Filial responsibility laws, rooted in centuries-old traditions, hold adult children legally accountable for supporting their indigent parents’ essential needs. These laws, once meant to prevent the impoverished from burdening public resources, are now resurfacing amid soaring healthcare costs and aging populations. Understand the historical context, enforcement landscape, and potential financial implications of these often-overlooked legal obligations.
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Introduction
At a time where healthcare costs are soaring and populations are aging more dramatically than ever before, the financial responsibilities for elder care are becoming an increasingly complex burden on families. Amidst this backdrop, the concept of filial responsibility laws, which may seem like relics from a bygone era, are gaining renewed attention. These laws, rooted deeply in history, hold adult children legally responsible for the financial support of their indigent parents, covering essentials such as healthcare and custodial care. Originally conceived centuries ago, these laws have evolved yet persist in various forms across several states in the U.S., potentially impacting many unsuspecting families today.
As Baby Boomers age and the cost of nursing home care climbs, the practical implications of these obscure, sometimes arcane laws are becoming more significant. Understanding filial responsibility laws is not only crucial for legal and financial preparedness but also forms an essential part of navigating the challenges of modern elder care. This article delves into what filial responsibility laws are, explores their enforcement and relevance in today’s society, and provides a guide on how families can navigate this often-overlooked legal landscape.
What Are Filial Responsibility Laws?
Filial responsibility laws are legal statutes that impose a duty on adult children to support their financially incapable parents, particularly in the realms of healthcare and custodial care. These laws can potentially make children legally responsible for a range of expenses, including medical bills, nursing home care, and even basic living costs if their parents cannot afford them on their own.
The origins of filial responsibility laws trace back to 16th-century English Poor Laws, which mandated family-based support for the indigent as a way to prevent the needy from becoming a burden on public resources. These laws were carried over to America by the colonists, and over the centuries, they have been codified in various forms across multiple states. Although they may seem outdated, these laws were originally rooted in the moral expectations of family care and the societal necessity of providing for elderly citizens without imposing on the public coffers.
The general legal premise of filial responsibility laws today is that if a parent is in need and qualifies as indigent or is receiving government assistance like Medicaid, and there are no other means of paying the expenses, the adult children are legally obligated to step in. This responsibility can be invoked either by the healthcare facilities or sometimes even the state itself, particularly if it seeks to recoup the costs covered by public funds. The scope and enforcement of these laws vary significantly from one state to another, which can lead to unexpected financial and legal challenges for families unprepared for these potential liabilities.
Historical Context and Modern Relevance
Filial responsibility laws have their roots deeply embedded in the early English Poor Laws of the 16th century. These laws were originally designed to address the needs of the impoverished by assigning the financial responsibility of care to the family, thereby reducing the burden on public funds. When British colonists established new communities in North America, they brought with them these laws, integrating them into the fabric of colonial governance. The premise was simple: it was a family’s duty to care for its elderly and dependent members, thus ensuring that the community didn’t have to bear the cost.
Over the centuries, as societies evolved and the structure of state support changed, the application and enforcement of filial responsibility laws in the United States varied widely. In the 20th century, especially with the establishment of social safety nets like Medicare and Medicaid in the 1960s, the necessity and enforcement of filial laws diminished. The government began to take a larger role in assisting the indigent, which alleviated some of the direct financial responsibilities from families. However, these laws were never fully abolished in many states and have lingered on the books.
In modern times, the relevance of these laws is resurfacing. This renewed attention is driven partly by the escalating costs of healthcare and long-term elderly care, which are not fully covered by Medicare. As the Baby Boomer generation ages and the incidence of diseases such as dementia increases, the financial strain of long-term care falls heavily on families and sometimes on public funds through Medicaid. In this context, filial responsibility laws are sometimes seen as a fallback mechanism for recouping care expenses, particularly in states where public resources are strained or where legal frameworks still strongly support these obligations.
These laws also reflect ongoing societal debates about the moral responsibilities of families versus the role of the state in providing for the elderly. While fewer families may rely solely on these laws for ensuring care for their elders, the existence of these laws can significantly impact family financial planning and elder care decisions. The potential for their enforcement, albeit rare, serves as a reminder of the historical expectation that family support for the elderly is not just a moral duty but, in some places, a legal obligation as well.
