Community Health Collective

Jill Steeley

I'm Jill Steeley, and I spent years as an FQHC CEO feeling like I was the only one struggling with impossible choices—mission or margin, staff or budget, growth or sustainability. Until I realized: I wasn't alone. None of us are. That's why I created this podcast—to build the community that community health leaders deserve. Whether you're leading a health center, a rural clinic, a public health program, or any organization putting community care first, you'll find practical wisdom, honest conversations, and a whole lot of "finally, someone gets it" moments here. Each episode tackles the big stuff—financial strategy, workforce challenges, policy changes—and the personal stuff—boundaries, burnout, and what it really takes to sustain yourself while serving others.

  1. 3d ago

    If We Serve the Poor, We Should Be Poor Too”: Why I Refused, and How We Got to Millions in the Reserves

    Community Health Collective Host: Jill Steeley No margin, no mission. In this replay of her guest interview on The Claim Game with Jeremy and Kathryn Zug of Practice Solutions (originally aired March 6, 2026), Jill tells the story behind the turnaround that shaped her whole career - how she backed into public health by accident, then walked into a county-run health center with nearly a $1 million deficit, no doctor recruited in five years, a closed dental clinic, and a county that believed "if we serve the poor, we should be poor too." She walks through the five moves she now teaches in the FQHC CEO Connect Bootcamp with Steve Weinman - increase and diversify revenue, reduce costs by plugging the leaks, market and brand your health center, create an exceptional patient experience, and keep the momentum going - and then gets into payer mix, why your health center's name might be scaring off insured patients, how she'd use AI if she were in the CEO seat today, and the KPI habit that turns your data into a rearview mirror. The surprise? She isn't doom and gloom about what's coming. Her take is that people are tired of transactional healthcare, and the health centers that get in front of their communities now will win. This one's for health center CEOs and senior leaders who are tired of living grant cycle to grant cycle. Highlights: How Jill fell into public health - starting a county health department from scratch in Virginia City, MontanaDay one at the health center: nearly a $1M deficit, no doctor recruited in five years, a closed dental clinic, and 42% of patients uninsuredWhy the county wanted the health center to stay poor - and the "run it like a business" mindset that changed everythingThe 12-month speaking crusade and the employer partnerships that brought in privately insured patientsThe five moves Jill and Steve Weinman teach in the BootcampThe no-show math: 2,000 missed Medicaid visits at $200 each is $400,000 a yearBrand recognition from 23% to over 90% after the rebrandWhy health centers are in a great position to attract Medicare patientsIs your health center's name keeping insured patients away?AI for coding, claims, scheduling, and phone calls - and why you should replace obsolete tasks, not peopleThe KPI mistake: only looking at your data once a yearWhat Jill sees coming in 2027, and why she isn't doom and gloom Quotes from the episode: "You attract people with a payer and serve people with a payer in order to serve the people without a payer.""They thought if we serve the poor, we should be poor too.""People are looking for transformational healthcare and not transactional healthcare.""If they don't know you exist, they're not coming."Mentioned in this episode: The Claim Game podcast, hosted by Jeremy and Kathryn Zug of Practice Solutions: practicesol.comSteve Weinman, Jill's Bootcamp co-leaderJill's Community Health Collective Episode #20 with Athelas on AI agents for insurance calls: www.jillsteeley.com/podcast/community-health-collective/reduce-denials-revenue-growth-health-centerEpisode #19 - Rural Health Transformation Funding: www.jillsteeley.com/podcast/community-health-collective/rural-health-transformation-funding FQHC CEO Connect Bootcamp. A 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Next cohort starts Spring 2027: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    If We Serve the Poor, We Should Be Poor Too”: Why I Refused, and How We Got to Millions in the Reserves
  2. Oct 21

