Commonwealth of Australia Explanatory Memoranda

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AGED CARE AND OTHER LEGISLATION AMENDMENT (ROYAL COMMISSION RESPONSE NO. 2) BILL 2021

                       2019-2020-2021-2022




THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA




                              SENATE




 AGED CARE AND OTHER LEGISLATION AMENDMENT
  (ROYAL COMMISSION RESPONSE NO. 2) BILL 2021




     SUPPLEMENTARY EXPLANATORY MEMORANDUM




       Amendments to be moved on behalf of the Government




(Circulated by the authority of the Minister for Health and Aged Care,
                       the Hon Greg Hunt MP)


AMENDMENTS TO AGED CARE AND OTHER LEGISLATION AMENDMENT (ROYAL COMMISSION RESPONSE NO. 2) BILL 2021 OUTLINE The Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021 (Bill) makes amendments to deliver the second stage of aged care reforms in response to the Royal Commission into Aged Care Quality and Safety's Final Report: Care, Dignity and Respect (final report). Amendments to Schedule 1 - Residential aged care funding These further technical amendments to Schedule 1 of the Bill ensure the Australian National Aged Care Classification funding model operates as intended. They have the effect of amending the Secretary's delegation powers under the Aged Care Act 1997 (Aged Care Act), consequential to other amendments in the Bill. They also amend the maximum daily amount of fees for reserving a place in a residential care service under the Aged Care (Transitional Provisions) Act 1997 so that this mirrors the equivalent provision in the Aged Care Act (as amended by the Bill). The amendments also make necessary changes to relevant application and savings provisions. Amendments to Schedule 2 - Worker Screening The amendments to Schedule 2 of the Bill will provide that the determination of a State and Territory law to be an aged care screening law is a disallowable instrument, providing for additional parliamentary scrutiny of this process. The disclosure of information contained within the Aged Care Screening Database (Database) by the Commissioner to approved providers, or their contractors or subcontractors, and registered National Disability Insurance Scheme (NDIS) providers, or another person or body, and the purpose of sharing information from the NDIS worker screening database, will also be narrowed to circumstances where the disclosure is necessary for the purposes of worker screening. In addition, minor amendments will clarify that the ability of the Minister to determine other purposes for the Database or information included in the Database will be limited to other purposes relating to aged care screening checks. A revised commencement date for Schedule 2, to a date to be fixed by proclamation within 24 months of Royal Assent, has also been included. This follows advice from the States and Territories that implementation within the next 12 months will not be possible. Formal agreement and implementation details will first need to be negotiated with the State and Territory jurisdictions, with each jurisdiction also required to make information technology changes and amend legislation prior to implementation. Amendments to Schedule 3 - Code of Conduct The amendments to Schedule 3 of the Bill will expressly recognise the privilege against self-incrimination in relation to the answering of questions or the giving of information or documents under Division 3 of renamed Part 8A of the Aged Care Quality and Safety Commission Act 2018. 1


Further amendments will specify the details of additional information which should be included on the register of banning orders in relation to each individual against whom a banning order has been made at any time, when it should be included, and how the information included in the register can be accessed and corrected. The amendments also impose an additional obligation on the Commissioner to make sure the register is kept up to date. An additional note in relation to the definition of aged care worker in clause 5 of Schedule 3 will clarify that this definition is inclusive of independent contractors. Amendments to Schedule 5 - Strengthening Provider Governance A revised commencement date of 1 July 2022 for Schedule 5 of the Bill has been included, as the original commencement date of 1 March 2022 has now passed. Amendments to Schedule 8 - Independent Health and Aged Care Pricing Authority A revised commencement date of the date of Royal Assent plus seven day for Schedule 8 of the Bill has been included, to facilitate the new aged care pricing functions commencing as soon as possible. Certain amendments relating to appointment and other process for the CEO of the Independent Health and Aged Care Pricing Authority have been removed in response to feedback, with the effect of retaining existing arrangements. Additional minor amendments clarify the appointment processes for the Deputy Chairs of the Pricing Authority. Financial Impact Statement Nil. Consultation These amendments have arisen in response to discussions in the Senate and proposed amendments to the Bill, as well as implementation discussions with the States and Territories. Further consultations are not considered necessary as these amendments are either technical only or consistent with the recommendations of the Royal Commission's final report, and consultation with the stakeholders will be ongoing in the context of related subordinate legislation. 2


