THE SPECTATOR: WHAT’S THE REAL STORY?

  

The Washington County Commissioners are set to vote on a new budget and tax rate Tuesday morning during their 9 o’clock meeting.  How much that total budget will be is unknown, as County Judge John Durrenberger told us he “won’t know until we vote on it”.  That sounds a lot like the US Congress, doesn’t it?  What we know for sure is that our property taxes are going up by an amount that will bring in an additional $1.6 million in revenue, a 7.22 percent increase in revenue for the County over last year.  We also know that the most recent budget total made public is more than $44.5 million.  That’s almost $4.3 million dollars more than this past year, a 10.7 percent increase! 

So, what is prompting this huge budget and tax increase?  Could it possibly be from the ever-growing deficit of the Washington County EMS Department?  A recent independent audit revealed that the EMS fund balance had a $1.7 million deficit at the end of 2022.  The auditor said that over a half million dollars of that loss occurred in 2022 due to “an increase in expenditures over budgeted transfers from the general fund.”  In layman’s terms, the EMS Department spent more than their budget.

We know that a large portion of that deficit is coming from the new Air Ambulance program that the County is funding completely.  Yes, I know we’ve been told many different things by the County Judge and Commissioners…everything from “it won’t cost County residents a thing”, to “it will only cost county residents about $3 per year”.  But now the story has changed, as Commissioner Kirk Hanath said “It’s not designed to make money.  It’s designed to save lives.”  Hanath continued saying “We understand that in an $8 million (EMS) budget, putting $1.7 million dollars of taxpayer money into it is not necessarily a loss for this community, it’s a gain!”  Hanath also said that the deficit would be addressed in the budget.  That part he got right…as tax revenue is going up over 7 percent, bringing in an additional $1.6 million in revenue.  Hmmm, that’s almost the same amount as the EMS Department deficit.

I’ll be the first to say that I want the option of an air ambulance transport if I ever need it.  But I’m tired of not being told the real story about this program’s cost.  In 2022 EMS Director Kevin Deramus projected the program to make a profit of $300,000.  And in the worst-case scenario, he said it might cost the County $250,000 a year.  But Deramus said “I think it’s worth it.”  Since then, all we have heard is excuses about insurance companies not wanting to pay.  Big surprise there.  What Washington County citizens deserve is to be told the “real story”, about the EMS Department and the entire County Budget.

And that’s the way it looks to this Spectator.

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44 Comments

  1. I think one of the things that has changed that NO ONE is addressing in this heli mess is the fact that we no longer have a Level 3 trauma center in county, and we also do not have pulmonologist, cardiologist, an MD on duty in the ER, no icu at the hospital and if it’s all the same to the rest of you-I’d rather have it and not need it rather than the other way around. Think about it. You’re at home and have had a major stroke. Or heart attack. Would you rather need air transport and not have it-or have it here and available?

    1. This. As BSW Brenham chooses to provide less local ER and hospital critical care (as stated, cardiac, pulmonary, trauma, ICU), rapid distance transport becomes even more critical. Perhaps it can be provided more efficiently as others have stated. Thank you for opening this discussion for the public to learn & consider!!
      I for one remember when the transport from Burton to lifesaving care in Brenham was in the back of someone’s station wagon.
      (Usually Sid Stevenson’s for those old enough to remember!)
      It’s hard to imagine now how that feels – helpless & frightening for a child.
      Glad things have improved over the years, and hope we don’t slowly revert to less rural care due to lack of reimbursement to hospitals.
      THANK YOU to ALL our first responders- medical, fire, law enforcement!!