Current Enforcement and Perceived Arcaneness
Filial responsibility laws, while still on the books in many states, are often viewed as arcane remnants of a bygone era. Their enforcement is sporadic, and the laws themselves are perceived by many as outdated in the context of modern social welfare systems. However, the variability in how these laws are applied across different states can lead to significant legal and financial surprises for unsuspecting families.
The enforcement of these laws is anything but uniform. In some states, they are almost never applied, serving more as historical curiosities than functional elements of the legal system. In others, particularly in cases where public funds are involved or when elder care facilities seek to recoup costs, these laws can and are used with serious financial implications for families. This sporadic enforcement contributes to a sense of unpredictability and can complicate efforts for comprehensive elder care planning.
Case Studies of Enforcement
- Pennsylvania: One of the most notable recent applications of filial responsibility laws occurred in Pennsylvania with the case of Health Care & Retirement Corporation of America v. Pittas in 2012. The state court held John Pittas responsible for nearly $93,000 of his mother’s nursing home bills after she moved out of the country. This case highlighted how aggressively these laws could be enforced, serving as a wake-up call for adult children about their potential liabilities.
- South Dakota: Another instance is from South Dakota, where an elderly mother successfully sued her son for failing to support her after her husband died, leaving her with insufficient means to care for herself. The court’s decision to uphold the mother’s claim underscored the law’s reach, impacting not only those who might seek to evade familial responsibilities but also those who are unaware of their potential obligations.
These cases illustrate not only the potential financial burdens imposed by these laws but also the broad discretion courts sometimes exercise in interpreting filial responsibility. The unpredictable nature of such laws can lead to significant financial strain, especially for those who are unaware of their legal responsibilities until they are brought to court.
The perceived arcaneness of these laws, coupled with their selective enforcement, can create a challenging landscape for families planning for long-term care. As such, it is crucial for individuals in states with active filial responsibility laws to understand their potential exposure and consider legal and financial strategies to mitigate these risks.
Comprehensive List of States with Active Filial Laws
The following table provides an overview of the 25 states where filial responsibility laws are still recognized, outlining the general premise of these laws, their enforcement levels, and where more detailed information can be found. It’s important to note that the degree of enforcement can vary significantly, and while some states may rarely enforce these laws, they can still pose a legal risk under certain circumstances.
| State | Summary | Level of Enforcement | Reference URL |
|---|---|---|---|
| Alaska | Parents and children are bound to maintain each other if unable to work and in poverty. | Unclear | Link |
| Arkansas | Legal liability for mental health service costs if the patient cannot pay and other criteria are met. | Unclear | Link |
| California | Adult children must support parents in need, unless otherwise specified by law. | Unclear | Link |
| Connecticut | Penalty for neglecting support to parents under 65 includes potential imprisonment. | Somewhat Enforced | Link |
| Delaware | Support priority: spouse, parents, children. Financial ability considered. | Unclear | Link |
| Georgia | Required support for “paupers” by parents or children, with county recovery rights. | Unclear | Link |
| Idaho | Repealed | ||
| Indiana | Financially capable children must support parents who cannot self-sustain. | Somewhat Enforced | Link |
| Iowa | Repealed | ||
| Kentucky | Adult children must support indigent parents if they can reasonably do so, with potential penalties. | Somewhat Enforced | Link |
| Louisiana | Alimony may be sought from children or grandchildren by those in need; parents and children must support. | Unclear | Link |
| Massachusetts | Refusing to support needy parents can result in fines and imprisonment. | Somewhat Enforced | Link |
| Mississippi | Descendants must support indigent relatives or face fines and possible repayment demands. | Somewhat Enforced | Link |
| Montana | Repealed | ||
| Nevada | Filial liability exists only under specific contractual agreements and control over assets. | Rarely Enforced | Link |
| New Hampshire | Relatives must support needy persons if their income allows. | Somewhat Enforced | Link |
| New Jersey | Financial assistance from relatives may be demanded by the state with legal recovery options. | Somewhat Enforced | Link |
| North Carolina | Adult children with means are required to support parents who cannot support themselves. | Somewhat Enforced | Link |
| North Dakota | Mutual support duty among parents and adult children if unable to support themselves. | Unclear | Link |
| Ohio | It is illegal to fail in providing adequate support to aged or infirm parents. | Somewhat Enforced | Link |