Statement of Compatibility with Human Rights Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011 Amendments to the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021 These amendments are compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011. Overview of the amendments The Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021 (Bill) makes amendments to deliver the second stage of aged care reforms in response to the Royal Commission into Aged Care Quality and Safety's Final Report: Care, Dignity and Respect (final report). Amendments to Schedule 1 - Residential aged care funding These further technical amendments to Schedule 1 of the Bill ensure the Australian National Aged Care Classification funding model operates as intended. They have the effect of amending the Secretary's delegation powers under the Aged Care Act 1997 (Aged Care Act), consequential to other amendments in the Bill. They also amend the maximum daily amount of fees for reserving a place in a residential care service under the Aged Care (Transitional Provisions) Act 1997 so that this mirrors the equivalent provision in the Aged Care Act (as amended by the Bill). The amendments also make necessary changes to relevant application and savings provisions. Amendments to Schedule 2 - Worker Screening The amendments to Schedule 2 of the Bill will provide that the determination of a State and Territory law to be an aged care screening law is a disallowable instrument, providing for additional parliamentary scrutiny of this process. The disclosure of information contained within the Aged Care Screening Database (Database) by the Commissioner to approved providers, or their contractors or subcontractors, and registered National Disability Insurance Scheme (NDIS) providers, or another person or body, and the purpose of sharing information from the NDIS worker screening database, will also be narrowed to circumstances where the disclosure is necessary for the purposes of worker screening. In addition, minor amendments will clarify that the ability of the Minister to determine other purposes for the Database or information included in the Database will be limited to other purposes relating to aged care screening checks. A revised commencement date for Schedule 2, to a date to be fixed by proclamation within 24 months of Royal Assent, has also been included. This follows advice from the States and Territories that implementation within the next 12 months will not be possible. Formal agreement and implementation details will first need to be negotiated with the State and Territory jurisdictions, with each jurisdiction also required to make information technology changes and amend legislation prior to implementation. 3


Amendments to Schedule 3 - Code of Conduct The amendments to Schedule 3 of the Bill will expressly recognise the privilege against self-incrimination in relation to the answering of questions or the giving of information or documents under Division 3 of renamed Part 8A of the Aged Care Quality and Safety Commission Act 2018. Further amendments will specify the details of additional information which should be included on the register of banning orders in relation to each individual against whom a banning order has been made at any time, when it should be included, and how the information included in the register can be accessed and corrected. The amendments also impose an additional obligation on the Commissioner to make sure the register is kept up to date. An additional note in relation to the definition of aged care worker in clause 5 of Schedule 3 will clarify that this definition is inclusive of independent contractors. Amendments to Schedule 5 - Strengthening Provider Governance A revised commencement date of 1 July 2022 for Schedule 5 of the Bill has been included, as the original commencement date of 1 March 2022 has now passed. Amendments to Schedule 8 - Independent Health and Aged Care Pricing Authority A revised commencement date of the date of Royal Assent plus seven day for Schedule 8 of the Bill has been included, to facilitate the new aged care pricing functions commencing as soon as possible after Budget 2022. Certain amendments relating to appointment and other process for the CEO of the Independent Health and Aged Care Pricing Authority have been removed in response to feedback, with the effect of retaining existing arrangements. This matter will be revisited subsequently as part of the broader aged care reform package. Additional minor amendments clarify the appointment processes for the Deputy Chairs of the Pricing Authority. Human rights implications The amendments to the commencement dates for Schedules 2, 5 and 8, as well as amendments to Schedule 1 do not engage any human rights. The remaining amendments engage the following rights: Schedule 1 - Residential aged care funding The proposed amendments are technical only and remain consistent with the rights to adequate standing of living, health and social security as outlined in the Revised Explanatory Memorandum for the Bill. Schedule 2 - Worker Screening The proposed amendments remain consistent with the rights to protection from exploitation, violence and abuse, health, not to be subjected to cruel, inhuman or degrading treatment, privacy, and to freedom of opinion and expression, as outlined in the Revised Explanatory Memorandum for the Bill. In the context of the right to privacy, these amendments further promote this right by implementing stricter arrangements around pre-employment screening and further limiting the purposes for which information can be collected and disclosed for the purposes of the worker screening database. 4