    2. Gramma,

      You raise valid and concerning points about the decreasing level of resources available within the county itself, but I would disagree with your assertion that it’s better for Washington County to have their own helicopter. As pointed out elsewhere, Washington County is not in the middle of an Air Medical desert, indeed, anywhere in the county can be reached within 9-25 minutes in any direction by the other legacy Air Medical providers that surround the county, all of whom hold higher accreditation and higher levels of capability than the county-ran program. The issue remains that we are now saddled with a service that we previously were told we didn’t need, by some of the some of the exact same folks that are now telling us we need it. I firmly believe that if the program had been billed as an EMS only program from the start, it would have never been approved, due to the lack of use demonstrated from the county. No one is looking to place a helicopter in a county that flies 10 or less patients in a month, much less 10 or less in a year, which was the previous amount. However, it being billed as a “Multi-mission” program, with rescue and fire capabilities in addition to EMS, cracked the door open. Well, that was over three years, and one vendor ago. Now, rescue has been dropped from the menu, and as fire goes, I’m not sure you’ve noticed, but “cooperation” isn’t the common theme between the EMS and Volunteer Fire Departments. I think they’d sooner gather around and spit on a fire rather than call that particular aircraft for assistance. To wit, I’m not certain it’s ever been used, even once, for that purpose. So now, all we are left with is the EMS use, again, which we were told we didn’t need, and probably wouldn’t have been approved as a stand-alone program to begin with. I would ask you, is it worth $3 million of our tax dollars (or whatever it is now), to have a Washington County branded aircraft stationed in the far north of the county, and frankly not much closer than the other programs to a majority of the county, just to say “well, it’s better to have it and not need it, than need it and not have it”? At the end of the day, this is not what we opened the door for over three years ago. What we were promised was a multi-mission aircraft, at almost truly zero cost to the taxpayer. Now, we have a single mission aircraft that costs the county more every month than the previous vendor charged for an insurance plan to cover the county for an entire year, the only actual cost the county saw. These are not opinions, these are the facts. I would encourage everyone to go back through since the original program inception, and read the promises and numbers quoted, and see how far we’ve come since the beginning.

    3. My brother had a heart attack in July the chopper was unavailable because it was out probably on a lesser medical emergency the ground unit had to stop twice to bring him back before getting to college station and he is still with us .The chopper needs to available for emergencies like this only.

    4. The ER at BSW in Brenham is staffed 24 hours a day with a physician. There is additional coverage 12 hours a day by a mid-level provider. (Nurse practitioner or PA).

  2. As a first responder, I know that there is the golden hour, which is ticking away at a emergency scene. Anyone who travels Highway 290 or 105 can attest to the tremendous increase in traffic, resulting in accidents. Seldom are these non-entrapments and require special attention and need immediate medical care. We are fortunate to have air EMS in our county and in surrounding counties. I support the value of a persons life, realizing that not every injury may appear to be life-threatening. There are a lot of factors into why someone could be transported by air rather than the time it takes for ground service. The comments demonstrate there is a interest in our air EMS, the selection of the helicopter, staffing, and the cost. Let’s all stay aware over the long haul. Thank You Commissioner Bullock for your information.

  3. At times, I think they use the helicopter to transport patient when it’s really not necessary. They do this to generate revenue because the air medical branch is operating in the red on $$. I have a friend they tried to transport when he didn’t think it was necessary (and it wasn’t) and he told them no thanks. This is what happens when elected officials use taxpayer dollars to buy a lemon. They keep throwing our money at it and then use broad and asinine statements to continue justifying their folly to citizens. Sounds like some conservatives have decided to effectively join the Democrat Party … no one wants to push granny and her wheelchair off the cliff … right??!!! Old school scare tactics to generate support and votes. Gimme a break.

  4. The Spectator raises some important questions, and I believe the time has come for a frank conversation regarding the need for a dedicated aircraft operated by Washington County. At the program’s inception, it was touted as a multi-mission aircraft, serving in EMS, Fire, and Rescue roles. After the departure of REACH Air Medical Services, the rescue mission was abandoned, likely due to the increased cost associated with maintaining proficiency in helicopter hoist operations, an important consideration as the county is now financially responsible for flight hours accrued, instead of a large corporation. The “Fire” mission has been retained, but with questionable utility, given the relatively small payload provided by the aircraft in comparison to dedicated fire fighting aircraft. I could be mistaken, but I don’t think anyone was on the phone asking for our help with the Huntsville fires recently, instead relying on larger firefighting aircraft. This brings us to EMS use. As pointed out by others, the citizens of Washington County do have, and have had, access to air medical services outside of the county run program. Travis County STAR Flight is a 25 minute flight from Burton. PHI is 14 minutes from Brenham. Memorial Hermann Life Flight is 15 minutes from Chappell Hill. St Joseph Air Med is 9 minutes from Somerville. Clearly, the access to established air medical providers is not limited, or excessively far away. Indeed, in the year prior to the original program, air medical was utilized less than 10 times in a calendar year, yet last June through December, the aircraft transported 167 patients, with estimates of transporting upwards of 300 patients annually. Has Washington County suddenly become an epicenter for misfortune? Or perhaps overuse of the aircraft in attempts to justify its existence is to blame. At the end of the day, would it be nice to have an aircraft? Sure! Do we need it? No, probably not. As the saying goes, it’s hard to have champagne taste on a beer budget.

