R98-181RESOLUTION NO. R98-/,~'/
A RESOLUTION OF THE CITY COMMISSION OF THE
CITY OF BOYNTON BEACH, FLORIDA,
AUTHORIZING THE MAYOR AND CITY CLERK TO
EXECUTE AN AGREEMENT BETWEEN THE CITY OF
BOYNTON BEACH AND JOSEPH YATES, M.D.,
PROVIDING FOR INDEPENDENT CONTRACTOR
SERVICES AS THE EMERGENCY MEDICAL
SERVICES DIRECTOR FOR THE CITY OF BOYNTON
BEACH; AND PROVIDING AN EFFECTIVE DATE.
WHEREAS, the City Commission, upon recommendation of staff, has
deemed it be in the. best interests of the citizens, employees and residents of the
City to enter into an Agreement with Joseph Yates, M.D., to act as the Emergency
Medical Services (EMS) Director for the City of Boynton Beach, providing that the
EMS Director shall perform certain duties, including but not limited to, supervision of
the direct, medical:related activities of the EMS Program, and providing local
training and certification to paramedics of the Fire Department; and
WHEREAS, Section 401.46, Florida Statutes, requires that each Emergency
Medical Services Program have an EMS Director.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF
THE CITY OF BOYNTON BEACH, FLORIDA, THAT:
Section 1'. The City Commission of the City of Boynton Beach, Florida
does hereby authorize the Mayor and City Clerk to execute an Agreement between
the City of Boynton Beach, Florida and Joseph Yates, M.D., providing for
independent contractor services as the Emergency Medical Services Director for the
City of Boynton Beach. A copy of said Agreement is attached hereto as Exhibit "A".
EMERGENCY MEDICAL SERVICE DIRECTOR CONTRACT
THIS CONTRACT, entered into on /"70 ~ i .~' ,1998, between the CITY
OF BOYNTON BEACH, Florida (hereinafter "CITY") and DR. JOSEPH YATES, M.D.
(hereinafter "MEDICAL DIRECTOR") for Emergency Medical Services Director, is entered
into subject to the following terms and conditions:
The City of Boynton Beach and DR. JOSEPH YATES, M.D. hereby agree that the
terms of this Contract provide an outline of the working relationships and responsibilities
of the CITY and the Medical Director for the City's Emergency Medical Services Program
(EMS), which is a part of the CITY's Municipal Fire Department. The items in this Contract
in the following Sections are aimed at identifying the MEDICAL DIRECTOR's general
relationship with the CITY, his responsibility for supervising the direct medical related
activities of the EMS Program, and the MEDICAL DIRECTOR's responsibility for local
training and certification of the Paramedics. The Contract further supports the principle
that the MEDICAL DIRECTOR will receive support from the Fire Department
Administration and will direct his requests for equipment and equipment assignments;
manpower and manpower assignments; and supplies of the Fire Department
Administration and recognizes that assignments to the Paramedic Program will be made
by the Fire Chief in accordance with the overall resources and needs of the Fire
Department.
The CITY hereby contracts with the MEDICAL DIRECTOR and the MEDICAL
DIRECTOR accepts this contract as MEDICAL DIRECTOR for the CITY OF
BOYNTON BEACH Emergency Medical Services Program under the provisions
of Section 401.46, Florida Statutes, and the applicable rules of any governmental
agency implementing said Chapter or other established duties required to be
performed by said MEDICAL DIRECTOR, or upon notice from the CITY that such
additional duties have been established by the Florida Department of Health and
Rehabilitative Services. It is recognized that the MEDICAL DIRECTOR's contract
with the CITY preserves MEDICAL DIRECTOR's right to practice as an
independent physician at all times.
The MEDICAL DIRECTOR shall accept responsibility for the medical performance
of the Emergency Medical Technicians, Paramedics and certified Emergency
Medical Dispatchers employed by the CITY and serving in the Emergency Medical
Services Program of the City Fire Department, herein referred to as EMS. The
Medical Director shall be responsible directly to the City Manager; however,
nothing herein shall in any way authorize any limitations or restrictions by the City
Manager on the professional acts or advice of the Medical Director.