Schedule 3 - Code of Conduct The proposed amendments remain consistent with the rights to protection from exploitation, violence and abuse, health, not to be subjected to cruel, inhuman or degrading treatment, privacy, to freedom of opinion and expression, and to work, as outlined in the Revised Explanatory Memorandum for the Bill. In the context of the right to privacy, these amendments further promote this right by restricting what information should be included on the register of banning orders and providing for a mechanism for correcting this information. Conclusion The additional Government amendments proposed are compatible with human rights because they promote the protection of human rights. [Circulated by the authority of the Minister for Health and Aged Care, the Hon Greg Hunt MP] 5


AMENDMENTS TO AGED CARE AND OTHER LEGISLATION AMENDMENT (ROYAL COMMISSION RESPONSE NO. 2) BILL 2021 NOTES ON AMENDMENTS Commencement Amendment (1) Amendment (1) replaces item 3, column 2 of the table at clause 2 of the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021 (Bill) to provide that Schedule 2 is to commence on a single day to be fixed by Proclamation or, if such Proclamation is not made within 24 months beginning on the day the Act receives Royal Assent, then the day after the end of that period. The extension to a 24 month period is required to allow sufficient time for negotiations with States and Territories, and for the States and Territories to establish laws to implement their respective schemes for the screening of aged care workers (which will then be determined by the Minister to be an aged care screening law). Amendment (2) Amendment (2) omits item 7 of the table at clause 2 of the Bill relating to the commencement date of Schedule 5 and replaces it with new item 7 which provides a revised commencement date for Schedule 5 of 1 July 2022. The revised commencement date for Schedule 5 is required as the original commencement date of 1 March 2022 has passed. A commencement date of 1 July 2022 will ensure that the commencement date is not retrospective. Amendment (3) Amendment (3) omits item 10 of the table at clause 2 of the Bill relating to the commencement date of Schedule 8 and replaces it with new item 10 which provides that Schedule 8 will commence on the seventh day after the Bill receives the Royal Assent. The revised commencement date for Schedule 8 will facilitate the commencement of the new pricing functions of the Independent Health and Aged Care Pricing Authority (Pricing Authority) as soon as possible after Budget 2022. Schedule 1 - Residential aged care funding Amendment (4) Amendment (4) replaces Item 51 in Schedule 1 of the Bill with the effect of changing the Secretary's delegations under subsection 96-2(14)(b) of the Aged Care Act 1997 (Aged Care Act) so that the powers and functions delegated to a person making an assessment for the purposes of section 22-4 include exercising all or any of the Secretary's powers and functions under the Subsidy Principles that relate to the basic subsidy amount worked out under Subdivision 44-B, rather than that relate to respite supplement as in the current Aged Care Act. 6