    1. Other important needs in the county have been put on hold in order to support the money pit and the dreams of EMS Director and some in our County Government. This problem will not get better with time.
      The other important needs that I’m referring to is that several years ago the Road and Bridge Department was relocated to make room for a much needed Courthouse Annex which would have been located next to the Sheriff’s Department. The Courthouse is outdated and unsafe for those working in the judicial system of government. No metal detectors prior to entering the courthouse. The courtrooms are overcrowded during docket days seating both felony inmates and citizens while conducting business. The same applies to the County Court at Law Courtroom. Our neighboring counties have all invested in secure Annex Facilities choosing to spend their funds on more relevant needs and not dumping hard earned taxpayer money into a money pit.

    2. As I read your comment I realized that you have hit the nail on the head! We in Washington County have become a community with champagne tastes on a beer budget! Literally and figuratively!! Washington County used to be a community of hard working people of German and Polish/Czech decent with pretty much a beer budget. We have let all these folks move in from Houston and the likes who have brought with them their champagne tastes without the hard working attitude to back it up. Now our county and city government have horrible issues and so do our school district and our law enforcement. If we had a majority of people in this county that had that hard working, living within your means attitude instead of the ‘gimme’s” we’d have a much better community!

  5. What I find extremely interesting is how many patients are being flown. Before this helicopter was put in service, the likelihood of someone being flown was minimal and rarely happened. Once this helicopter was placed in service, they started flying multiple people a day. The question is, what changed overnight? I’ve been in healthcare for a little while, and I can say I feel like they are flying people not just because they think they need it but mostly because they need to find a way to recoup costs. Now, with that being said, I would like to see Washington County EMS’s protocols for what constitutes a flight. Most services in Texas have this protocol. Instead of worrying about building new stations and putting more squads in service Kevin needs to focus on putting more ambulances in service to cover the call volume and allow fire departments to perform first responder. If the fire departments were open to running first responder calls that would alleviate some of the call volume especially lift assists with no injuries. Or the amount of lives that could be saved in cardiac arrests. There is a lot of options to reduce cost but I think Kevin is more worried about his “legacy” than he is patient care.

  6. What is greater than the EMS deficit is the ego of Mr Deramus. There’s only been one constant factor when problems arise within EMS and he’s still the chief.

    The initial air ambulance program which first commenced on 4/27/2020 was at near zero cost to the tax payer and no financial risk to Washington County. Unfortunately Mr Deramus was not satisfied with a vendor putting safety before ridiculousness and had the contract terminated. The shiny new helicopter is costing the county almost a quarter of a million dollars per month. Yes, $250,000 per month just to operate where as years earlier the EMS director was adamant that there was no need for an Air Ambulance in Washington County.

    Adding insult to injury, Washington County chose to not follow national standards with Air Ambulance certification and ditched the CAMTS (Commission on Accreditation of Medical Transport Systems) certification. Since the decision for the county to operate its own helicopter, hospitals have now refused to use the Washington County Air Ambulance. The decision not to meet the Air Ambulance standards including removing nurses from the helicopter was a terminal decision by Mr Deramus. What could have been an amazing opportunity in Washington county is now a joke in the Air Ambulance industry.

    The other problem which is being kept a well guarded secret is that the Washington County is attempting to fly patients which quite frankly don’t meet the needs or medical necessity required by medical insurance companies. Mr Deramus bragged about how fine the insurance payer mix was Washington County and how profitable an Air Ambulance would be. Not the case is it!

    Mr Deramus decided on having the expensive EC145 helicopter despite being very costly to operate compared to other helicopters. Why wasn’t a cheaper alternative selected when the county decided to cowboy the operation?

    This is to be expected when you have a well spoken politician who always finds the right words to appease the masses.