The Fire Chief, through the Department staff and operation procedure, will
establish Department polic~ for equipment and equipment assignment, and for
supply purchase and use. The MEDICAL DIRECTOR, in conjunction with the Fire
Chief, shall establish dispatch procedures and priorities. The Fire Chief will
establish Department policy for manpower assignment in conjunction with
recommendations made by the MEDICAL DIRECTOR.
The MEDICAL DIRECTOR shall perform all services required pursuant to Chapter
401, Florida Statutes; Section 401.46, Florida Statutes; Chapter 64E-2, Florida
Administrative Code; duties and regulations promulgated by the Florida
Department of Health and Rehabilitative Services; and all present rules and
regulations of any governmental agencies implementing said Chapter or other
established duties required to be performed by said MEDICAL DIRECTOR.
The MEDICAL DIRECTOR shall serve as the Fire Department's physician for
purposes of advising the Fire Chief on matters pertaining to occupational safety
and health. MEDICAL DIRECTOR shall serve as the Medical Director for the
City's Life Guards, who may be certified as Emergency Medical Technicians.
The MEDICAL DIRECTOR agrees to both directly and indirectly supervise and
accept responsibility for the medical performance of Emergency Medical
Technicians, Certified Emergency Medical Dispatchers, and Paramedics
functioning for the EMS and shall have full authority to direct and supervise the
medical activities in the field, in training and for certifications. Such supervision
shall be accomplished by, but not limited to:
A. Actual accompaniment of Paramedics and EMT's on rescue calls.
B. Monitoring of radio transmissions to and from hospital emergency
departments and related facilities.
C. Review of incident reports and associated documentation, and
D. Conference and/or meeting in both individual and group situations.
Review of standard operating procedures and protocols involving multi-
agency responses to medical emergencies.
These duties will be performed periodically by the MEDICAL DIRECTOR at
his/her convenience as often as is necessary to insure that proper medical
standards and procedures are being followed. Cost for supplying necessary in-
service instruction material will be assumed by the CITY and the material will
become the property of the CITY. Further the EMS Coordinator shall be the
MEDICAL DIRECTOR's agent for purpose of quality assurance pursuant to
Florida State Statute.
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10.
11.
12.
13.
The MEDICAL DIRECTOR shall have the services of the Departmental training
program, facility and staff to assist in carrying out training requirements for the
EMS. MEDICAL DIRECTOR shall participate in daily in-service training
scheduled by the Fire Department.
The MEDICAL DIRECTOR shall be eligible as a member as defined under
Section IV. Members of the Agreement between the City of Boynton Beach and
Florida Municipal Liability Self-Insurance Program. Coverage under this
agreement shall be limited to the scope of duties as MEDICAL DIRECTOR for the
City of Boynton Beach Fire Department as outlined in Florida Statute, Section
401.46 and Florida Administrative Code, Chapter 64E-2, as set forth in Exhibit "A"
to this Agreement.
MEDICAL DIRECTOR shall provide the Fire Chief with written reports as required
by Fire Chief regarding efficiency, effectiveness, and general performance of the
CITY's Emergency Medical Services System.
The provider shall indemnify and save harmless the MEDICAL DIRECTOR from
any and all liability for acts or omissions committed by the MEDICAL DIRECTOR
while acting in the capacity as Medical Director of the Boynton Beach Fire
Department, but said indemnification shall be to the extent only of any amount
due and owing from MEDICAL DIRECTOR which exceed applicable insurance
coverages maintained either by MEDICAL DIRECTOR or by the CITY on behalf
of MEDICAL DIRECTOR.
The provider shall indemnify and save harmless the MEDICAL DIRECTOR from
any and all liability incurred as a result of acts or omission of employees of the
City of Boynton Beach Fire Department.
The CITY will pay the MEDICAL DIRECTOR the sum of TWENTY THOUSAND
FOUR HUNDRED DOLLARS AND 00/100 CENTS ($20,400.00) with the monthly
rate being ONE THOUSAND SEVEN HUNDRED DOLLARS AND 00/100 CENTS
($1,700.00) per month for twelve (12) months, payable at the end of each month
for services outlined in this contract.
The CITY will provide portable radio communications and an Alpha Numeric or
Digital Pager for the use of the MEDICAL DIRECTOR.
