Aging Prison Population Poses Unique Challenges Aging inmates often require special care, which drives up the cost of incarceration. NPR's police and prisons correspondent Laura Sullivan and Jonathan Turley, director of the Project on Older Prisons, discuss the options available to prison systems in dealing with thousands of inmates growing old behind bars.


Aging Prison Population Poses Unique Challenges

Aging Prison Population Poses Unique Challenges

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Aging inmates often require special care, which drives up the cost of incarceration. NPR's police and prisons correspondent Laura Sullivan and Jonathan Turley, director of the Project on Older Prisons, discuss the options available to prison systems in dealing with thousands of inmates growing old behind bars.


This is TALK OF THE NATION. I'm Jennifer Ludden, in Washington.

An elderly man in a wheelchair, a woman who requires dialysis: These probably don't fit your image of the typical prisoner. But as prison rolls grow, so do the ages of inmates. Crime reforms of the 1980s and '90s meant mandatory sentences and reduced parole. That means more people growing infirm and dying in prison, and taking care of them is expensive.

Many states now operate geriatric prisons, some with round-the-clock care. Some are experimenting with early release programs, arguing that a convicted felon may no longer be so dangerous in his 80s or 90s.

Joining us this hour in Studio 3A is Jonathan Turley. He directs the Project for Older Prisons at George Washington University. And also NPR's police and prisons correspondent, Laura Sullivan.

Welcome to you both.


Mr. JONATHAN TURLEY (Director, Project on Older Prisons, George Washington University): Thank you, Jennifer.

LUDDEN: Later in the hour, a Tuesday mini-edition of the Political Junkie. We'll talk with the Republican and Democratic House candidates from Colorado's Fourth District.

But first, aging in prison. We'd like to hear from those of you with direct experience with this issue, in law enforcement, the prison system or families of older inmates. Tell us your story. Should states grant parole to aging inmates?

Our number here in Washington is 800-989-8255. Our email address is And you can join the conversation at our website. Go to and click on TALK OF THE NATION.

We begin with Jonathan Turley for an overview here. Tell us: How many people are we talking about?

Mr. TURLEY: Well, there's no single source of data to show us the exact numbers of older prisoners across the country. What we do know is that it's the fastest-growing segment of prison populations.

States are reporting that the number of older prisoners - which are often measured at 50 older. At POPS, we set it at 55 and over. But they are the fastest-growing segment.

To give you an idea of that growth, in Virginia, you have just one prison reporting that they had 900 inmates in 1990, and today, they have 5,000 that would fall into this category. So you have that's just one state.

And so you have a very fast-growing population. And part of the problem for these states is that they're not just occupying cells that are in great demand, but these older prisoners often cost twice the amount of younger prisoners.

LUDDEN: Twice as much.

Mr. TURLEY: Yes. And so they're not only in systems that are often overcrowded, where they need these cells, but they're doubling, and in some cases, tripling the cost.

What you have to realize is that 67 percent of older prisoners have at least one disability. And so that adds to these costs.

LUDDEN: I mean, they're like the general population, right?

Mr. TURLEY: They are.

LUDDEN: I mean, this is like the budget-buster for the national government, and it's also I mean, what about in a geriatric unit -I've read some, in Virginia, I think there's a unit with 24-hour care. What would that cost per year?

Mr. TURLEY: Well, in the Deerfield facility, which is probably the one that you're referring to, the care there is about almost $29,000 for an older prisoner. The average care costs are about $19,000.

That actually represents a reduction of cost. Part of the things that part of the problem that we address in POPS, when we go to different states, is that you can reduce costs by moving older prisoners who are too high-risk to release into specialized units.

You get the sort of economy of numbers that come with having a consolidation of these prisoners. The problem is that most states don't have that. And so they have overcrowded systems. You have guards moving 200 inmates at a time. Two or four of those may be geriatrics. And they tend to duplicate and multiply costs within that system.

LUDDEN: So are more states, then, looking to build these geriatric units? Is this something that we're going to see more of?

Mr. TURLEY: You will definitely see more of it. One of the things that we've often encouraged at POPS is that they need to look at low-risk, high-cost prisoners that can be safely released.

And for those prisoners that would not be viewed as low-risk, they're not high-risk for escape. Many of these people are in walkers and wheelchairs. They're not going to go over a razor-wire fence. And you can save a considerable amount of money just moving someone from a medium to a minimum-security facility.