  7. Thank you Spectator for asking the tough questions. Let’s all remember that Commissioner Hanath was elected originally on a strong conservative platform to challenge the costs for a local county water district nearly two decades ago. It was a plan to monitor the well water and excessive pumping of local groundwater. He worked hard to kill the local water district and soon after, he then was elected into office on that conservative “low cost -small government” platform.

    I wonder what that younger penny-pinching low-tax advocate Kirk Hanath would have to say if he met the current man in office who is blowing through millions of taxpayer dollars annually to fund a money-losing helicopter EMS program?

  8. Lets us all go back to the way it should be. You get called. Your bills are frozen, you job is there when you get back. No exceptions. You serve 2 years. Then the next crew comes in after that. This way. It’s by the people only. No pay. Then we make the decision not the one’s getting paid for it. We save money and we only have our own selves to blame. That’s how it was meant to be. I agree with this. Do you. Let’s vote as a community on this

  9. Sheep (commissioners) being led by the sheep herder (county judge). Kinda like boss hog in the dukes of hazard. Spectator is like uncle Jesse fighting for what’s right. We need some Bo’s, Luke’s, and Daisies to step up and help out!!

  10. This article is categorically false and speculative. As Trump likes to say, “fake news”! It was reported that the EMS Department is “in the red” or as otherwise is experiencing a $1.7 million dollar “deficit”. We cannot express this any other way than false and misleading. Mr. Crane, the outside auditor, reported a transfer from the General Fund of $1.67 million into the EMS Fund, which he said has increased over the years, which is in fact correct. However, what you must understand is that the $1.67 million dollar transfer was the total amount of tax-payer revenue required to “fund” the EMS budget. In fact, the EMS department is the only public safety department that has the opportunity to offset/subsidize tax dollar allocations (i.e., Operating Expenses) with significant revenue. The EMS Department in 2022 had an amended budget of $5.66 million dollars. 82% of the $5.66 million in operating expenses was funded by “fees for services” (i.e., revenue), which consist of payments from insurance, grants, donations, etc. Additionally, there are reports that the aviation division is costing the tax-payers millions. Again, this is categorically false. In truth, if we removed the aviation division from the EMS budget in 2022, we would reduce operating expenditures by $1.4 million dollars, however we would also be removing $1.89 million dollars in generated revenue. This theoretical removal would actually be a $400K net loss to the tax-payer! Did you know that to date less tax dollars go towards funding EMS than ANY other public safety department/office (Dispatch, Fire, Jail, Police, Sheriff’s Office) in Washington County or City of Brenham! In close, it is understandable that many do not understand the “mechanics” or expense to revenue ratio within EMS therefore I believe a public forum is in order – that way anyone willing to participate can be informed and the integrity of public officials like myself will not be called into question seeing that I love my community just as much as anyone else.

      1. The audit, budget and revenue should all be subject to Freedom of Information requests. There should be no hesitation on the part of the County to not immediately release it. It does not meet the criteria to be withheld. Any FOIA request that the County wishes to suppress can be referred to the Texas AG for ruling. Hopefully they won’t drag their feet or require the requester to pay for copies. Or maybe just request digital copies.

        The 2024 budget should have been posted prior to any action by the CC. This is called open and transparent government. A transparent government would post the documents prior to the budget process and frankly for all CC sessions. Just posting an agenda does not provide citizens enough information to see how their government is functioning. This is normal process in other Texas Counties. This issue is probably indicative of a non transparent government and a larger issue.

        The aero medical contract is -$250,000 per month. That is $3,000,000 per year. Flight time is additional expense. That doesn’t include any of the Washington County personnel, training, housing or equipment cost.

        That seems to conflict with statements that the program cost 1.89 million.

        If it is as good a deal as it’s being claimed should be easy to prove.

    1. I firmly believe that the answer the commissioner just gave, whether intentional or not to be false or “fake news”. The reason being is that the EMS director likes to play a little “sleight of hand” if you will with his numbers. They put in their budget that their revenue or money made as the total dollars that they billed for, and NOT the total dollars that were paid or received. And for those that do not know, if it’s private insurance you will receive approximately 33% of what you billed and if it’s Medicaid/Medicare that drops to approximately 25%. So with that being said, if EMS billed $5 million dollars last year, and you were generous and said they collected 33% on every claim (which you know they did not) their revenue was ACTUALLY $1.65 million dollars, not $5 million. So my question is when will the EMS director and the commissioners court start being totally honest about the numbers?? And one last thing the commissioner said that I believe is false, is as someone who has firsthand knowledge of what the funding is for the volunteer fire departments in this county, I can assure you that the EMS departments budget FAR exceeds the approximately $600k dollars that the 10 county fire departments must share annually. I bet it’s pennies on the dollar compared to EMS’s funds. Honesty and transparency is what we need here.