This is a technical amendment consequential to an amendment to repeal the respite supplement (see Item 35 of Schedule 1 of the Bill). The overall effect of this amendment is to maintain the current situation that the Secretary may delegate to a person making an assessment for the purposes of section 22-4 of the Aged Care Act the power and function to extend the number of days in a financial year that a residential respite care recipient can receive subsidised care. This remains appropriate as a person making an assessment for the purposes of section 22-4 of the Aged Care Act is qualified to assess a person's continuing need for the types of aged care provided for by the Aged Care Act. An equivalent delegation is not required under the Aged Care (Transitional Provisions) Act 1997 (Transitional Act). Amendment (5) Amendment (5) inserts a new item 80 to Schedule 1 that changes section 58-6 of the Transitional Act so that the maximum daily amount of fees for reserving a place in a residential care service for a residential care recipient under the Transitional Act is an amount determined by the Minister by legislative instrument or worked out in accordance with a method determined by the Minister by legislative instrument. This amendment aligns the maximum daily amount of fees for reserving a place in a residential care service for a residential care recipient under the Transitional Act with that of a residential care recipient under the Aged Care Act as amended (see Item 42 of Schedule 1 of the Bill). This amendment is necessary to ensure that all residential care recipients at the same residential care service are subject to the same maximum daily amount of fees for reserving a place, regardless of whether they are subject to the Aged Care Act or the Transitional Act. This amendment corrects an oversight in the initial drafting of the Bill that excluded consideration of residential care recipients under the Transitional Act in relation to this matter. Amendment (6) Section 52C-5 of the Aged Care Act and section 58-6 of the Transitional Act provide for the maximum amount of resident fees to reserve a place, and are already amended by Bill. Amendment (6) replaces item 99, an application provision, and item 100, a saving provision, so that the items deal with application and saving provisions in relation to the maximum daily amount of fees for reserving a place in a residential care service for both a care recipient under section 52C-5 of the Aged Care Act (see Item 42 of Schedule 1 of the Bill) and a care recipient under section 58-6 of the Transitional Act (see Item 80 of Schedule 1 of the Bill). This amendment is consequential to amendment (5). Item 99 as amended provides that section 52C-5 of the Aged Care Act and section 58-6 of the Transitional Act, as amended by the amending Part, apply in relation to a day that is on or after the commencement day. Item 100 as amended provides that section 52C-5 of the Aged Care Act and section 58-6 of the Transitional Act, as in force immediately before the commencement day, continue to apply in relation to a day that is before the commencement day. 7


Amendment (7) Amendment (7) omits Item 106, a saving provision in relation to the operation of section 96-2(14) of the Aged Care Act. Consequential to the amendment to Item 51 of Schedule 1 of the Bill through amendment (4), this saving provision is no longer required. Schedule 2 - Screening of aged care workers, and governing persons, of approved providers Amendments (8) and (9) Amendments (8) and (9) amend item 4 in Schedule 2 of the Bill, which inserts new section 7A into the Aged Care Quality and Safety Commission Act 2018 (Quality and Safety Commission Act) to outline the process by which the Minister will determine a law of a State or Territory to be an 'aged care screening law'. Amendment (8) removes the note after subsection 7A(1) which provides that a legislative instrument made under new section 7A is not subject to section 42 (disallowance) of the Legislation Act 2003 (Legislation Act) (see subsection 44(1) of the Legislation Act). Instead, amendment (9) inserts new subsection 7A(3) to clarify that despite subsection 44(1) of the Legislation Act, a determination made by the Minister under new section 7A for the purposes of worker screening is to be a disallowable instrument, providing for additional parliamentary scrutiny of this process. Amendments (10) and (11) Amendments (10) and (11) amend item 7 in Schedule 2 which inserts new section 61A into the Quality and Safety Commission Act. Section 61A details the permitted disclosures of protected information contained within the Aged Care Screening Database. The amendments remove the wording 'for purposes relating to' contained within subsections 61A(a) and 61A(b) and replace it with language which provides that disclosure is permitted if necessary for the purposes of the screening of an individual who is, or is seeking to become, an aged care worker or governing person of an approved provider, or of a worker (as defined in the National Disability Insurance Scheme Act 2013 (NDIS Act)) employed, or otherwise engaged (including on a voluntary basis), by a registered NDIS provider, another person or body or a person who is seeking to become so employed or engaged. Screening in this context includes checks undertaken by providers in accordance with their obligations under new section 63-1(1)(l) as introduced by the Bill. This means that the Commissioner can disclose protected information from the Aged Care Screening Database to approved providers, or other persons such as the contractors or subcontractors of approved providers, who are seeking to employ or engage new staff, for the purposes of checking for any up to date information that is included in the Aged Care Screening Database in relation to these individuals. This is a necessary part of the screening process. Amendments (12) to (15) Amendments (12) to (15) amend item 8 in Schedule 2 which inserts new Part 8AB into the Quality and Safety Commission Act. The amendments clarify new section 74AG relating to the Aged Care Screening Database. 8