| Oregon | Mutual support obligations exist between parents and children who are poor and unable to work. | Unclear | Link |
| Pennsylvania | Active enforcement of support for indigent persons by spouse, children, or parents. Recent court cases noted. | Actively Enforced | Link |
| Rhode Island | Fines, imprisonment, and cost recovery from facilities for adults who neglect needy parents. | Somewhat Enforced | Link |
| South Dakota | Adult children notified of their duty to support destitute parents, including necessities. | Unclear | Link |
| Tennessee | Possible requirement for relatives to reimburse medical assistance under federal law. | Unclear | Link |
| Utah | Children are primary responsible for supporting indigent parents, followed by other relatives. | Somewhat Enforced | Link |
| Vermont | Fines and imprisonment for adults who neglect to support needy parents. | Somewhat Enforced | Link |
| Virginia | Joint responsibility of children over 18 to support needy parents if financially able. | Somewhat Enforced | Link |
| West Virginia | Duty of relatives with financial ability to support indigent relatives, including burial expenses. | Unclear | Link |
This table is designed to provide a snapshot of where these laws stand across the U.S. and give readers a resource for deeper exploration into specific state statutes. It is recommended for individuals to consult legal experts in their respective states to understand the full implications of these laws on their personal circumstances.
Five states have recently taken these laws off of their books: Idaho, Iowa, New Hampshire, Maryland and Montana.
Legislative Activities and Reforms
As societal norms and economic realities evolve, several states are reconsidering the practicality and fairness of filial responsibility laws. Legislative efforts to modify or repeal these laws are driven by a recognition of the financial burdens they can impose on families, as well as a desire to align legal obligations with modern social welfare practices. Here’s a look at recent legislative activities in this area:
Pennsylvania’s Legislative Efforts
Pennsylvania has been at the forefront of this discussion due to its active enforcement of filial responsibility laws. Recent efforts in the state have focused on modifying these laws to reduce potential financial distress among families. A significant proposal is the “Stop Bankrupting Pennsylvanians Over Family Medical Bills” Act, introduced by State Representative Kristine Howard. This bill seeks to amend the existing laws by limiting the circumstances under which adult children can be held liable for their parents’ medical debts. Specifically, it proposes that adult children would only be held responsible if they have colluded with a parent to hide assets or have failed to cooperate in the medical assistance process. This move aims to prevent undue hardship on financially stable children who might otherwise be blindsided by sudden and substantial medical bills from their parents.
Motivations Behind Legislative Changes
The push to modify or repeal filial responsibility laws is motivated by several factors:
- Reducing Financial Burden: As healthcare costs continue to rise, the potential financial impact of these laws on middle-class families can be devastating. Lawmakers are increasingly aware of the need to protect families from financial crises that can arise from unexpected medical debts.
- Aligning with Social Welfare Practices: There is a growing consensus that the welfare of elderly citizens should be a collective societal responsibility rather than a private family burden. This aligns more closely with the principles underpinning modern social welfare systems, such as Medicaid.
- Fairness and Equity: Concerns about equity have also driven these reforms. Legislators recognize that it is unfair for adult children to bear the brunt of healthcare costs, especially when they may not have had close relationships with their parents or when their parents have other means of support available.
Other States
While Pennsylvania is a notable example, other states have also taken steps to address filial responsibility laws:
- Maryland repealed its filial responsibility laws in 2017, acknowledging that such laws were outdated and out of step with current social and economic realities.
- North Dakota and Indiana have seen discussions around adjusting these laws to make them fairer and less punitive, although significant changes have yet to be enacted.
These legislative activities indicate a trend towards reconsidering and potentially phasing out filial responsibility laws across the United States. As these discussions evolve, they reflect broader shifts in how societies view the responsibilities of families and the state in caring for the elderly. These changes are crucial for many families who, in an era of precarious financial security, find themselves potentially liable for extensive medical costs.
Implications for Families and Elder Care Planning
The presence of filial responsibility laws in nearly thirty states carries significant implications for family financial planning, elder care options, and even Medicaid eligibility. Understanding these laws and preparing for their potential impact is crucial for families wishing to secure financial stability while ensuring proper care for aging relatives.