    2. Ms. Bullock,

      Is categorically false like, “I misremembered”?
      Having been in health care a few minutes I’m aware that Medicare/Medicaid reimbursement rates are pennies on the dollar. I am further aware of some families that will spend the rest of their lives paying for absolutely medically necessary ‘chopper’ rides. Because their insurance didn’t cover it under the most dire of situations.
      And, lastly I would like to see in writing, (not yours), the budgets for all of the departments you listed above. Plus what the county agrees to pay each of the volunteer Fire Departments vs. what they are actually paid. And if it’s not the agreed upon amount, why? If there is a deficit couldn’t it come out of the General Fund? Remember these volunteers donate their time, often buying their own equipment (unless they don’t mind trying to save lives and property in 20+ year old gear), their vehicles, their gas and insurance on said, and all of their training! Did you notice I wrote “donate”?
      And most of the departments you listed above save lives too! They just don’t care if they make the headlines or have their picture on the front page of the newspaper. Those people are the real heroes, those are my people!

    3. A public forum sounds great!
      I and many other’s have questions. These are some of mine, as well as something’s I think others may like to know.
      Are the budgets to all of the above mentioned funded by insurance, grants, donations, etc? It would make sense that insurance payments partially, and minimally fund the EMS budget. Having been in Healthcare a few minutes I am aware that Medicare and Medicaid pay pennies on the dollar. Do the other departments benefit from grants? Donations? Are all county departments allowed to send out a postcard/letter stating that as a patient/citizen of the county they will not receive a bill? And then ask for a donation.
      I haven’t heard of anyone getting such from the dispatch, fire, police or SO. I know if EMS provides a service you receive one within days.
      It looks like thus far the air-ambulance service is a bust. How long do we continue to dip into the General Fund to bail it out. I’m aware there is an agreement between the county and the Volunteer Fire Departments. As in recent years when the county does not provide the agreed upon funds why can’t that deficit come out of the general fund? Should this be audited also?
      In the event the public doesn’t know all of the County Volunteer Fire Departments are all just that – volunteers. They drive their own vehicles to their station or the scene with no mileage reimbursement. They often personally provide much of their own gear. Mainly because much of their gear is extremely outdated, if available at all. Some are not able to spend the money on their own and end up defending lives, property, livestock and croplands with gear and equipment that is 20 or more years old. All of their training is done on their personal time and donated to the citizens of Washington and surrounding counties!
      We are all acquainted with the hot Texas summers. Can you imagine putting on the fire resistant gear that can’t permit airflow of any kind when the temperature is 100+ and the feels like is almost 10 degrees higher? Why do they do it? They have servants hearts and are committed to each other, the communities and county they serve! They do it because they care!
      The dispatchers have to juggle multiple jobs, many in life threatening situations. EMS has their own lingo and codes. VFD’s have boundary lines. The dispatchers contact the appropriate departments with their lingo/codes. If you have a medical emergency, EMS; the Police, Highway Patrol and SO handle public safety in an infinite number of situations. None of which I would want to be in! They all basically have one vehicle to provide their services.
      If you have a fire in a two story house you probably would like to see a ladder fire truck show up or in the event your hay pasture full of freshly baled hay is blazing you know you will need a vast amount of water to put it out. Different fires need specific fire trucks/vehicles. Most are very expensive due to being specifically outfitted for their need.
      My point in all of this is there should be equity in budgeting in county services departments.
      These people, the real heroes, not looking to make the headlines or have their photo or name on the front page of the newspaper, these are my people!