    We Replaced the Microwave: Why Your Staff Forgive Bad News but Not Silence

    Community Health Collective Podcast Host: Jill Steeley Invisible work looks exactly like no work. In almost every employee focus group Jill runs during strategic planning, someone says it: "They ask us, they do the surveys every year, but we never see them do anything." When she takes that back to leadership, the answer is always the same - "But we did do things." And they did. They just never said so. In this episode, Jill unpacks the gap between what you did with your staff's feedback and what your staff think you did, puts real turnover math behind it, and walks through her Close the Loop Cadence - ask more than once a year, say it back before you've fixed anything, fix one small thing fast, and report out on a schedule. She shares how a weekly all-staff update, sent even on weeks with nothing new, helped her keep 99% of her staff when her health center separated from county government and employees lost their public employee retirement system. And she makes the case that a new break room microwave, announced out loud, can build more trust than a six-month initiative nobody ever hears about. Here's the thing: staff forgive bad news, but they don't forgive silence. This one's for CEOs, directors, and supervisors who keep reading "nothing ever changes here" and know that isn't true. Highlights: The sentence Jill hears in almost every staff focus group - and what leadership always says backWhy high performers are the best at invisible work, and why that backfiresThe math: $45,000 a year in hourly turnover, about $112,000 to replace one nurse, and hundreds of thousands for a providerThe county separation story: losing the public employee retirement system and keeping 99% of staffWhat to put in a weekly update when there's nothing new (a quote, a book, even drinking more water)The Close the Loop Cadence: Ask, Say It Back, Fix One Small Thing Fast, Report OutThe three parts of every update: what's done, what's in progress, and what's not happening and whyWhy the microwave beats the culture committeeLine of sight in reverse: your staff can only see what you tell them20-minute homework to start this week Quotes from the episode: "Your staff don't experience your work the same way that you do. They experience your communication about your work.""Invisible work looks exactly like no work.""Staff forgive bad news, but they don't forgive silence.""A clear no builds more trust than your staff trying to figure out why it's not happening on their own."Mentioned in this episode: Episode #42 - "You Didn't Lose Control. You Lost Line of Sight."Leadership Team Development with Jill: www.jillsteeley.comJill's Healthcare Leadership Trainings and free resources: www.jillsteeley.com/leadershipThe Healthcare Leadership Style Quiz: www.jillsteeley.com/leadershipquiz FQHC CEO Connect Bootcamp. A 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Next cohort starts April 2027: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    We Replaced the Microwave: Why Your Staff Forgive Bad News but Not Silence
  3. Oct 14

    Your 340B Discount Just Became a Mail-In Rebate. Here’s What That Costs a Health Center.

    Community Health Collective Podcast Host: Jill Steeley Guest: Steve Weinman The 340B rebate pilot is happening, and it isn't a hospital problem. On October 1, HRSA approved 10 drug manufacturers to pay the 340B discount as a rebate instead of an upfront price cut, starting January 1, 2027. In this episode, Jill Steeley sits down with Steve Weinman, principal and CEO of FQHC Associates, to explain what changed since last year's pilot was blocked in court, how the rebate actually works (pay list price, file within 45 days, wait up to 10 more for your money), and why the drug list lands squarely on health centers: diabetes, AFib, COPD, and behavioral health drugs your providers prescribe every day. Steve's bottom line is "hope is not a strategy." There's a lawsuit and there are bills in Congress, but you plan as if this starts on January 1, the same day the Medicaid cliff hits and UDS season starts. Then he walks through seven moves to make now, starting with knowing your float, the dollar amount you'll have to front while you wait on rebates. The flip lands at the end: don't quietly adjust. If health centers make this look tolerable, it'll be 30 more drugs next year. This one is for health center CEOs, CFOs, and pharmacy leaders who need a plan, and a board briefing, before January. **Highlights:** - Where things stand: 10 manufacturers approved October 1, the pilot starts January 1, 2027, and a lawsuit and bills are already in play - What's different from last year's pilot, which a judge in Maine blocked as "hastily assembled" - How a rebate works compared to an upfront discount, explained with a $10 store coupon - Why 45 days to file isn't really 45 days once your contract pharmacy reports and your TPA get involved - The drug list: Jardiance, Farxiga, Januvia, Janumet, Tradjenta, Eliquis, Breo Ellipta, Vraylar, Austedo, and more - The January 1 collision: the rebate pilot, the Medicaid cliff, and the start of UDS season, all on one finance team - The good news: no denials for diversion or duplicate discount disputes, capped data collection, and required denial reporting - Seven moves to make now: know your float, call your wholesaler, pin down your TPA, re-check your sliding fee pricing, brief your board, log every late payment and denial, and keep a story log - Whether to change your formulary, drop contract pharmacies, or bring pharmacy in-house - Why the pilot is a test of how much health centers will tolerate **Quotes from the episode:** > "Hope is not a strategy. So yeah, we hope it'll be delayed, but we better be ready to deal with it." - Steve Weinman > "These are not some high-cost drug that's being used for chemotherapy." - Steve Weinman > "I would not switch TPAs right now because one of them will do it for a nickel cheaper." - Steve Weinman > "This pilot is just that. It's a test to see how much they can subject us to and get away with." - Steve Weinman **Mentioned in this episode:** Steve Weinman, Principal and CEO of FQHC Associates: https://www.fqhc.org, sdweinman@fqhc.org The 340B Rebate Pilot quick guide (how it works, what to do now, and which drugs are included): REBATE GUIDE LINK HRSA's 340B Model Pilot Program page: https://www.hrsa.gov/opa/340b-model-pilot-program Report late payments and denials to HRSA: 340Bpricing@hrsa.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her (https://calendly.com/jill-v7c/30min). ---