Fifty percent of all costs of a prison are actually guard salaries and benefits. So you can dramatically reduce those costs. And that's what you see in places like Deerfield. Even though it's higher than average, it would be much higher if they were spread throughout the population.

LUDDEN: Laura Sullivan, you have visited prisons with a large older population. Tell us about it. What is it like?

SULLIVAN: Well, I've been to I mean, I've been to a number of prisons, probably half a dozen or so, that have specific geriatric wards where they put a number of inmates - very elderly, older inmates - into these sort of - their own little facility. And they actually feel a lot like hospitals.

I mean, these look like they're yellow walls. They're linoleum floors. There are no bars. You don't have that cell feeling. And the people walking around are nurses. I mean, this is it's just, you know, there's not there's no sense of sort of the correctional officers that you see in the cell blocks. And most of the inmates are in wheelchairs or they're in bed.

And I have to say, actually, that there's - in the couple of places I was at - a sort of a congenial atmosphere. I mean, there was a lot of, you know, card-playing going on. There was a lot of, like, wheelchairs coming up to the metal table. There was a lot of, you know, Oprah-watching. There was just - it was very laid back and very it did not feel like a prison.

LUDDEN: And tell us about some of the people that you've met. I mean, you know, we hear about a life sentence, but you just don't imagine the 93-year-old continuing to serve this.

SULLIVAN: Right. Well, here's the interesting thing about that, is that most of these life-in-prison-without-parole sentences started in the '90s, and most of the people getting them were in their 20s, 30s, 40s at the latest. I mean, these are generally crimes that are committed by a younger population - first-degree murder, things like that.

So those inmates that you give about 20 years, those inmates are really only in their 60s or 70s now. They're just starting to have medical issues and geriatric problems.

People age a little bit faster in prison because the food's not as good, and there's not a very healthy lifestyle. But in any case, this -there's a boom - there's a real push of inmates that are coming through the system that are about to overload a lot of these geriatric wards.

So right now at the moment, what you're seeing with these 80s and 90-year-olds are people who committed a very rare crime late in life. There are a couple of people I interviewed who - there were some crimes of passion. There was, you know, they had committed their wife's lover. There was a couple of those. And also, there's a high degree, a high percentage of sex offenders in some of these geriatric wards. Yeah.

LUDDEN: Who have been in for how long?

SULLIVAN: They have the shorter sentences. The people who committed the violent crimes had several-decade-long sentences. They had been in since their 50s or 60s. They're, you know, 80, 90 years old now. Sex offenders were mostly they, you know, had gotten 10 or 15-year sentences when they were 70 or so. It's an interesting little statistic about geriatric wards in prisons.

LUDDEN: So is it hard to get in one of these geriatric wards? Are there spaces available, or are there waiting lines?

Mr. TURLEY: Well, they're actually harder to get into. If you look at Stanton in Virginia, there was a long list to get into that facility, before Deerfield in Virginia accepted more.

And part of the problem is how to count older prisoners. The actual number of physiologically older prisoners is greater than what you would consider in the chronological sense.

And as Laura sort of pointed out, there's a lot of studies that indicate that people age faster in prison. In fact, many studies say that you're about seven years older if you have long-term incarceration in a prison. It's due to the stress. It's often due to bad lifestyles, with chemical dependency and other issues.

So the number of physiologically geriatric prisoners is much higher than what appears, and that explains why there's these ballooning costs.

When we go into states like California, one of the first things that they raise with us is, you know, we're seeing this ballooning cost that is going beyond the rate of increase for health care. It's going beyond the increase in prisoners. And the reason is because the prisoners themselves are becoming more expensive as they age.

LUDDEN: And I mean, is the full range of health care provided there? I mean, some people may need operations and so forth. How...

Mr. TURLEY: Well, that's exactly right. And for systems that don't know how to handle it, they do ridiculous things. I cut my teeth in this area in Louisiana, when I taught at Tulane - that's where we started POPS -at Angola Prison.

And at Angola, I remember they had one guy that would go to get dialysis multiple times a week with two guards in tow, and they would drive them all the way to Baton Rouge. And it's that type of cost that mount up.

