My name is Trudy Grable and I'm going to be your speaker today on In-Home Support
Services and how to prepare for the assessment for In-Home Support Services.
I am a long time employee at Parents Helping Parents, and I also have a
daughter who uses In-Home Support Services, and I also have about 27
years experience in working with families, so I hope to do you justice in
this training, and and help you to get the hours that your child needs and is
entitled to, so let's get started.
I want you to do some downloading of the handouts that you want to be able to
either refer to during the training, or refer to later.
So, let me just also tell you that if you are watching this webinar,
we have made every effort to make sure that the information is
current and accurate, though things do change County to County and you'll
always need to check to see if any changes have been made in your County.
So, to download; what you're seeing is this screen, here, in the top button or
the top image. If you look to the arrow you'll see a blue button with what looks
like a text, a little document with text.
When you click on that you'll then see
the list of downloads that you can capture on your own computer in PDF format.
So, go ahead and download those now.
I'll give you just a few minutes.
Well, not even a minute.
You can advance this as you're going along so actually I
don't need to give you any minutes; here's what we're going to cover.
We're going to cover eligibility, preparing for that assessment, making sure that you've
documented the information that's going to yield the best results for the
outcome of your child, we're going to look at the medical forms that are
required, and, specifically, we're going to spend some time on protective
supervision, because that's a service that isn't usually offered on the menu
of services from IHSS, so you need to be sure to ask for that.
Each person that is
applying for In-Home Support Services must physically reside in the US,
they must be a California resident that has Medi-Cal and live in their private family home,
or their own home; so people who are living in residential care
are not going to be eligible for In-Home Support Services
These are the available services that are there to help keep the person in their home.
So Domestic Help, and that's primarily for adults; not for minor children.
Meal, clean up, laundry, shopping, and gardening.
On Personal Care,
hygiene: can they get themselves to the toilet, can they wipe after themselves,
can they wash their own face and do their own hair?
What about toenail clippings, do you have to clip their toenails and they are 25?
Most 25 year olds are not letting their mother and father, or care provider, clip
their toenails, unless they're at a pedicure.
What about accompaniment to the doctor; do they have appointments that require
you to wait for them?
Then, there's Paramedical.
Paramedical is something that's typically prescribed by a physician, or a therapist,
and they include things like: dressing wounds, caring for a G-tube suctioning,
and so on. We'll get more into that later.
And then Protective Supervision, which is
just what it sounds like, it's helping to keep someone safe.
This program was originally designed for seniors,
and so, a lot of the language used by In-Home Support Services
might make you say, "How does this apply to a three-year-old?"
But that's why.
Activities of Daily Living, there's going to be a lot of
reference to that misconception in this workshop, so, I want to make sure that you
understand what it is.
So here's a list, and you have this in your handout,
so I'm not going to go through it all.
The link below actually takes you to a wonderful document
which will supplement what we're talking about today,
so I encourage you to go to that list, and review that, or download it, and make the most of it.
The more information you have about how to prepare for this process, the better.
So Protective Supervision, again, is just observing
their behavior, making sure that if they need intervention for safety, that you're there to provide it.
Let's talk about who can provide In-Home Support Services.
Essentially, it's anybody that you feel would provide
the best care for your son, daughter, or client.
They can be parents, neighbors, cousins, and they can even be a sibling,
who's eligible to work.
You can also work with the public authority, through Santa Clara County,
to identify providers who may be available to work with your child.
You'll want to surely provide training and support to whomever
you're bringing in to your jobs or client's home, in order that they do the
best job possible, and that their person-centered, and providing the
support that really works for the individual. You're also responsible for
hiring and firing that person supervising, if you're an adult person or
you're someone with a disability who's applying for In-Home Support Services,
you would you would serve this role.
There's more information at this link on
how to become a provider, so I recommend that you take a look at that once you
get past this first step of actually getting prepared and getting authorized.
So, services can be provided by parents and can be provided by non parents.
Now this specific slide is talking about parents who have minor children.
So, if you are working out of the house, you're going to school,
or you're at a training, then you can bring someone in to provide
that service to your child
And you can read that.
I'm not going to read every slide to you and bore you to death.