Specifically, new subsection 74AG(3) outlines the purposes of the Aged Care Screening Database, which includes a number of specified purposes and any other purpose determined under new subsection (8). In addition, new subsection 74AG(5) outlines the information that may be included in the Aged Care Screening Database, including information relating to the matters specified in subparagraphs (a) to (i), and may also include any other information determined under new subsection (8). New subsection 74AG(8) allows the Minister to determine, by legislative instrument, a purpose of the Aged Care Screening Database for the purposes of new paragraph (3)(c) and/or information for the purposes of new paragraph (5)(j). Amendments (12) and (13) clarify that the determination of any other purpose for the Aged Care Screening Database or for information included in this database must relate to aged care screening checks (as defined in clause 3 of Schedule 2). Amendments (14) and (15) amend new subsection 74AG(8) to reflect that the Minister may determine a purpose relating to aged care screening checks for the purposes of paragraph (3)(c) or determine information relating to aged care screening checks for the purposes of paragraph (5)(j). Amendment (16) Amendment (16) amends new section 74AI relating to the additional purpose of the NDIS worker screening database. This amendment mirrors amendment (10) by removing the wording 'for purposes relating to' contained within subsection 74AI(a) and replacing it with language which provides that it is a purpose of the NDIS worker screening database under the NDIS Act to share information with an approved provider, or a contractor or subcontractor of the approved provider, if the sharing is necessary for the purposes of the screening of an individual who is currently, or seeking to become an aged care worker, or governing person of an approved provider. Screening in this context includes checks undertaken by providers in accordance with their obligations under new section 63-1(1)(l) as introduced by the Bill. This means that the Commissioner can disclose protected information from the Aged Care Screening Database to approved providers, or other persons such as the contractors or subcontractors of approved providers, who are seeking to employ or engage new staff, for the purposes of checking for any up to date information that is included in the Aged Care Screening Database in relation to these individuals. This is a necessary part of the screening process. Schedule 3 - Code of Conduct and banning orders Amendment (17) Amendment (17) inserts a note to item 5 of Schedule 3 at the end of the definition of aged care worker to make clear that an individual engaged by an approved provider includes an independent contractor. 9


Amendment (18) Amendment (18) inserts new item 24A after item 24 of Schedule 3 of the Bill to include an additional section, new section 74GAA, at the end of Division 3 of Part 8A of the Quality and Safety Commission Act. New section 74GAA expressly recognises the privilege against self-incrimination in relation to the Division 3 of renamed Part 8A of the Commission Act. It specifies that nothing in Division 3 affects the rights of an individual from refusing to answer a question, give information or give a document on the grounds that these actions might tend to incriminate the individual. The inclusion of this provision is not intended to depart from the settled position that the privilege against self-incrimination is not abrogated unless the relevant legislation expressly provides for this. Amendments (19) to (23) Amendments (19) to (23) make amendments to item 25 of Schedule 3, which inserts new Division 4 - Banning orders at the end of Part 8A of the Quality and Safety Commission Act. New section 74GE requires that before the Commissioner makes a banning order, they must first notify the relevant individual in writing that an order is being considered, unless the Commissioner reasonably believes that there is an immediate and severe risk to the health, safety or wellbeing of one or more care recipients. Subsection 74GE(3) sets out the requirements of what must be included in the notice, including that the Commissioner must invite the individual to make a written submission to the Commissioner in relation to the matter. Amendment (19) omits subsection 74GE(3)(b) in its entirety and inserts new subsection 74GE(3)(b) to provide that the Commissioner must invite the individual to make submissions in relation to the notice within 14 days of receiving the notice, with the period unable to be shortened. Amendments (20) to (23) amend new section 74GI which, as introduced, requires the Commissioner to establish and maintain a register of banning orders, including banning orders that are no longer in force. New subsection 74GI(1) requires that the register include certain information in relation to each individual against whom a banning order has been made at any time, including for example, the name of the individual and details of their banning order. Amendment (20) inserts after paragraph 74GI(1)(c) subparagraphs (ca) to (ce), which detail additional information to be captured by the register, including, for example, a statement where the Commissioner is considering whether or not to revoke a banning order, or a request for reconsideration of a banning order decision has been made but not yet determined. After subsection 74GI(2), amendment (21) inserts new subsection 74GI(2A) to make clear that while subsection (2) states that 74GI(1) applies to banning orders which are no longer in force - subsection (1) does not apply in relation to banning orders which have been revoked or which have been set aside on reconsideration of the decision, or on review. This amendment also inserts new subsection 74GI(2B) to ensure the register is kept up-to-date. Amendment (22) inserts new subsection 74GI(3A) after subsection 74GI(3), which provides that the Rules must make provision for, or in relation to the process by which information included in the register can be corrected, including how an individual may access and seek the correction of such information. 10