Part of the problem is, also, if you don't have a facility or a unit or a staff that's trained, it's very hard to do preventative medicine because of a phenomenon called masking. And masking comes with age, that as you age, the symptoms of aging can mask types of illnesses.

And someone who's experienced with geriatric medicine can account for masking issues. But most doctors can't. So many of these illnesses for older prisoners go chronic, and they become extremely expensive.

LUDDEN: All right. Let's take a phone call here. We have Jay in Fresno, California. Go right ahead.

JAY (Caller): Yeah. And I like the show, by the way. You know, I kind of think it's ridiculous to release any of these offenders. You know, I do believe that they can still commit harm, you know, if they choose to do so.

And another thing is that I understand, you know, just like lawyers, you know, or young lawyers have to do pro bono, you know, how come young doctors can't be interned to have to perform some sort of service as part of their training?

And it is prison, you know, after all. These people committed crimes. So, you know, I mean, I understand, you know, cruelty. But there again, aren't you trying to I mean, it just don't seem I mean, what am I missing here? You guys are talking about caring for these people and the type of care that they need when they should have thought about that before they committed a crime, don't you think?

LUDDEN: Okay, thanks for the call. Laura Sullivan?

SULLIVAN: Yes, let me tell you, there are a lot of people out there that feel exactly the same way you do. And that is probably the number one reason why most of these compassionate release programs never get off the ground, because if you this is your sentence. You've committed your crime, and the public has been promised that they are getting life in prison without parole or that they have a sentence to serve, that they don't get they shouldn't get out, for whatever reason. There is that.

The countervailing forces underneath that are state budgets. And there are a number of people, state officials - and I talked to some even in the state of Pennsylvania who were saying: We would do anything to get some of these 80, 90-year-old inmates out of our prison system and onto the federal, you know, Medicare and Medicaid system so that we don't have to pay for them anymore.

We want to just send them out and put them in a home so that they can pick up federal dollars, and we don't have to pay the state budget. Because some of these inmates are costing them hundreds of thousands of dollars.

So but it ends up - you know, a lot of victims' rights groups.

LUDDEN: Okay, we're going to get Jonathan Turley has something to say on that. We'll hear that in just a moment. We're talking about the challenges of aging inmates in prison systems. More with Jonathan Turley and NPR's Laura Sullivan in a moment.

Tell us your story: 800-989-8255. The email address at TALK is I'm Jennifer Ludden. It's TALK OF THE NATION from NPR News.

(Soundbite of music)

LUDDEN: This is TALK OF THE NATION from NPR News. Im Jennifer Ludden.

We're talking about the aging of prisoners in America and what prison systems are doing to adapt. And we'd like to hear from those you with direct experience with this issue, in law enforcement, the prison system or families of older inmates. Tell us your story. Should states grant parole to aging inmates?

Our number here in Washington is 800-989-8255. Our email address is And you can join the conversation at our website. Go to, and click on TALK OF THE NATION.

Our guests are NPR police and prisons correspondent Laura Sullivan and Jonathan Turley, a legal scholar at George Washington University. He also runs the Project on Older Prisoners.

And we have an email from Cliff(ph) in Utah, who writes: In Utah, we've had issues with legislators who have constituents with family members in facilities where the state wants to parole a geriatric offender. There are all kinds of concerns about who gets informed, how they're informed, what rights the geriatric parolee has and so forth. Can you comment on this?

We just heard a caller opposing the idea of paroling these prisoners. Jonathan Turley, you wanted to say something about this.

Mr. TURLEY: Well, I think you have to keep in mind that many of our systems are still overcrowded. Some of them are chronically overcrowded. Most of them are beyond designed capacity. And in some of those systems, one prisoner in can mean one prisoner out. There are people being released under court order today.

And the question for society is not whether someone will be released. Someone's going to be released. The Constitution requires that they be released unless we do a massive expansion of our prison system.

The question is who. And we're not making a decision, a logical decision, in our society anymore. The United States used to be the leader in correctional philosophy. There's actually a thing called correctional philosophy.

We used to be the world leader in that, and then in the 1980s, we went to a warehousing approach. We tore up parole and pardon laws, and we started to stack these prisoners. And recidivism went through the roof, and overcrowding went through the roof. So we have to deal with this in a mature way and make qualitative decisions.