    Your 340B Discount Just Became a Mail-In Rebate. Here’s What That Costs a Health Center.
  4. Oct 7

    Twelve Months Analyzing a Weight-Loss Program. A Competitor Launched It in Six.

    Community Health Collective Podcast Host: Jill Steeley Indecisiveness has a cost, and Jill Steeley paid it. When she was a health center CEO, her team spent 12 months analyzing whether to start a weight-loss program while a competitor in the community simply launched one. The cost: roughly 500 patients and $900,000 in revenue. In this solo episode, Jill tells that story, owns her part in it, and does the math most leaders never see, about $75,000 for every month the decision sat on the agenda. She explains why clinically trained leaders are especially likely to get stuck here, then walks through the three things she does now: decide at 80% of the information, put a deadline on the decision itself, and ask the regret question. The flip is the part that stays with you. Waiting is a decision too, and it's the one mistake nobody will ever call a mistake. This one is for health center CEOs and senior leaders with an item on the agenda that keeps rolling to next month. Highlights: The story: 12 months of market analysis, a competitor who went first, and about 500 patients lostThe math: roughly $900,000, about $1,800 a patient, and about $75,000 for every month of waitingWhy waiting feels safe, and why it's still a decision with a priceWhy a business decision is not a diagnosis, and what that means for clinically trained leadersThe 80% rule, and the one question that tells you when you have enoughHow to put a deadline on a decision, and how a three-month pilot makes a big decision smallerThe regret question: a year from now, which will you regret more, acting now or waiting for more data?Homework: find the oldest item on your leadership agenda, price it, and pick a date Quotes from the episode: "It's not like a direct cost that is glaringly staring at you in a budget line item, but it is a real cost, and I did pay it." "Waiting is also a decision. It just doesn't feel like one." "It's the one mistake you can make over and over that no one will ever call an actual mistake." "A business decision is not a diagnosis. In a diagnosis, the answer already exists, and your job is to find it." Mentioned in this episode: FQHC CEO Connect Bootcamp. A 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Enrollment is now open: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    Twelve Months Analyzing a Weight-Loss Program. A Competitor Launched It in Six.
  5. Sep 30

    I Just Paid $3,500 for a Conference (and I'm Still Going)