Effects on Family Financial Planning and Elder Care Options
Financial Planning Challenges: Filial responsibility laws can introduce unexpected financial burdens on families. Adult children might find themselves responsible for substantial costs, including unpaid medical bills or long-term care expenses, which could affect their savings, retirement plans, and overall financial health.
Elder Care Options: These laws might limit options for elder care. Knowing that one might be financially liable for a parent’s care could influence decisions about the type of care that is economically feasible. For example, families might opt for less expensive care options or even forego professional care altogether, potentially leading to inadequate care for the elderly.
Medicaid Eligibility: Filial responsibility can complicate Medicaid planning. Since Medicaid eligibility often requires recipients to exhaust their assets, families might employ asset reduction strategies. However, transferring a parent’s assets to reduce their countable assets can trigger Medicaid’s look-back period, leading to penalties and delayed eligibility. Moreover, if a parent is disqualified from Medicaid because of asset transfers, the state might seek reimbursement from the children under filial responsibility laws.
Advice for Families on Preparing for Potential Liabilities
Understand the Laws in Your State: The first step is to become familiar with the laws specific to your state. This includes understanding under what circumstances you might be held liable for your parents’ care costs. Consulting with an elder law attorney can provide clarity and direction.
Financial and Legal Planning: Engage in proactive financial and legal planning, including:
- Long-term Care Insurance: Consider purchasing long-term care insurance for parents, which can cover the cost of home care, assisted living, or nursing home care, reducing the potential burden on children.
- Estate and Medicaid Planning: Work with an elder law attorney to discuss safe and legal strategies for asset management and transfer that do not jeopardize Medicaid eligibility.
- Emergency Fund: Build an emergency fund that can address potential unexpected expenses related to a parent’s health care.
Family Discussions: Have open and honest discussions with family members about expectations, potential responsibilities, and financial planning concerning elder care. This includes discussing the wishes of the parents and the financial capabilities of the family to support those wishes.
Regular Reviews and Updates: Family financial plans and legal strategies should be reviewed and updated regularly to adjust for changes in laws, financial status, and the health of parents. This ongoing review helps ensure that strategies remain effective and legally compliant.
By taking these steps, families can better manage the risks associated with filial responsibility laws and plan more effectively for the financial aspects of elder care. Preparing in advance can help mitigate the impact of these laws on family finances and ensure that elderly parents receive the care they need without undue financial strain on the children.
Conclusion
Filial responsibility laws, with their deep historical roots and sporadic enforcement across the United States, remain a significant yet often overlooked aspect of family financial planning and elder care. These laws can impose unexpected financial burdens on adult children, potentially requiring them to cover the costs of their parents’ healthcare and custodial care when other resources are exhausted. While the enforcement of these laws is inconsistent, their existence underscores the need for careful, proactive planning.
The ongoing relevance of filial responsibility laws is intricately tied to broader societal trends, such as aging populations and escalating healthcare costs. As government programs like Medicare and Medicaid provide substantial but limited support, the gap between what is needed and what is covered can sometimes fall on the shoulders of family members. This situation highlights the delicate balance between state assistance and individual family responsibilities. While public funds help mitigate some burdens, the residual responsibility often inadvertently shifts to family members, potentially leading to significant financial and personal strain.
To navigate the complexities introduced by filial responsibility laws, families must engage in proactive planning and informed decision-making. This includes:
- Educating themselves about the specific statutes in their states to understand potential liabilities.
- Investing in financial and legal planning, such as acquiring long-term care insurance and consulting with elder law experts to explore all available options for asset management and care planning.
- Maintaining open lines of communication within the family to set realistic expectations and collaboratively develop strategies that respect the wishes and needs of all involved, particularly the elderly family members.
By taking these steps, families can not only protect their financial future but also ensure that their elderly loved ones receive the care they deserve in a dignified manner. It is through such preparedness and understanding of both the legal landscape and the available state resources that families can effectively manage the potential impacts of filial responsibility laws. As society continues to evolve, it is crucial for both policymakers and families to revisit and reassess these laws to ensure they align with contemporary needs and ethical standards.
Call to Action
Navigating the complexities of filial responsibility laws and ensuring adequate planning for elder care are essential tasks that require informed decision-making and strategic foresight. As we have explored, these laws can have profound implications on family finances and responsibilities, making it imperative for families to be proactive and well-prepared.