In matters of employee relations and concern, the MEDICAL DIRECTOR, under
the terms of this contract is considered to be a member of the administration and
supervisory division of the Fire Department and will be expected to aid the Fire
Chief as the Fire Chief carries out grievance procedures, discipline, interviewing
paramedics, paramedic school assignments, and union contract administrative
requirements.
3
14.
The MEDICAL DIRECTOR will be expected to report to the Fire Chief the
Circumstances relating to any employee decisions for the Emergency
Medical Services System such as discipline, de-certification or promotion in
which the MEDICAL DIRECTOR is involved.
Bo
The MEDICAL DIRECTOR agrees to participate as required at personnel
hearing boards such as the Civil Service Board, grievance procedures of the
union contract, etc. as a part of his Department administrative
responsibilities of the Department without additional compensation,
The MEDICAL DIRECTOR agrees to participate in the oral interview and
skills test administered to all new firefighter applicants who have a
paramedic certificate prior to their employment. MEDICAL DIRECTOR
retains the right to prevent the hiring of any such individual for the purpose
of employment as a paramedic if he or she does not perform satisfactorily
during the interview and/or skills test. The content of the skills test will be
in accordance with current standardized criteria set up by the American
Heart Association and American College of Emergency Physicians.
The MEDICAL DIRECTOR agrees that anytime a firefighter employed by the
City of Boynton Beach wants to attend paramedic classes for purposes of
becoming a licensed paramedic they must have written approval by the
MEDICAL DIRECTOR prior to attending and/or enrolling in such classes.
From time to time the MEDICAL DIRECTOR will be expected to attend
Department administrative staff meetings so that he can give input to the
administrative staff on the needs and status of the EMS Program and so that he
can become involved in and informed of Departmental Standard Operating
Procedures relating to:
A. Response procedures
B. Equipment and personnel allocations
C. Department priorities
D. Departmental procedUres for handling emergencies
E. Working with other departments
F. Emergency medical dispatching
G. Infectious disease procedures
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15.
16.
17.
18.
19.
20.
Any staffing changes that result in modifying the Department's current EMS
response protocols must be cleared through the MEDICAL DIRECTOR.
Either party to this contract may, upon giving thirty (30) days written notice to the
other .party, may terminate this contract for any reason whatsoever, and after the
effective date of such notice all parties will be relieved of any further obligations
under this contract.
The MEDICAL DIRECTOR will assure the continuous availability of at least one
qualified physician as Director who shall serve as Acting Medical Director in the
absence of the MEDICAL DIRECTOR. In addition, the MEDICAL DIRECTOR will
notify the Boynton Beach Fire Rescue Department whenever he/she will be
unavailable for whatever reason, and will attempt to provide twenty-four (24) hour
prior notification of such unavailability except under emergency circumstances.
The notification shall be given to the Office of the Fire Chief, and shall include the
name and telephone numbers of the Acting Medical Director.
Upon request, the MEDICAL DIRECTOR will advise the Department on
appropriate procedures to address incidents in which an employee of the Fire
Depa.rtment has been or may have been exposed to infectious diseases or
hazardous materials.
MEDICAL DIRECTOR hereby agrees to perform those duties set forth in Exhibit
"A" and in the Specifications for the position set forth in Exhibit "B." Exhibit "A"
and "B" are attached hereto and incorporated herein.
This term of this agreement shall be one (1) year from the date of execution, with
CITY.having the option to renew on a yearly basis for the next two (2) years, by
providing written notice to MEDICAL DIRECTOR at least twenty (20) days prior
to the expiration of the term that the CITY 'intends to renew the contract for an
additional year. MEDICAL DIRECTOR shall indicate whether he or she wishes
to remain a party to the agreement prior to the expiration of the term.
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IN WITNESS WHEREOF the parties hereto have caused these presents to be
signed by their duly authorized officers and by the MEDICAL DIRECTOR on this
day of .,,,~~,~,~ ,1998.