Amendment (23) omits subparagraph 74GI(4)(a) as this subparagraph is no longer required due to the insertion of new subsection 74GI(3A). Schedule 5 - Governance of approved providers etc. Amendments (24) and (25) Amendment (24) is a consequential amendment in response to the revised commencement date of Schedule 5, which clarifies that the definitions contained within item 35 of Schedule 5 apply to Part 2 - Application and transitional provisions of the Schedule. Amendment (25) amends item 35 to reflect the revised commencement date of Schedule 5 (see amendment (2)). Amendment (26) Amendment (26) is a consequential amendment in response to the revised commencement date of Schedule 5, that amends sub-item 37(1) of the Schedule to provide that under new if a person is an approved provider immediately before the commencement day, new section 63-1D of the Aged Care Act, as inserted by Item 16 of Part 1 of Schedule 5, applies in relation to the person on and after 1 July 2023. Amendment (27) Amendment (27) is a consequential amendment in response to the revised commencement date of Schedule 5, that amends item 38 of the Schedule to provide that new section 63-1G of the Aged Care Act, which relates to the requirement for approved providers to prepare an annual statement, applies to a reporting period that starts on the commencement date of the Schedule as defined by amendment (25). Amendment (28) Amendment (28) is a consequential amendment in response to the revised commencement date of Schedule 5, to sub-item 39(1) of the Schedule to provide that if a person is an approved provider immediately before the commencement day, new section 63-1H of the Aged Care Act, as inserted by Item 16 of Part 1 of the Schedule, applies in relation to the person on and after 1 July 2023. Schedule 8 - Independent Health and Aged Care Pricing Authority Amendment (29) Amendment (29) omits item 34 of Schedule 8 of the Bill and inserts new items 34, 34A and 34B which make amendments to section 144 of the National Health Reform Act 2011 (National Health Reform Act) concerning the appointment processes for members of the Pricing Authority. The effect of new item 34 is to clarify that subsection 144(2) of the National Health Reform Act applies to the appointment of the Deputy Chair (Hospital Pricing), which requires the agreement of State/Territory Premiers. New item 34A amends subsection 144(3) to clarify that the appointment of a member of the Pricing Authority (other than the Chair or a Deputy Chair) requires the agreement of State/Territory Premiers and the Prime Minister. 11


These amendments reflect the establishment of the new position of Deputy Chair (Aged Care Pricing) and the renaming of the existing position of Deputy Chair as Deputy Chair (Hospital Pricing). New item 34B re-inserts new subsections 144(3A) and 144(3B), previously included in the Bill, which prescribe the required experience of the Deputy Chair (Hospital Pricing), the Deputy Chair (Aged Care Pricing), and other members of the Pricing Authority as follows: • The Minister must ensure that the Deputy Chair (Hospital Pricing) and at least one other member of the Pricing Authority has substantial experience or knowledge; and significant standing in either or both of the following fields: public hospital strategic leadership or operational management; or public hospital pricing and costing. • The Minister must ensure that the Deputy Chair (Aged Care Pricing) and at least one other member of the Pricing Authority has substantial experience or knowledge; and significant standing; in either or both of the following fields: aged care strategic leadership or operational management; or aged care pricing and costing. The new provisions for qualification of members are appropriate to ensure that the Pricing Authority has the right mix of knowledge and experience to perform its expanded functions. Amendments (30) and (31) Amendment (30) opposes items 50 to 63 of Schedule 8 which relate to the appointment process, including acting appointments, registration and termination, of the Independent Health and Aged Pricing Authority CEO under the National Health Reform Act. The effect is that the Pricing Authority will continue to perform these processes in consultation with the Minister. Amendment (31) opposes item 134 of Schedule 8, which provides for transitional arrangements relating to items 50 to 63, as a consequence of items 50 to 63 being opposed. 12


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