So, parents can provide it, and this is
when a child is under 18, because, remember the age of majority is 18, and
after that they stand alone, financially, and support wise, as far as how the
government, and how the state, looks at them in relationship to your income and
your responsibility. So if a parent can't maintain employment, so let's say mom
used to work full-time and, all of a sudden, she's unable to provide or find
appropriate caregivers, and has to provide the supports to her child
herself, or the dad. Then that would make her eligible to become the provider for
her child, whether her child is 3, 13, or 17½.
At 18, that rule doesn't apply. If the child is at risk of out of home
placement, such as a group home and you know the parents don't have adequate
care in the household, and then the parent may be able to provide those supports.
Now, when both parents are in the house, there's an assumption that one
of you is going to be tending to the child. This is a minor, remember, but if
the other parent is out of the house, working, at school, or is disabled
themselves, you can both be home, then you can be the provider.
So, the first steps in in this whole process is to call the Santa Clara County IHSS office.
The number is at the top. You can also print and fax your request, and that number is provided.
If you are intending to ask for Protective Supervision, be sure to
include that in your conversation, or into your request.
After that, a social worker will call, to make an appointment to come to your home and
do the assessment process.
So, things that you can do, to get ready for that, is start
writing a list of everything you do for your child and the duration of what you're doing.
For those of us who have children with special needs,
we've been doing this all their life, and so, it seems normal, even though, you know if you
had a child. I'll tell, you my daughter is 33, and I still have to help her with her hair,
I have to help her make sure her oral care is done, some of its just prompting,
some of its hands-on, and, so, you know, I have two other daughters
who are older who don't require that kind of care anymore,
and so those are things that you want to start recording.
So don't try to guess about this because
I'm sure that you will underestimate what it is that
you're doing, generally, because we're so used to doing it.
The other thing that you want to start recording are incidents that have happened
that put your child at risk of injury or safety issues.
What would have happened if you hadn't been there to prevent it?
So let me give you an example: Crossing the Street.
So if you have a son, or a daughter, or a client,
who really doesn't look for cars and, you say, "Let's stop, let's look for cars," and
they're just looking back and forth, even though they're not looking for cars,
or they might just wander into the street,
that would be an example of a posed risk for their safety.
So you would write that down: "At every time we're at a stop,
to cross the street, I have to actually hold that person's hand and we
cross together. I have to make sure that it's safe to cross, because my client or
my child would just walk out into the street and
doesn't understand that it's a danger to them."
So, here's what happens with the assessments.
They're going to come to your house, they are going to want to
talk to your child, they will do an assessment of time for tasks.
And then, if protective supervision is being requested, you must initiate that and
tell them that you are asking for that, or it may be overlooked, and you also
want to have your documentation.
A little bit about them wanting to talk to your child.
They may ask your child things like, "What do you do in an emergency?" and
your child might respond with "Call 9-1-1" and they will probably note that this
person knows what to do in an emergency. However if they don't understand what an
emergency is, then it doesn't really apply that this person does understand.
So you'll want to ask your child to define "What's an emergency?" and see what
the response is and so, you know, they may ask questions that you need
to further dive into, with helping them understand your child's definition of an
emergency. It might be "I really need a Coke today, that's an emergency for me,"
So, we really want to make sure that what they're recording is actually truly
reflective of their competence.
One of the things that we like to suggest is,
that if you can find another person to come and entertain your child for an
hour, that once you have had the opportunity for the social worker to
meet your son, or daughter, or your client, that they take them in another room to
watch a TV show, or take them for a walk, or whatever, just to get them out of the
room, if possible, because you're going to be talking about their hygiene and their
their inability to do things for themselves, and it's it's not a good
emotional boost for them, and so, we want to make sure that, you know, we're
maintaining their dignity in this process, as well as getting the hours
that are necessary to keep them at home.
So that's just a suggestion, and I'll leave that up to you.
There's something called the functional index scale and
this is what it looks like.
As you can see, one is "I can do it all by myself,
I don't need any prompting; I don't need any help and I can accomplish it."
And then, as you go down, there's different kinds of support that the person might
need, up into number five, who cannot perform.
For instance, somebody with a developmental disability,
who cannot cook for themselves because they're unaware of safety and health.
That would be a five.
We want to make sure that when
we're recording the information about how we're helping our child, we're indicating
"Did I do it for them because they can't?"
"Did I just have to remind or walk them through the process?"
"Do they need a little bit of hands-on help?"
and so on. You kind of get the idea, I hope.