WITNESS:
WITNESS:
CITY OF BOYNTON BEACH, FLORIDA
MEDICAL DIRECTOR
/// /
PRINT~AME '
ATTEST:
City'Clerk
CMS DIRECTOR
6
EXHIBIT "A"
Be responsible for advising the ALS provider as to his assessment of the competence
of each of the provider's paramedics and for making recommendations regarding the
medical procedures which each paramedic should be authorized to perform. Such
assessment should be made by utilizing reasonable evaluative processes and
techniques and should include at least assessment of each paramedic's ability to:
A. appropriately evaluate emergency medical patients and determine proper
priorities for emergency medical care;
communicate the findings of such evaluation to a physician who has agreed, in
writing, to provide responsible supervision of that paramedic;
C. receive and understand proper orders from a physician providing direct
supervision of the paramedic;
understand and properly apply any standing orders authorized by the Medical
Director;
understand legal relationship between the paramedic, Medical Director,
physician(s) under agreement to provide responsible supervision 'of the
paramedic and any other physician;
insure that any ALS performed by the paramedic is done with responsible
physician supervision; and
G. perform the specific medical procedure(s) which the paramedic is specifically
authorized by the Medical Director and by the ALS provider to perform.
Continually evaluate the medical capability of the paramedics and the ALS provider and
advise the ALS provider regarding the appropriate level and standard of care which the
ALS provider should seek to achieve.
3. Assist in identifying the specific medical skills and knowledge which paramedics must
possess to achieve the desired level and standard of care.
Assist in identifying the training and experience necessary for the paramedics to
acquire the desired skills and knowledge and, in cooperation with approved
educational programs, in assuring that each paramedic receives such training and
experience as required.
7
Develop and implement an appropriate process for periodic audit and review of medical
procedures performed by paramedics. Such audit and review process must comply
with such standards and requirements as may be set forth by the Department from time
to time.
Develop and authorize or review and authorize for use standing riders which allow the
paramedics to properly manage certain medical emergencies when voice
communications with the responsible physician is not available. Such standing orders
must be specified and must at least provide for managing immediately life threatening
emergencies though they are not required to be so comprehensive as to include all
possible medical emergencies.
Be responsible for the medical correctness of any standing order which he authorizes
for use by the paramedics and for properly instructing the paramedics regarding the
correct use of standing orders.
Assist the ALS provider in assuring continuous availability of at least one responsible
physician. Determine the qualifications necessary for a physician to provide
responsible supervision of the paramedics.
Retain the ultimate authority to permit and/or prohibit any system paramedic to utilize
ALS techniques. (Specific authority 401.35, 381.031(1)(g), 20.05(5) FS. Law
implemented 401.46, 401.47 FS. History New 9-10-78).
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EXHIBIT "13"
SPECIFICATIONS
FOR A
MEDICAL DIRECTOR TO OVERSEE THE EMERGENCY MEDICAL
SERVICES AS PROVIDED .BY FIRE_._RESCUE/EMTS
The City of Bo.ynton Beach is seeking to employ a Medical Director to oversee the Emergency
Medical Services as provided by Fire Rescue, as well as other departmental administrative
purposes and functions. The Medical Director will be an independent contractor supervising and
accepting responsibility for the medical performance of Emergency Medical Technicians
(EMTs), Paramedics, and first responders/life guards functioning in the Fire and Emergency
Medical Services Department and the Parks and Recreation Department under applicable
provisions of Florida Statutes.
Standards to be met by the Medical Director
A. The Medical Director shall be a Florida State licensed physician; and
Is an ACLS (Advanced Cardiac Life Support) provider with instructor
certification, and is an ACLS affiliate faculty member of the American Heart
Association; or
Is a Board-Certified Emergency Physician, or is currently employed as an
Emergency Department Physician in the State of Florida, or who has previously
been an Emergency Department Physician in the State of Florida within the past
(5) five years;
Maintains official privileges and affiliation with one or more of the following
medical facilities: Bethesda Memorial Hospital, Dekay Community Hospital,
Boca Raton Community Hospital, or John F. Kennedy Hospital.
II.
Related Responsibilities
A. The Medical Director serves as the Fire Department's physician for the purposes
of advising the Fire Chief on matters pertaining to occupational safety and health.
B. The Medical Director serves as the Medical Director for the City's Life Guards,
who may be certified as Emergency Medical Technicians.
B-1
EXHIBIT "B"
SPECIFICATIONS continued ......