    4. Candice Although I can appreciate Your Reply You should know that the Brenham/Washington Co People ( Tax Payers) have Lost Trust in You all. For me personally I was told something from My Represented Commissioner about how they voted on a specific Road Project, Only to find out it was a total Falsehood. Hoping that someone will step up and run against him next time around Thinking it may be time for Term Limits

  11. All we ever hear at budget time is all the new subdivisons wil bring money in on taxes but never make our taxes lower. Remember this is Brenham and not Houston and we should do in Brenham is do what is good for us and not what everyone else does. Really all I hear about is what the EMS wants it gets and the Sheriffs department gets nothing and I believe that is right. We need to pray with all our heart to God and He will tell you what you need to do. I believe we are headed the devils way. I mean all city officals and everyone should get on our knees and pray or better yet get to you Church every Sunday to pray instead of the golf course, fishing, pickle ball etc. He only wants us to put aside one day a week for Him.

  12. Not sure of the Relationship between Hannath and EMS But seems that whatever they want He is more than willing to give it to them.. I Guess spending other Peoples Money is easy …

  13. I understand we need air medical in the county, but why should we pay for it? Waller county just got a service at no cost to the county by HCA. PHI offered the same thing. Both services have a critical care Nurse and Paramedic on the aircraft. Washington County doesn’t have a nurse on the aircraft majority of the time, only two Paramedics. So they are below standard with it comes to air medical by other services that surround us. Maybe that’s the reason why they can’t get paid by insurance. It’s time for a change before DeRamus and Hannath breaks us.

    1. Deramus got rid of the nurses, he doesn’t think they’re needed on his wonderful helicopter. Why would WashCo follow suit like every other program in the country does?

  14. EMS and emergency air lifts
    I need help understanding why our county can’t rely on “Life Flight” or St. Joseph helicopters? As is the past.
    I can’t speak for anyone but myself, but I can handle and work through any issues that result from the truth! As a tax paying citizen of this county it’s the least our commissioner’s can do. And as previously pointed out there is an election
    soon!
    Spectator, thank you for the questions!

    1. Our EMS system doesn’t want to rely on other providers because of the ego of the director. He wants a resume that says “look what I did, I brought an air medical provider to this area”. It’s a notch in his belt that will help him move on to bigger things when he’s ready. And he’s not the only public safety device provider director who does these kinds of things; it’s common across the country. At some point in their career, taking care of others is no longer the top priority. I support air medical in our county. I think it can make the difference in the outcomes of the patients that need it. But I’ve also seen them fly a broken leg to the hospital which is a totally unnecessary expense on the patient. And one thing most people don’t understand: EMS services are not designed to make money. They are designed to provide emergency medical care and save lives. And in a county where a large number of people are on Medicare/Medicaid, there is very little chance of even breaking even.

  15. Certainly everyone wants the best/quickest ambulance care as possible. But, we also have to use common sense. It’s easy for a commissioner to puff his chest out and say it’s worth saving lives. But I’ve asked this question without answer…in the last 20/30 years how many people have died or had worse injuries because of delayed ems service…air or ground. I’ve never heard that but tell me if there are documented cases of these. As is typical government, this Deramus guy showed, convinced the commissioner Court he was super duper ems cat and could do no wrong. Now, how to you tell these out laying areas we can’t provide all thes e extra stations??? Typical!! Additionally, I sent an email to my commissioner over a month ago…never got a reply…

  16. Considering the taxes we pay there should be no budget deficits anywhere. You can’t say yes to everything. I vote for tax decreases and budget cuts in government agencies and services across the board!

  17. This should make you mad as hell , it does me. If they can” tell us the truth, they shouldn” tell us anyhting, just to hear themselves talk. Remember 2/5ths of the court is up for re election this cycle. Tell them to hit the road and take Deramus with them.

  18. How are you going to vote them out. When no one runs against them. And when someone does, the good old boy systems kicks in. small town politics.

    1. You are correct Mr.Wunderlich. Any person who runs for office must have the endorsement of the majority party. But they don’t get that endorsement or the money to run unless they toe the current court and judges line. If even a qualified moderate from another party runs, the current majority voters will support one of their own or simply decline to vote. Why? Because they need to be in their special herd, they need to have all the invites to the special get togethers and they just can’t function without those special considerations from the majority local businesses. No positive changes will take place until all parties decide to work together for the common good.

  19. Thank you Mr. Spectator for your news coverage. Now would you have any comments about B.I.S.D. budget deficit.

  20. Honestly, if they can’t tell us the truth of things, should they all be voted out and get vote In people that we can trust? Because if they are doing this with the EMS spending, what else can they be shuffling around???

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