    Community Health Collective - The Monday Morning Problem Episode Host: Jill Steeley Jill Steeley just registered for a November conference, added up the bill, and landed at about $3,500 before she'd learned a thing. And that's only half the receipt. The other half is what she calls the Monday morning problem: the conference ends, you go home, and on Monday morning you're alone with all those ideas and none of the help to do them. In this episode, Jill runs the full math on a conference versus the FQHC CEO Connect Bootcamp, walking through the direct costs, the time costs that never show up on an expense report, and the three things you don't come home with: implementation tools, someone to call, and content built for your health center. Then she flips it. Jill is still going to her conference, and she explains why the mistake isn't going, it's asking a conference to do a cohort's job. This one is for health center CEOs and senior leaders deciding how to spend a professional development budget in a year when the coverage cliff is on the calendar. Highlights: The full receipt on one conference, one person: about $3,500 direct and roughly $7,000 once you count timeA quick formula for pricing a day of your own time (annual salary divided by 260)The five hidden line items: days out, the catch-up, no tools to implement, no one to call, and content that isn't built for your health centerThe same math run on the fully virtual Bootcamp, including the surprise that the learning hours are about the sameWhy conferences are great at connection and terrible at implementationThe one question to ask about your budget this year: which option changes my numbers by April?Homework: find your last conference receipt and name one thing you changed because of it Quotes from the episode: "The conference ends, you go home, and on Monday morning you're alone with all of those ideas and none of the help to actually do them." "The mistake isn't going to a conference. The mistake is expecting a conference to do the job of a cohort." "I don't go expecting to come home with a plan, because I know I won't, and I've stopped being disappointed about that." "It's not the content. It's whether you're by yourself with it afterward." Mentioned in this episode: FQHC CEO Connect Bootcamp. A 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Enrollment is now open: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    I Just Paid $3,500 for a Conference (and I'm Still Going)
  6. Sep 23

    Hire an 18-Year-Old at $17 an Hour to Run Your Lobby

    Community Health Collective Podcast Host: Jill Steeley Jill calls it the Self-Checkout Hire - and it started with her 18-year-old son, who makes $17 an hour at Lowe's mostly helping people through self-checkout. Meanwhile, health centers are paying nurses, MAs, and front-desk staff to do the same kind of work by phone: portal signups, check-in, password resets, and rescheduling. In this solo episode, Jill makes the case for putting one young, tech-fluent person in your lobby and exam rooms whose whole job is getting patients onto the portal and scheduling themselves, walks through the five jobs of that role, runs the math on what it frees up, and names the prerequisite most centers skip - templated provider schedules. Then she flips the conversation: online scheduling isn't a nice-to-have anymore, and the belief that patients don't have a choice is a myth health centers can't afford. This one's for CEOs, COOs, and practice managers who are tired of watching licensed staff play phone tag. Highlights: Why Lowe's puts a $17-an-hour employee next to the self-checkout - and what health centers can learn from itThe hidden cost of licensed staff doing portal signups, password resets, and rescheduling by phoneThe 5 jobs of the Self-Checkout Hire: greet and enroll, teach self-scheduling, be the help desk, speed up check-in, and track the numberThe rough math: about $44K a year, fully loaded, versus the licensed hours you get backWhy templated schedules are the gate to patient self-schedulingThe captive-patient myth - and why patients who want to book at 7:30 at night will go somewhere that lets them Quotes from the episode: "Here's the thing, none of those tasks requires a professional license to help with." "When your most expensive people spend their day on ten dollar tasks, you end up paying for it twice... because nobody went to nursing school to reset passwords." "I call it the captive patient myth, the belief that patients will put up with whatever we offer because they have nowhere else to go." "This work is really hard, but some of the best fixes are simpler than we think. Sometimes it's just a friendly person standing next to a machine helping a patient." Mentioned in this episode: FQHC CEO Connect Bootcamp. A 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Enrollment is now open: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    Hire an 18-Year-Old at $17 an Hour to Run Your Lobby
  7. Sep 15

    Your Levers Have a Lead Time. The Cliff Doesn't.