These slides go into more detail about each one of those functional index rankings.
You can look at that and really decide if you think your
child needs a total help, or a different kind, where they're just being prompted.
Now there's a number six, and that's a Paramedical Service so if you're doing,
as we talked about earlier, maybe some G-tube care or suctioning, then that
would be something that is totally required and it falls into a different
category and you'll notice this italicized text here, "Laundry only uses
ranks one, four, and five," so just an FYI.
There's some limits on the number of hours for some of the items.
For domestic help, this is where we're talking
18 and older; so people who don't know how to make their bed, or don't see
the importance of it, or change their sheets, or, vacuum and dust, and
things maybe they're not safe with chemicals, so six hours a month is
typically what you're going to get for that Laundry, an hour a week, unless
you're using a laundromat, food and shopping, an hour. Other shopping and
errands, a half an hour per week. Now, if your child requires extra laundry,
because of their disability, or because of their hygiene, or because they're
just needed, then, you would be able to ask for an increase in those hours.
A lot of the clients that are applying for IHSS are also regional
center clients, so this only applies to regional center clients.
In-Home Support Services and Respite are not the same
Respite means you are going off to relax, rejuvenate.
It does not mean that you are doing someone's laundry.
So the intent for the service is focused on you when you're getting Respite.
If you have difficulty, because we've heard, on occasion, that, maybe, a service
coordinator who's new says, "Well now that you have IHSS, you don't need as much
Respite." But remember that's different.
The different intent for that.
You can call OCRA, which is Office of Clients Right to Advocate for assistance
when needed, if you're having difficulty, and that's true for any regional center
service. But we recommend that you try to resolve it with your service coordinator,
and if not there, then with their manager before you call the OCRA office.
You're going to become an educator.
A lot of the social workers at In-Home Support Services
may have never worked with people who have a developmental disability.
And as you know, I'm sure you've heard, the phrase of:
"If you've met one person with autism, you've met one person with autism,"
and the rules of engagement are different for every individual, whether it's autism, or
intellectual disabilities, or cerebral palsy; we want to make sure that
you're educating that person about your child. Remember, they are making a
decision about the level of need for your child in an hour, maybe an hour and
a half, so you want to be succinct, you want to be prepared.
So, Measuring the Need, this is a great worksheet that you can use to track the time.
I'm going to click through so you can see what it looks like.
And here is an IHSS fair hearing and self-assessment packet.
This, if you scroll down, I think it's page 33, and I'm going to scroll.
I don't know if it'll let me do that, but let's try. Yeah it did.
Page 33:
You can just put down the moments that you're doing things for each of these areas.
You can print two copies, do two weeks worth, and get a good average.
It's a wonderful document to be able to use.
And, again, it starts on page 33.
I'm going to go back
to the beginning, because I want you to see that there is a lot of really good information.
There's information about children, there's share of cost information.
Anyway it's a really good document for you to consider downloading.
Let's go back to our slideshow.
oops.
okay.
So as I said, we're looking for an average of time,
because you might do the same task and one day it takes five
minutes, and the next time it takes 50, so depending on the level of the ability
for your child to cooperate, or to be physically able to be supported,
it might take twice the time on some days versus others, so you definitely
want to be averaging out.
We talked about domestic supports being limited to six hours a day,
but, for example, if your person also has severe allergies, or
asthma, and you need to keep things clean and dust every day, or vacuum every day,
then, certainly, you can bring that to the attention of the social worker and they
would consider that
You're doing extra laundry, you're cleaning up after accidents,
you're changing bed sheets frequently, you'll want it, again, that's
why we say do it over the course of two weeks. It doesn't have to be two
continuous weeks, it might be, you know, I know, you guys are busy and so maybe you
skip a couple of days, we'll just resume it, but guessing will probably undervalue
the time that you are spending.
So, Protective Supervision we've talked about what that is, so let's go a little bit more.
Again, make sure that you
are asking them to consider Protective Supervision for your person.
You will need some documentation and evidence of needs, so that tracking
is really, really important for this, because if you look at the income for a
service provider, an independent provider, providing IHSS, if somebody's getting the
maximum number of hours, we're talking about $42,000 in income per year for
somebody that receives 283 hours, and as taxpayers, and as
the community, we want to make sure that who's getting that kind
of money out of taxpayer dollars, it's necessary, so we don't want people to
just say "Yeah, I need it," and have somebody just go "Okay;" we want to make
sure that the documentation is there, and that way, there's no question about the need.