C. The Medical Dkector agrees to both directly and indirectly supervise and accept
responsibility for the medical performance of Emergency Medical Technicians
and Paramedics functioning in the Fire and Emergency Medical Services
Department and the Parks and Recreation Department. Such supervision shall be
accomplished by, though not limited to:
D. Actual accompaniment of Paramedics and EMTs on rescue calls
E. Monitoring of radio transmissions to and from hospital emergency departments
and related facilities,
F. Review of rescue incident reports and associated documentation,
G. Conference and/or meetings in both individual and group situations,
H. Review of Standard Operating Procedures and Protocols involving multi-agency
responses to medical emergencies,
I. Active participation in daily in-service training scheduled by the Fire Department.
These duties will be performed periodically by the Medical Director at his/her convenience and
as often as is necessary to insure that proper medical standards and procedures are being
followed. The Medical Director shall provide the Fire Chief with written reports as required by
the Fire Chief regarding efficiency and effectiveness and general performance of the City's
Emergency Medical Services System.
1II. The Medical Director shall perform all services requked of him pursuant to Chapter 401,
Florida Statutes, and the applicable rules of any governmental agency implementing said
Chapter' or other established duties required to be performed by said Medical Director, or
upon promulgation of additional duties established by the Florida Department of Health
and Rehabilitative Services.
IV. The Medical Director shall give necessary instructions to the City's Emergency Medical
Technicians (EMTs) and Paramedics and supervise and arrange such in-service
instructional sessions, and promulgate such rules and directives, as may be necessary to
assure that all medical services performed by EMTs and paramedics are in accordance
with proper medical standards and procedures.
· In addition, the Medical Director shall participate in general Paramedic staff meetings at a
time and date mutually agreeable with the Medical Director and the Fire and Emergency
Medical Services Department; provide sufficient didactic lecture and instruction to insure
that standards of emergency medical care are maintained, review and comment on comment
and emphasis on in-service training and testing procedures; and shall initiate a review of all
pre-hospital emergency medical service protocols and levels of personnel and equipment
response at least every six months to detemine their applicability and appropriateness with
respect to currently accepted emergency procedures. Recommended revisions of said
protocols or response procedures shall be furnished to the Fire Chief.
B-2
sPECIFICATIONS continued ......
EXHIBIT "B"
Services and responsibilities:
A. The Medical Director will assure the continuous availability of a least one qualified
physician as outlined in Section I, who shall serve as Acting Medical Director in the
absence of the Medical Director.
In addition, the Medical Director will notify the Boynton Beach Fire and Emergency Medical
Services Department whenever he/she will be unavailable for whatever reason, and will
attempt to provide 24 hour prior notification of such unavailability except under emergency
circumstances. The notification shall be given to the office of the Fire Chief, and shall
include the name and telephone numbers of the Acting Medical Director.
B. The Medical Director will provide liaison services as required and requested between
the Fire and Emergency Medical Services Department of the City, and other
departments, divisions, boards and bodies of the City, County and the State of
Florida, as well as educational, institutions, medical societies and other agencies or
institutions relating to the provision of Emergency Medical Services.
C. The Medical Director will retain ultimate authority to permit or deny any Paramedic
or EMT the utilization or advanced life support techniques, basic life support, patient
assessment, or patient stabilization procedures. Upon request, the Medical Director
shall advise the Fire Chief or the Director of Parks and Recreation, if appropriate, on
disciplinary recommendations related to medical care.
D. The Medical Director shall cause to be administered a protocol examination on a
regular basis to determine the competence of all EMS personnel covered by this
agreement.
E. Upon request, the Medical Director will participate in the design and structure of
selection procedures for entry level personnel for the City of Boynton Beach.
F, Upon request, the Medical Director will consult with the Fire Chief regarding
promotional testing criteria for incumbent personnel.
G. Upon request, the Medical Director will advise the department on appropriate
procedures to address incidents in which an employee of the Fire and Emergency
Services Department or the Parks and Recreation Department's Life Guard unit, has
been, or may have been, exposed to infectious diseases or hazardous materials.
H. Upon request, the Medical Director will maintain data regarding the status of
employees who have been, or may have been, exposed to the infectious diseases or
hazardous materials.