    Community Health Collective Podcast Host: Jill Steeley Jill has been getting the same question three different ways, always at the end of a call: "I hear you on the four levers, but if I can only focus on one right now, which should I pull first?" In this episode she says plainly that she's been answering it wrong - not wrong exactly, just answering the question people asked instead of the one that matters. The right question is which lever pays out when you actually need the money, because every lever has a lead time, and those lead times run from 30 days on one end to four years on the other. She opens with a correction she hears constantly and has made herself: January 1st is not the day the money disappears. The redetermination clock runs from each patient's own original application date, so there is no single deadline - patients roll through renewals a few hundred at a time and the losses accumulate across all of 2027. Which means replacement revenue has to land in 2027, which means the 12-to-18-month levers had to start in Q3 of 2026. Then she ranks all four by speed: cost and productivity at 30 to 90 days, patient retention at 6 to 9 months, revenue diversification at 6 to 18 months, and market presence at two to four years. The flip lands near the end and it's the opposite of what logic suggests. The fast lever is still there in January and in June - cost reduction doesn't expire. The slow lever is the only one with an expiring start date. So you pull two, and the fast one doesn't just fund the slow one, it shortens it: money freed up from vendor contracts or a renegotiated commercial rate gets reinvested in market presence, and that four-year lead time starts shrinking. Jill closes with what she got wrong in her own turnaround - she rebranded in year one but didn't start the real market presence work until year two, and because that's the lever underneath the other three, the delay pushed everything downstream. If you're building a Q4 budget and wondering whether a revenue line that pays out in 2029 is a luxury you can't afford this week, this one is for you. Highlights: Why "which lever should I pull first?" is the wrong question, and the one to ask insteadThe correction on January 1st - there is no single redetermination date, it runs from each patient's own application dateWhat actually changes: expansion adults 19 to 64, six-month renewals, 80 hours a month of work requirements verified at application and renewalLever two, reduce costs and increase productivity: 30 to 90 days, and why the money is already yoursLever four, retain patients: 6 to 9 months, and the COO who recovered $700,000 in eight months without adding a single serviceLever one, increase and diversify revenue: 6 to 18 months, including what Jill learned about payer contracts from sitting on the Blue Cross Blue Shield side of the tableLever three, build market presence: two to four years, a 700-person community survey, and 27% brand recognition to 94%The flip: the fast lever never expires, the slow one does - so pull two on the same dayWhy the fast lever doesn't just fund the slow lever, it shortens itThe mistake Jill made in her own turnaround, and the years she thinks it cost herTwo pieces of homework you can start this week, one fast and one slow Quotes from the episode: "January first is not the day the money disappears.""No one tells you that, so people pick the lever that sounds best, they pull on it, and then wonder in March why the needle hasn't moved.""The fast lever is available to you in January. It's available in June. Cost reduction doesn't expire. The slow lever is the only one with an expiring start date.""The fast levers saved the health center. The slow lever is what made it unkillable.""That was my mistake. I sequenced them. I should have just started stacking them.""The best day to pull the slow lever was four years ago. The second-best day is today."Mentioned in this episode: The free live webinar with Steve Weinman on Friday, September 18th at 10:00 AM Pacific / 1:00 PM Eastern - a repeat of the September 11th session, same registration link. All four levers in detail, four health centers doing this now, and how to pick yours. Live attendees get the HR 1 exposure worksheet, the HR 1 90-day action plan, and the offense playbook, plus a birthday trivia giveaway. Replay goes to everyone who registers. Register: webinar.fqhc-ceo.com/register FQHC CEO Connect Bootcamp. An executive-level, 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Enrollment is now open: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    Your Levers Have a Lead Time. The Cliff Doesn't.
  8. Sep 8

    They Held a Closed-Door Session at CHI Called "Protecting the CEO"