LUDDEN: You're saying that the population is growing so much that people do have to get released before their time is up?

Mr. TURLEY: Oh, people...

LUDDEN: Because it seems I have the impression that the system has grown so much, but you're saying it still can't keep pace and is not expected to keep pace.

Mr. TURLEY: Yeah, it depends on which state you're talking about. I remember when I was in New Orleans, they used to release people every day at OPP, the prison downtown. I wouldn't let my students go down there because it was so dangerous to be there when those releases occurred.

What's fascinating about our system is that we actually work to release prisoners when they are most dangerous, when the recidivism rates are the highest - young prisoners who are graduating up in crime.

And then, around 30, we tend to hit them with long-term sentences, just about the time when they start to fall in their risk.

What we know about recidivism is around the age of 30 or so, most males, which are predominately the people in these systems, drop in terms of their risk. And that doesn't apply to everyone. As Laura pointed out, there are late bloomers, people who, you know, commit these crimes late in life.

But many of these prisoners are actually stagnant. They're in there because there's no parole and no pardon, and so they're getting older on the vine, and they're becoming more expensive, and they're occupying a lot of space that we need.

LUDDEN: All right, let's take a phone call from Rob(ph) in Wildwood, Florida. Go right ahead.

ROB (Caller): Yeah, I just had two questions for the panel, and then I'll or, you know, two comments, and then I'll just hang up and let you guys discuss it off the air.


ROB: My first comment is, after you let somebody serve 40 years in prison, it seems to me, kind of odd that you would release them and then hope that they would reintegrate into society after such a long time behind bars.

And then the second thing is: If they're in their 60s or 70s, and they're not eligible to work, and you release them back into the population, do they just become a burden on the Social Security system? That's all. Thank you.

LUDDEN: All right, thanks, Rob.

SULLIVAN: Yes, they do.

(Soundbite of laughter)

LUDDEN: Laura Sullivan.

SULLIVAN: Absolutely they do, and I think that that's why the states have an incentive to release them because it takes them off of the state budget structure. They're no longer a state problem; they're a federal problem.

But, you know, some of these inmates that I talked to in these facilities, they dont have anybody to go home to. They haven't had a visitor in 20 years. I mean, they have become so old in these facilities, I mean, any idea of family or grandchildren is sort of long gone. You know, they've just sort of gotten forgotten about in these places.

And one of them that I spoke to, they were in California. He was 97 years old. And he actually told me that he didn't want to be released. The state was trying to release him to some sort of a home where the federal government could pick up the cost, and he was saying I don't want to go because this is my family, this is my home, this is where I've been for 40 years. I don't know anything else but this.

LUDDEN: Jonathan Turley?

Mr. TURLEY: I certainly have heard stories like that, and obviously, they're quite credible. But I have to tell you, I've met very few older prisoners who want to stay in jail, the sort of "Shawshank Redemption" type of characters.

And I don't doubt that there are some, including the one that Laura spoke to. One of the things that we do at POPS is we don't recommend someone for release unless we know exactly where they will live and what they'll live on.

But one of the most difficult things that we have is speaking with governors. And one of the things I tell them is we're going to save you a lot of money. And in return, we expect some of that money to go to what we call a soft landing, so that you don't throw these guys into society.

LUDDEN: All right, but Dennis(ph) writes an email: If geriatric prisoners are released from prison, the public will still have to pay for their care. Laura just said it goes from the state to the federal payroll - budget. So where's the savings?

Mr. TURLEY: Actually, there is a considerable savings because the state systems are very efficient in dealing with medical care. Everything tends to be more expensive in a prison system, because the real estate's more expensive, the care is not very good so they don't do preventative medicine, more things go chronic.

When you go into the general welfare system, you've got agencies I know people don't view that as very efficient, but they are much more efficient than a prison system in dealing with that type of care.

And there is an introduction process. I mean, I released one guy, had one guy that was released who went to jail when Truman was in office. And it was like bringing, you know, Rip Van Winkle into society. But he adjusted well.

And the important thing is to make sure that you have a soft landing, and as long as you do, they do very, very well. In fact, they're ideal. I mean, part of the problem is trying to get these guys to leave their nursing homes. They tend to want they're afraid of society, and you sort of coax them out and reintroduce them to society.