Consult Professional Help: To fully understand your potential liabilities under filial responsibility laws and to tailor a plan that suits your family’s specific needs, it is highly advisable to consult with elder law attorneys. These professionals specialize in issues affecting the elderly and can provide comprehensive legal advice on how to prepare for potential financial responsibilities. Additionally, financial planners can offer insights and strategies to safeguard your assets and ensure financial stability while accommodating the potential costs of elder care.
Utilize Resources and Support: Numerous resources and organizations are available to assist families in planning for elder care:
- National Academy of Elder Law Attorneys (NAELA): This organization offers a directory of qualified elder law attorneys across the United States (naela.org).
- AARP: Provides extensive resources on elder care, legal issues, and insurance options to assist families in navigating their responsibilities (aarp.org).
- Eldercare Locator: A public service of the U.S. Administration on Aging that can help you find services for older adults and their families in your area (eldercare.acl.gov).
- The National Council on Aging (NCOA): Offers tools and information to help older adults and their caregivers find support and manage their responsibilities (ncoa.org).
Take Action: Do not wait until it is too late. Begin discussions within your family about elder care plans and potential legal responsibilities. Being proactive can significantly reduce the stress and financial burden associated with unexpected healthcare costs. Schedule consultations with legal and financial experts to ensure your plans are robust, flexible, and compliant with current laws.
By engaging with professionals and leveraging available resources, you can navigate the complexities of filial responsibility laws effectively, ensuring that your family is prepared to meet any legal obligations while providing compassionate care for your elderly loved ones. Take the necessary steps today to secure peace of mind for tomorrow.
All text © 2024 James M. Sims and all images exclusive rights belong to James M. Sims and Midjourney or DALL-E, unless otherwise noted.
References
- Allsop, J. (2016). Filial responsibility laws in the United States: An historical exploration. Elder Law Journal, 24(1), 1-35.
- Callaghan, M. (2022). The resurgence of filial responsibility laws: A legal and ethical analysis. Journal of Elder Law and Policy, 12(2), 121-148.
- Forbes. (2024, April 27). Why you might be responsible for paying your parents’ medical debts. https://www.forbes.com/sites/kellyphillipserb/2024/04/27/why-you-might-be-responsible-for-paying-your-parents-medical-debts/
- Howard, K. (2023). Stop Bankrupting Pennsylvanians Over Family Medical Bills Act (HB 1234). Pennsylvania General Assembly. https://www.legis.state.pa.us/cfdocs/billInfo/billInfo.cfm?sYear=2023&sInd=0&body=H&type=B&bn=1234
- Kline, P. M. (2018). The ethical implications of filial responsibility laws in the United States. Journal of Bioethical Inquiry, 15(2), 201-214. https://doi.org/10.1007/s11673-018-9846-5
- Pearson, K. C. (2012). Filial support laws in the modern era: Domestic and international enforcement. Elder Law Journal, 20(2), 365-396.
- Rendall, M. S., & Bahchieva, R. A. (2021). The potential impact of filial responsibility laws on the economic security of older adults. The Gerontologist, 61(6), 865-875. https://doi.org/10.1093/geront/gnaa107
- Schwartz, R. A. (2010). Filial responsibility in the modern era: Renaissance of an aging medieval doctrine. Yale Law Journal, 119(4), 699-737. https://www.yalelawjournal.org/article/filial-responsibility-in-the-modern-era
- Stiegel, L. A. (2018). Understanding filial responsibility laws. American Bar Association Commission on Law and Aging. https://www.americanbar.org/groups/law_aging/resources/health_care_decision_making/filial_responsibility_laws/
- Trust & Will. (n.d.). What states have filial responsibility laws? https://trustandwill.com/learn/what-states-have-filial-responsibility
- Tumlinson, A., & Taubman, C. (2019). Filial responsibility laws and long-term care: Modern challenges and policy implications. Health Affairs, 38(11), 1856-1863. https://doi.org/10.1377/hlthaff.2019.00570
- Zwolinski, R. F., & Salter, K. N. (2020). Filial responsibility laws: An overview and ethical analysis. Journal of Ethics in Aging, 2(1), 17-36. https://doi.org/10.3138/jea.2019-0025
Resources
Watch the video here.
Highlights:
0:11 – Filial responsibility laws make adult children financially responsible for their parents’ long-term care.