    Community Health Collective Podcast Host: Jill Steeley Guest Host: Steve Weinman Steve Weinman came back from NACHC's Community Health Institute in Las Vegas with one observation that says more than any policy briefing: they held a closed-door session called Protecting the CEO, and you had to prove you were a health center CEO before they'd let you in the room. In this episode Jill and Steve unpack what that room means, and what everyone outside it was talking about. The number that dominated the hallways was 375,000 - the touchpoints a 25,000-patient Medicaid panel generates once you stack monthly work-requirement verification on top of doubled redeterminations. Steve walks through the panel math so you can run it for your own center: panel size, times a 30% procedural loss rate, times $650 per member per year. For a 25,000-member panel that's $4.9 million at risk, and not one dollar of it comes from a patient who actually became ineligible. Jill and Steve also cover the mergers-and-acquisitions conversations happening all over the conference and what those really signal, why a three-day coverage lapse can change your reimbursement, the 340B and retroactive Medicaid plays that put cash in the door fast, and why your enrollment team just became your retention team. Then Steve says the thing that reframes the whole episode: after 42 years inside health centers, he doesn't think this is a funding problem at all. It's a business model problem. Which is actually good news, because a business model is something you control. If you're a health center leader looking at January 1st and doing quiet math about what happens to your budget, this one is for you. Highlights: What Steve heard in every hallway conversation at CHI - and the closed-door CEO session that tells you how the room really feels375,000 touchpoints a year: what doubled redeterminations plus monthly work-requirement verification actually creates on a 25,000-member panelThe panel math, step by step: panel size × 30% procedural loss × $650 per member per year = your numberWhy a three-day coverage lapse isn't a rounding error - new plan, new benefits, new startup friction, different reimbursementWhy the mergers and acquisitions conversations at CHI are a symptom, not a strategyWhat's actually changing January 1st, and why 50 states doing it 50 ways is the part nobody can plan around yetYour enrollment team just became your retention team - and how to repurpose the people already in your buildingFast cash right now: 340B lines of business, retroactive Medicaid recovery, and commercial payer contracts you haven't renegotiated in yearsThe four levers Jill pulled to take a health center from 62.5% federal dependency to 17% - with a 42% uninsured rateSteve's first move for anyone with four months on the clock: get with your CFO, run your number, and take it to your board before they're surprised Quotes from the episode: "It was sort of this secret CEO session that you actually had to prove that you were a health center CEO before they would let you in the room." "It's not from actual loss of eligibility, but just having them throw so many barriers in front of the patients that they don't make it to the finish line." "Every touch point that gets missed is a lapsed record, and it's basically money walking out the door." "It is definitely not a funding problem. It is a business model problem." "If you put one hand in the oven and one hand in the ice box, the average temperature is a nice, comfortable 70 degrees, but one of them is frozen and the other one's on fire." Mentioned in this episode: Steve Weinman, principal at FQHC Associates and Jill's co-lead on the CEO Connect Bootcamp, with 42 years inside community health centers. NACHC's Community Health Institute (CHI), including the governance workshop on mergers and acquisitions and the closed-door "Protecting the CEO" session. The free live webinar on Friday, September 11th at 10:00 AM Pacific / 1:00 PM Eastern - "I've Already Run a Health Center at 42% Uninsured: Here's Why the Medicaid Cliff Doesn't Scare Me." Register: webinar.fqhc-ceo.com/register Episode #43, where Jill tells her own turnaround story in detail: www.jillsteeley.com/podcast RetroCAID, from Howard Archer at Fix Healthcare Technology - retroactive Medicaid recovery on a pure contingency basis. Schedule a call with their CEO: https://fixht.com/meeting/retrocaid-qa-jsteeley/ Vital Interaction, the patient engagement platform Jill and Steve have hosted in Bootcamp sessions on managing redetermination outreach at scale. To schedule a call with VI and get a 33% discount go to: https://guidance.vitalinteraction.com/jill-steeley FQHC CEO Connect Bootcamp. A 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Enrollment is now open: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    They Held a Closed-Door Session at CHI Called "Protecting the CEO"

Ratings & Reviews

5
out of 5
2 Ratings

About

I'm Jill Steeley, and I spent years as an FQHC CEO feeling like I was the only one struggling with impossible choices—mission or margin, staff or budget, growth or sustainability. Until I realized: I wasn't alone. None of us are. That's why I created this podcast—to build the community that community health leaders deserve. Whether you're leading a health center, a rural clinic, a public health program, or any organization putting community care first, you'll find practical wisdom, honest conversations, and a whole lot of "finally, someone gets it" moments here. Each episode tackles the big stuff—financial strategy, workforce challenges, policy changes—and the personal stuff—boundaries, burnout, and what it really takes to sustain yourself while serving others.

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