So here's what it says about Protective Supervision for children.
Just because somebody has an intellectual impairment,
does not mean they're automatically qualified.
There's plenty of kids who have intellectual impairment, who also are relatively safe.
They are going to look at the age comps of the child.
So, when the child is five, most children can be left to,
maybe watch a show while mom goes and does a lot of laundry in the
other part of the house. There are some children, who are five with a
developmental disability, who cannot be left alone while mom goes and does a
load of laundry in another part of the house.
They're going to really look at age comparisons, it does not include protector, I'm sorry,
routine child care or supervision, so that would be a different service and you can get
that from regional center, if your child's a regional center client; you can
get some support for child care when a parent is working.
It's also not for any of these,
and the one that I'm going to focus on is Anticipation of a Medical Emergency
because, a lot of times it, comes up at trainings by parents who
have children with seizures is, "Well, what if my child has a seizure, might
fall and hit his head." Well, sadly, it's still not one of the services that
In-Home Support Services provides Protective Supervision for,
so it's not going to be something that you need to write down.
On the other hand if, your child has a seizure and they're postictal,
which means following the seizure period of time and they're not able to be told
stay seated or you might fall down and they keep getting up because of their
cognitive impairment that might be covered so it's really a situational
an evidentiary process of how you're going to provide the evidence of need to
the social worker and compare it to a medical emergency. That's a tough one
sometimes. The other thing is I want to focus on is the antisocial or aggressive
behavior of the person receiving IHSS. So In-Home Support Services does not
provide supports around behavior, so if you say, "Well, my child might go hitting
someone and then get hurt" They're gonna say, "mmm that's not our area". But the
Regional Center if your child's a regional center client, they might be
able to help you with behavioral supports, or the school can help you with
behavioral supports, so if you find yourself in that situation and you need
help identifying resources give us a call at PHP, we can probably guide you in
in what direction to take. All right, I think we covered that a little bit, but
let me just make sure that I covered the Exception of the Medical
Prevention. So let's say you have a child with an intellectual disability, who
was pretty unaware of danger, and they break their leg, and they're in a
wheelchair, and they're casted. Now some people who might be in a wheelchair with
a casted leg who don't have intellectual disabilities might get up and try to get,
you know, a soda out of the refrigerator that they can't quite reach, and they
might fall down, and they'll say, "Oh I shouldn't have done that."
(cough)pardon me. But if it's a person with an intellectual disability who is in the
same situation and they decide to get up because they really want a soda, and they
don't understand, if I get up I'm going to fall down and injure my leg further
or injure something else, it's due to their cognitive impairment, then that
would be covered. It's confusing, right? All right, so 24/7 coverage, what does
that mean? It means that somebody that has a high level of need,
a high level of activities of daily living supports, and protective supervision. So
they don't provide 24/7 coverage through In-Home Support Services, but you will
tell them outside of those maximum number of hours that your child receives,
how is that person going to be covered 24 hours a day for their safety and
health. So you'll be able to write an explanation on a form that tells them
you know my child's at school from this time to that time, after school I pick
them up, and we go have dinner and, you know whatever it is that you do.
On the weekends they're always with a family member. So you can kind of
scope that out maybe scratch, you know do some chicken scratches, to make sure that
you have that, so it's not as intimidating it's really not as
complicated as it sounds, so don't let that intimidate you. Some people ask
about why are children and adults
prone to injury, and this is a nice list. So this might help stimulate some of
your thoughts of what it is that your child needs supports with, and how to
keep them safe, and and, you know, kind of reduce the risk for them. But you know, we
may get the maximum number of IHSS hours, but does that mean they're going to have
a lifetime of injury free situation? Probably not, because everybody has
accidents and even the most attentive provider sometimes misses something. So
the high pain tolerance is important. So people who have a high pain tolerance
will get into a very hot shower and before you know it, they've been
scalded, and so that's kind of, if you aren't sure what that means, that's kind
of what that means. So it might be somebody who you have to tend to while
in the shower constantly because they may change the, you know, the regulator on
the temperature, and end up being scalded. So here's some other examples of what
could happen if this person was left alone, or maybe it has happened as you as
your child ages, or you get, you know, they have more opportunity of risk, and so
these are just some things for you to think about.