LUDDEN: All right, let's take another phone call, Chris(ph) in Tallahassee, Florida. Go right ahead.

CHRIS (Caller): Hi, I just had, like one little, quick question. Basically, I guess bluntly, let me ask is this: why should we care so much about I guess...?

LUDDEN: Perfectly good question, Chris.

CHRIS: Yeah, like certain offenders, like, you know, someone that what I like to say breaks the law of nature and takes the life of another human, shouldn't have these options available to them as far as because as far as I'm concerned, our prison system is many prisoners have it pretty good.

You know, you get three meals a day. You have a place to sleep. You have rest time. You have a weight room. You know, it's quite hospitable.

LUDDEN: Are you ready to go?

(Soundbite of laughter)

LUDDEN: Thank you for the call, Chris, and let's put that to Laura Sullivan.

SULLIVAN: Well, what we have here is a world of extremes, because you can't send say somebody, you know, robs a bank, and you send them to prison, and they get a toothache, and they die of the tooth infection. That hardly seems fair, and that's actually exactly what happened in California, and it launched one of the largest prison health care lawsuits the country's ever seen.

So when you get sent to prison to serve a 10-year term or to pay your debt to society, it's not supposed to be a death sentence. It's supposed to be whatever the judge gave you.

But on the other hand, if the health care becomes so luxurious or more than what people are getting on the outside, it raises these questions of why do they deserve to have this terrific health care, and people on, you know, in society don't get to have that?

So some prison systems across the country are trying to find some kind of middle ground, where they are not killing people, and they are actually taking care of them and keeping them alive, but they're not, you know, giving them anything beyond what other people would have.

And, you know, he raises a really good question that I hear all the time from people: why do we care about inmates that are dying in prison? And, you know, it's just, it's one of those philosophical divides.

LUDDEN: Jonathan Turley, does that make...?

Mr. TURLEY: Well, first of all, I've never been to these prisons. I've been to a lot of prisons in my career, and I haven't been to one that's quite that luxurious. Prisons are horrible places.

And many of the prisons, by the way, have gotten rid of recreation rooms and even television. We've gone to a warehousing approach, where we stuff people into cells like kindling wood. And the public has no idea what it is like in most of these prisons.

But the reason you should care is because when that person is occupying a cell, there's someone that should be there, who's more dangerous. And all those politicians that say I don't want anyone to be released, what they are not telling the public is that people are being released. What they're not telling the public in places like California is that there's a crisis, an epidemic of recidivism.

We studied the California system, and I was absolutely shocked by the level of recidivism. What people should be upset about is that we have a system that isn't working, that we have people going out that are committing new crimes because we're not making mature decisions.

We're running systems on soundbites, and there are people that are being victimized because those younger prisoners, the more dangerous ones, they're the ones who will end up in your living room tonight. And so we need to make decisions.

LUDDEN: All right, let's take another phone call. Brian(ph) is in Birmingham, Alabama.

BRIAN (Caller): Hi. We've had a number of public officials convicted here. And one official in particular has not been sentenced along with the rest of the lot because of his age. And I understand that the judge in the case believes the sentencing guidelines will affect age. Is that true? Or lower the guidelines for senior citizens?

Prof. TURLEY: Well, no, not really. I mean, the age can be considered in some sentencing systems. It can certainly be a basis for downward departure. Generally, if someone commits a crime in older age, it is negated as a factor because you can't commit a crime as a 90-year-old and say, my God, I'm 90. And courts will generally ignore that. So I don't think it's a very significant factor if the person is already elderly when the crime is committed. It...

BRIAN: The judge is looking for a departure here. He might...

Prof. TURLEY: Yeah. I mean, the thing is the judge is allowed to look over - at all of the circumstances in terms of the prisoner and history and medical conditions. But I must say, generally, they - judges are usually fairly hostile to arguments of age when the person has committed the crime as an elderly individual, particularly for violent crimes that's the case.

LUDDEN: All right. Well, Brian, thanks for the call.

BRIAN: Thank you.

LUDDEN: And Steve(ph) is in Vernon, Connecticut. Go right ahead, Steve.

STEVE (Caller): Hi. I think the question that we have to look at is like the role of the prisons. Are we here to punish these people or are we here to correct actions and put them back in society? I mean, are we trying to remove a man from society for 40 years as a punishment? Do we really think it's going to take 40 years to reform him? Is he going to be useful to be put back in society or is he going to cost too much money in further crime prevention or in health care in prison?

