) needs of a pregnant or parenting foster youth to ensure that he or she is prepared to be a parent; and

(C) specific Title IV-E prevention services that will meet those needs.

(3) expected service outcomes.  The referring CW specialist documents the specific behavioral changes demonstrating improved protective capacities that support the child's safety which are expected as a result of Title IV-E prevention services; and

(4) supporting documentation.  The supporting documentation for a Title IV-E prevention services referral in:

(A) an FCS case requires:

(i) Form 04MP078E, Family Service Agreement (FSA)/Safety Plan, also referred to as the Title IV-E prevention plan, in conjunction with a Safety Plan, when applicable; and

(ii) Form 04KI030E.  When Form 04KI030E is not completed at the time of the Title IV-E prevention services referral, the CW specialist may submit the referral, and provide completed Form 04KI030E to the OCS contract liaison within seven-business days of the referral date.

(B) court-involved case requires:

(i) Form 04KI030E;

(ii) Form 04KI005E;

(iii) Form 04KI012E and most recent Form 04KI014E, Progress Report, when applicable; and

(iv) Form 04MP046E, Family Meeting Report, when applicable. 

4.  Supervisory responsibility for CHBS, PAS, and Title IV-E prevention services referrals.  Referrals for CHBS, PAS, and Title IV-E prevention services are approved via KIDS by the CW supervisor after the CW supervisor ensures each referral is complete with eligibility determination and supporting documentation appropriate for the referral.

5.  CHBS, PAS, and Title IV-E prevention services authorizations.  The OCS contract liaison authorizes or rejects CHBS, PAS, and Title IV-E prevention services referrals approved by the CW supervisor.  An authorized referral is forwarded to the contractor for acceptance.  A rejected referral is returned by the OCS contract liaison for additional information or denied with reasons cited.  The CW supervisor and OCS contract liaison determine the priority of referrals based on greatest need.

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