B-3
sPEcIFICATIONS continued ...... EXHIBIT "B"
Upon request, the Medical Director will provide oversight and instruction to assist in
the preparation of personnel in the Fire and Emergency Service Department in
professional competitions which may be selected by the Department.
At his/her election, the Medical Director may util/ze the services of a Licensed
Physician Assistant who shall be designated as a Deputy Medical Director to facilitate
the delivery of the services enumerated in the Medical Director's contract.
However, re. sponsibility for the efficient delivery of these services shall remain with the
physician selected as the Medical Director and no increase in the annual fee shall occur based
on this election.
Upon request, the Medical Director will provide oversight and instruction during
department scheduled in-service training. The Medical Director will devote no less
than 6 hours per month for this type of training.
Consideration of the City of Boynton Beach
Because the Medical Director may be subject to the risk of certain liabilities by entering
into this agreement, the City will obtain and pay the annual premium on a medical
malpractice insurance policy insuring the Medical Director against liability arising out of
negligent acts or omissions of the Medical Director in the performance of his duties as
Medical Director during the term of this Agreement. If this insurance policy provides
coverage on a premium of this policy for a coverage period ending not less than four (4)
years following termination of employment of the Medical Director, the provisions of
this paragraph shall survive termination of this Agreement, regardless of whether
termination is by the Medical Director or by the City, or by expiration of the term of this
Agreement, until four (4) years after termination.
In addition, the City shall reimburse the Medical Director for registration fees, travel,
hotel and meals to permit the Medical Director or the Deputy Medical Director to attend
professional conferences pertaining to Emergency Medical Services in each fiscal year
provided, however, that such expenses to the City shall not exceed four hundred dollars
($400.00) in any fiscal year, and provided further that such funds are provided for in the
annual budget of the City in any fiscal year during the term of this Agreement. Approval
of any such professional conferences shall be at the sole discretion of the Fire Chief, and
city travel policy guidelines shall apply to individual and specific expense categories.
The Medical Director at-his/her sole discretion, may elect to have these funds
incorporated into his/her basic fee for service and in such case, the preceding conditions
of Section VIII shall not apply.
Appropriate communications equipment such as a portable radio,, digital pager, etc., may
be provided to the Medical Director and the Deputy Medical Director, if applicable, by
the city.
13-4
sPECIFICATIONS continued ......
EXHIBIT "B"
The Medical Director shall be directly responsible to the Chief of the Fire and Emergency
Medical Services Department of the City. The Fire and Emergency Medical Services
Department will provide limited and department related administrative and secretarial
support .to the Medical Director through the Office of the Fire Chief.
The Fire and Emergency Medical Services Department, through the Office of the Fire
Chief, and the Parks and Recreation Department, shall cooperate to the greatest possible
extent in the delivery of competent emergency medical care, including implementation of
the policies established by the Medical Director and approved by the Fire Chief.
In consideration of the requirements and standards enumerated herein, I propose to
perform these functions and duties for a fee of $1700.00 monthly. I am able to assume
these responsibilities:
Signature
Date
//
ATTACH COPIES OF ALL REQUIRED LICENSES, CERTIFICATIONS
DOCUMENTATION OF PRIVILEGES AND AFFILIATIONS, A CURRICULUM VITAE,
ALONG WITH THE OTHER MATERIALS YOU WISH TO HAVE CONSIDERED BY THE
CITY AS PART OF THIS REQUEST FOR QUALIFICATIONS/SERVICES. 1N ADDITION,
ALL CURRENT AND ANTICIPATED CONTRACTUAL AGREEMENTS NAMING THE
PHYSICIAN AS MEDICAL DIRECTOR FOR THE OTHER GOVERNMENTAL AGENCY,
BODY, INSTITUTION OR PRIVATE OR PUBLIC SERVICE SHALL BE IDENTIFIED AT
THE TIME OF SUBMISSION OF THIS REQUEST FOR QUALIFICATION/SERVICES.
EVALUATION PROCEDURE:
All physician chndidates will be interviewed by a panel of fire rescue personnel to include fire
administration and shift officers with paramedic certification. Interviews will focus on
experience in pre-hospital EMS, medical training and experience, medical organization
affiliations, certifications and instructor certificates and/or experience, and experience in dealing
with fire rescue organizations.
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