LUDDEN: Jonathan Turley?

Prof. TURLEY: Well, you know, the problem - that's a very good point. I mean, there is certainly an element of retribution in any penal system. The United States, however, was one of the first major systems to get away from pure retribution. And we went to reforms in determinant sentencing. And by the way, the Framers, one of the first things that was done after the Republic was to reexamine the purpose of prisons in a country like the United States when it was still a young and nascent republic.

The answer, I think, is that we don't have enough prisons to hold everyone. We can't - we're already one of the were one of the leading countries in terms of the percentage of people behind bars right now. We're right up there with China. And we can't just continue to build our way out of the problem. We have to make qualitative decisions.

And, yes, these people are going to end up back in society. They're not all going to be serving life in prison. So we've got to reexamine what we did in 1980s and look at our recidivism crisis, and to say, what can we do to reduce that? That should be our attention, to stop people from being new victims.

LUDDEN: All right. Steve, thanks for the phone call.

You are listening to TALK OF THE NATION from NPR News.

Laura Sullivan, is there any discussion about changing sentencing guidelines? You know, is it tougher to say life when everyone is going to be living until 95, and we know what that's going to cost?

SULLIVAN: Everything that we've seen so far shows that that has not played - had any impact whatsoever. Most - all the laws from the past 20 years have been toward harsher, longer, stricter sentences. There is some discussion in some states about how we want to, you know, eliminate the crack cocaine disparity. Some of these sort of egregious examples of lengthy sentences.

But for the most part, the majority of states now have life without parole. The majority of states have lengthened their sentences for crimes. Your bank robbery used to be five years, now it's 20. I mean, it's - there's no movement so far in the opposite direction.

LUDDEN: What about - we did mention that some states are experimenting with early parole for the senior population. Is that - how widespread is that and how is it going?

SULLIVAN: Not very widespread because it's a political hot potato. You're basically releasing inmates that had a sentence and you're, quote, unquote, "releasing them early" is the way that victims' rights and advocates reflect that sort of idea. And the idea of being released early means you're getting a deal. You're getting something that you are not due.

I think that on the other side, people are saying that there's no - they serve no purpose in prison. They're - any rehabilitative effort has been accomplished. They can't commit another crime. It's time for them to go home. So, you know, that sort of - there's - it's going to be interesting to see how it pans out over the next 10 years.

LUDDEN: Well, let's take another call. Peter(ph) in Denver, Colorado. Go right ahead.

PETER (Caller): Yeah. I was in a project to build and house aging inmates in nursing homes. And we worked on this project for, oh, I don't know, over a year and a half, and we presented to government.

And even though we knew we could save the state probably around four or $5 million dollars a year, the interest from the politicians - and I did meet with them - is that they didn't want to support it. They just couldn't get political support to house inmates in a nursing home where we had to build to all the ADA standards, the health safety issues, to go from, you know, five-by-nine cell to a cell that was probably 200 to 300 square feet so we could meet all the codes. And we knew we would save a lot of money to the state but they just weren't interested so...

LUDDEN: All right.

PETER: ...the whole project just died.

LUDDEN: Peter, thanks for letting us hear about that. And we have time for one last call. I believe we have someone who has recently been released from prison. Ted(ph), go right ahead.

TED (Caller): Hello. I'm just calling - I enjoyed listening to your program. I've been a guest of the state prison system for the last couple of years and recently released. And I can assure people that theyre no picnic. And I'm not saying this is undeserved, but the caller that touted the advantages of imprisonment has obviously never been inside a prison.

LUDDEN: And you were only in for a short time? Is your transition out going all right?

TED: Well, compared to a few weeks, it's 10,000 percent better. Yes. And I'm I was one of the most elderly people in the prison. And I have experienced that, you know, they have absolutely no medical care whatsoever. I mean...

LUDDEN: You know what, Ted? I'm so sorry. We are running out of time. We thank you so much for the call, but we have got to let you go. We've been speaking with Jonathan Turley, law professor and director of the Project for Older Prisoners at George Washington University, and Laura Sullivan of NPR News. Thank you so much.

Prof. TURLEY: Thank you.

SULLIVAN: Thank you.

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