So we also recommend that you begin a list of situations that have resulted or
could have resulted in harm to your child, because of their lack of awareness
of safety, and so there are some examples here for you to look at, some ways to
look at what kind of support they needed, what was the risk, and again what was the
situation. So I encourage you to start getting a list of this.You can also
share this list, and there's a download with this list with other
child care providers who work with your son or daughter or client, their day
program if they're an adult, with school, to just document the potential for risk.
Here's an example of, actually this was my daughter's, and so you know it was a
good example for us to use. This was a long time ago but it's still a good
example. So the three factors in assessing
protective supervision are memory, orientation, and judgment. And so, let's
say it's, you know, it's storming outside, it's winter, it's storming, and your
person goes, comes, you know, ready for program or school in shorts and a
t-shirt. They're unaware of the weather. They're also using bad judgment, right? So
we're looking for these three areas. A lot of our kids don't learn from past
experiences, so you know, we, we may think that we're doing a great job of every
time, you know, they have to do something we tell them and they're going to
remember, and one of these days it's gonna stick. Not necessarily. So memory
would be recalling learned behavior. So maybe they've almost had a near miss
with a car, maybe they've been hit by a car, yet they still walk out into the
street. So keep thinking about all of those potential risks. Now they want
these risk factors to be recent, within the last six months or year, so when they
were five, and they're at 17, that doesn't matter. They want to know present day,
what are the risks. So let's talk about the hours that someone might receive.
Remember I said activity date of daily living is gonna keep coming up, and
here's where it's very critical. So both the list of potential risks and
the activities of daily living are critical in your documentation, because
if your person has less than 20 hours of activities of daily living supports, and
that was things like bathing, and grooming, and food preparation, and all of
that stuff, if they have less than 20 hours, the maximum number of hours that
they will receive from IHSS is 195 and they are considered non severe.
For 20-plus hours a week they would receive up to 283 hours a month. So just
a reminder of the activities of daily living.
Now let's talk about the forms I mentioned that we were going to go over.
The forms- this first form SOC 8 7 3 is the first form that you're going to
receive from them to have filled out, and this is going, it's a two-page document,
they're going to send this to your doctor, or they're going to ask you to.
I'm going to actually go show you how to find this later. So if I do SOC, I think
it was 873, and I go to find that form on the website, let's just, yeah 873,
application form PDF- and here it is- and it looks different than what I'm used to.
Maybe this is the application for IHSS. Let's go back- that's not, that's not the
one we want. Here's IHSS program forms and here's 873,
and the nice thing about finding it online is you can fill it out right here.
So you can fill this out, print it, provide it to the physician, and it is a
really nice clean way to provide this information. Let's go back to our slide
show. This is the other form, and this form is, is very important in the process
of determining the need for protective supervision, so I'm going to just focus
on this for a minute. They're going to ask for the patient's last date seen
by the physician, length of time, prognosis for disability, here's the
conditions, and then they're going to ask, remember, those three areas? Memory,
orientation and judgment, and at what level of impairment does this person
function. So they will check a box, and they also request that there be some
examples in here, and typically, these are not things that we talk to our doctors
about very often when you take them, when they have a cold, you take them, you know
when it's time for a physical, but these things typically don't come up a lot. And
unless the person is spending a lot of time in the doctor's office, the
physician may be unaware. So we recommend that you provide examples for the doctor
so that they can fill this form out in a way that really is going to reflect the
need of the person that is being requested protective supervision for, and
you can find this form the same way. Go to your browser
and- I think it's 820- I can type right now-
I'm just changing the number because it should come right up- folks 821. I'm just
gonna change that zero to a one and there's the form, and you can fill
this out as an example for the doctor what you believe to be true. Maybe
provide the same documentation that you prepared about risk of injury for the
social worker. Wouldn't be a bad idea to have that as a part of the medical
documentation, so that when you apply for SSI or other benefits it's already in
the medical record. So this form is a one-page form. Now what I like to suggest
people do is, before you have the assessment get this form to the doctor
have them fill it out. I usually have their office call me when it's ready and
I go pick it up, cuz I don't want it to get lost in the sea of mail that's, you
know, arriving at the IHSS Senter Road office. So I usually go pick it up and
make the copy I keep a copy for my own records, and I provide the other copy to