0:25 – Adult children may be legally responsible for their aging parents’ long-term care costs.
1:43 – Filial support laws date back to the Elizabethan poor law of 1601.
2:46 – 26 States in the US still maintain filial responsibility laws.
3:28 – Filial responsibility laws impose a legal obligation on adult children to support their parents.
4:15 – Adult children may be required to pay for their parents’ necessities under filial responsibility laws.
4:52 – Failing to fulfill filial responsibility obligations can result in serious legal consequences.
5:25 – More than half of the US states maintain filial responsibility laws, each with different rules and penalties.
6:13 – 26 States and Puerto Rico have active filial responsibility laws.
7:02 – State laws differ in the extent of support required and penalties for non-compliance.
07:26 – Children must be notified before they can be held responsible for their parents’ care.
07:38 – Understanding state-specific filial responsibility laws is crucial for your family situation.
08:00 – Medicaid can help cover long-term care expenses for elderly parents who qualify.
08:59 – Being aware of the Medicaid estate recovery program is important to protect shared assets.
09:33 – Strategies to manage filial responsibility include financial planning and seeking legal assistance.
11:25 – Seeking legal assistance early can minimize potential financial consequences related to filial responsibility laws.
12:01 – Real-life cases provide insight into the enforcement and implications of filial responsibility laws.
12:05 – In a Pennsylvania case, a son was sued for his mother’s care costs under filial responsibility law.
13:13 – Filial responsibility laws exist internationally with varying degrees of enforcement and consequences.
Video: How to Avoid Paying for an Elderly Parent’s Nursing Home Bill
Watch the video here.
Highlights:
0:08 – Introduction to the topic of avoiding paying for an elderly parent’s nursing home bill.
1:01 – Explanation of scenarios where parents may need nursing home care.
2:01 – Medicare or insurance coverage for nursing home care typically lasts for one to three weeks.
3:30 – Caregivers can avoid paying parents’ nursing home bills by ensuring the parent signs the paperwork.
4:45 – Signing the nursing home agreement as a power of attorney without personal financial liability.
5:51 – Importance of long-term care planning and understanding options like Medicaid.
06:46 – Explaining the Medicaid application process for nursing home care.
07:23 – Guidance on seeking help from the nursing home billing department for Medicaid application.
08:02 – Emphasizing the importance of diligence in following up on Medicaid applications.
09:51 – Utilizing elder law or estate planning attorneys for Medicaid assistance.
10:01 – Avoiding personal financial liability for nursing home bills by proper signing authority.
10:32 – Importance of planning for elderly care in advance to alleviate stress during crises.
11:44 – Considering long-term care insurance options for future financial security.
Video: You Can Be Responsible for Your Parents’ Nursing Home Bills
Highlights:
0:36 – Introduction to filial responsibility laws
1:19 – Explanation of filial laws as a legal obligation
2:39 – Overview of states with filial responsibility laws
3:00 – Consequences of not financially supporting parents
3:33 – Emotional impact of being legally responsible for parents
4:11 – Challenges posed by government penalties for not caring for parents
4:55 – Nursing homes relying on federal funding to avoid enforcing filial laws
5:27 – States removing filial responsibility laws
5:55 – New Hampshire’s unique approach to financial responsibility for parents
06:17 – New Hampshire broadened its legislation, creating a larger trap for those responsible for aging parents.
06:26 – Montana repealed its filial responsibility law in 2021 due to federal laws preventing nursing homes from requiring payment guarantees.
07:10 – Pennsylvania court allowed a nursing home to charge a son $93,000 for his mother’s care solely based on the parent-child relationship.
08:00 – Nursing homes may try to make family members financially responsible by deceptive contract terms.
09:30 – The cost of caring for elderly citizens is rising, posing challenges for middle-income families.
09:54 – Concerns about large corporate nursing homes profiting from elderly care at the expense of families.
10:05 – Filial responsibility laws transform moral duty into a legal obligation, impacting private property rights.
10:33 – Individuals are held to higher moral standards than corporations and government in terms of legal obligations.
11:00 – Failure to address rising care costs and accessibility issues in elder care through filial responsibility laws.
11:46 – Importance of understanding state laws on long-term care and seeking advice from elder law attorneys to protect family assets.
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