the social worker. This, the 24-day coverage plan, remember I
talked about that earlier. Now you're gonna fill out the top part
or your social worker is going to fill it out. You're gonna list the other
providers that take care of the person, and then you're going to describe how
this coverage is being provided to keep this person safe 24/7, and so it's pretty
simple. A notice of action will be sent to you after the after the
assessment. They may even call you, and say, okay, here's what we determined, but
this is what the notice of action looks like on the right. You're going to get
that, you may or may not agree with everything they have on it. At the bottom
it will say total minutes of service you can get per month, total hours, and that
will be 283 hours in this document, but if you look at the left side, it tells
you where they're applying those hours and minutes - and if there's any changes
they show up over here. And sometimes, there are changes. If you're being
reassessed and you see a significant reduction, it's possible that there was a
data entry error, and you should ask the service or the social worker to recheck
the numbers and make sure that was entered properly. That just happened to
me this year with my daughter's application, and so he found that he was
putting it in for a day instead of a month, or a month instead of a day, I
don't know, anyway, we got it corrected. And I was pleased that he took care
of that, so if you have questions about these documents it's best to communicate
with the service or the social worker directly. So let's talk about your child
gets approved. Now you need to hire people to help support your child with
those hours. They're all called Independent Providers whether it's you
or whether is a neighbor or a friend or somebody
that you've connected with through the Public Authority. Independent Providers
get 13 dollars an hour in Santa Clara County, well, one of the highest-paid
counties in the state. If someone works at least 35 hours, they're eligible for
health, dental and the Vision Plan at only $25 a month, and it's wonderful
coverage through Valley Health Plan. They get a free Clipper card, which means you
can ride VTA for free. They may become union members, it's now $40 a month, but
it provides you to access to discounts and other benefits. You can look at the
Union Benefits page once you get that information. And they also provide free
training, so they provide CPR, First Aid, Transferring, all kinds of really good
opportunities that are free for the IP to attend and in multiple languages. But
they do not pay you to attend those trainings. There's an overview of IHSS, a
statewide listing of IHSS offices if you're not in San Jose area, in the Santa
Clara County, you'll check that list for your local place. I mention the Public
Authority a couple of times, and that is kind of the employer of record for
independent providers, even though they're considered independent
consultants. So, if we go to this page, let's just do that,
you will see provider enrollment, the training opportunities, the registry,
provider benefits, and the advisory board. So it's a very useful link to bookmark
for the future, and so we encourage you to, to take a peek at that. If you need
supports, if you've been totally denied and you really think you have a case,
Disability Rights California may represent you. The whole page for IHSS
for the county is here. There's a Mental Health Advocacy Project if you have
somebody who has mental health support needs, and you need help around that, and
I did create a handout with the document, so that you can just click on
them, and go to the side so you don't have to try to type all those letters
and numbers in because I never get them right. Here's the number to call when you
are ready in Santa Clara County. If you're not in Santa Clara County, again,
refer to that other list on this page, and it's the second link. Have your
child's Social Security number, they're going to check to make sure your child
has Medi-Cal, and it must be full scope Medi-Cal, unless it's share-of- cost, and
most of our folks that doesn't apply. If that applies to you, give us a call, we
can help guide you around that, but have the Social Security number, they're going
to make sure in the system that Medi-Cal is in place. If it's not, they're going to
tell you, and they're not even going to do an intake over the phone. So if you
have questions afterward, give us a call at four zero eight, seven two seven, five
seven seven five, or you can visit some of the links that we provided in the
handouts, but we're happy to help you if you're confused by anything. You can
always rewatch this video. Feel free to share it with others because we want to
make sure people are able to safely keep their child at home and have the
supports they need. Here's some other programs that are available here at
Parents Helping Parents, also listed in your handouts, and we encourage everyone
who finds this beneficial or any PHP service beneficial, to please support our
agency. We're a lot like PBS, we're, your memberships and your donations really
make a difference at our agency and allow us to continue to further
educating and and empowering families to be their child's best advocate. So that's
it for today, and I hope to get to meet you in the future, again, my name is Trudy,
and take care- have a great day.
For more infomation >> Top 4 kitchen Gadget - you must have !! - Duration: 2:38. 
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