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4LIKTuLGmJ4e8gLFV02algHptC2DN3Qm7fjeu8CpToby9we+KSufXDuQMnBByEIg1nEaUftKKQp1ZF8SUc2kAHbeC/Lf0S5gqM2/yeXAb4oYt7TLFIOYKi6yVVSjOb0RNqjfD+okRyzK8+fBHKrTcH+5IlOGGBceUab6RfnDWHEz+8bdhGSysgLIYM2etFZ6589v2NKUGsnmVFP2rBPSysgBCn+n3yZp3q7G8RpPCpU3Ih6STNdierrcmxX44jHGMjUQlzYBtvTwh5fliQ/RofIBc08/vYiVb/sRUUW6CAT8VuibVbMGM2sTkEvek1L+fSMWF5nDAUa6yiZE5gar86fY3BZYZL6MrRKMopgT8XgAdh19SMwlil6u8bk/5diy2/DdNw9zk144oVmMcYap0Plz9cvTu/ge5zSWdqghP+94ee4Dj5DDSTf4wTNcVFKxlbR0ZLjisPwibTHV41zjt+xxyYDI3nIq5DRP7o2zgE4plohaiiIWBHTB2COmsHIgEvL6//4sA5IpzSLOqQ2A01TsLU1CzYdIj+nkjPmRUafbijgz4ltUKx/LCZ2ix1HIf+VzWpKdB2WwFRQR6QahwB1NsQeJlSZGJG5Qc12/dnCfU3fsmqoTjqGj9OJIY9z5x5EjBYVw9R24ukGaSMB8lzbhGLSywUzh/xbM5nB2pI6KpMrmiRFN0cKVDyq0vsXZhrl1Zkkx5659e+5OCf3QE3mt4/+0RhkS+fuVjBE/HhTH3fbWvRpUiFT9dYYkuqueISivoVcp6Z8d9+c2MIcg4my5HTej+1ZcmCdpK4LsYFjn7chuzcIG1UvE8ijTijhZCpCEDItIyiYTJVRr6rACoLWIdFiRoWtQtTIs/IHnKI4v3nbxupAhFWiibbJUvcIaSMjhyz5NeJCd1oDRIWqgL8PO6//VX/lndPKyNCoxC540fI5F5D2KNarmjeqqnVeKu9vOwmsGFuv1RPD9BeommlVvf93ogh5ghNJoh8kO6/cokMNSVSuckrP4rbTIherFUJIzTwmw+e0P1/sbWwSJk+uC+nJbihJkxgzViMlJNTyEWPNhFGEQ/9xYUJhS3aWiLbJwhYC0zEtXTWBTdgGmr5bP+6Thuxfkb3m/ACZLmWPIPku9kAymflJDSY5s8WbVV9LorhYMAW93wJuxjLbAruL7I35lbxU+VisYkwHxb32fySXIcHs/tCeDhn+Ws0x4zSqbsyOHRwBGepmaDsJeqpNtVjytCQ723EAp3iyAx71extJz52OXWONs7PTu+3mdxHqHKpN6gp9c5ueZit9+7IqecDAUuVoCimEPTeopOyQoTCpkPA/72K7AKnj/kn949FSE6awwpMBMePjlfSuu6CkkDqWJFmd2CvhcLtaAKk9KPe+oNy6tSRv8IS4uw9CE6wHx3H5dYtS4BgPmfdSuISzUpWOPF/NqVRvMwW8OG5qbdsJUaHSCp658UH98PQM+Dz/6Lj0moL+iFGulgzdOgcWpBqXJjMNirkN/Y+vuH0NGPhMl6ntTtH1A+NLT6tL8Ej4cqqgwuAqmWtFHzxAcRuKyeOiqNTU46RQkID5KgELeKzPD5e9NcO4ck8HrxuUsxBaOttyuo8vbz/7KXLxHUYXP5mowVF9YaEWww3KDsni5CCLeMhGagt8SMAHF6Ey7lGgJMdeKwxA651rRa8rbMHLA0GI9Qr+e8eR9XusxZiRPBADlx+oyBtvyMnWiWANHg9pOA/p9ge6pDkOk7vvPpXlFp3CBmFLmEJ8/Gq1bFlOFNetJJ6zJI204hj1T781pSnhLJWKlJL9S15DO4OjLbBASw/KBJ4IweoCPnCSSe2O306GU9ZaqMb//vTa5QMo22EKRIdHtydrSebXApWYL3wUBds0QSfXlpLdxAJI8+hMpeBLX19cpLLefHMLhkNtxei8DDv3bbVhoLxwsAE6sVeZnZh0nTb4LZOmO3JHituART0F5v2xVTZ/Cq0H0OoWWBJqLegUpNFiQ7N8Hf+cfO5hSJ65OUuyw/IVIlKHIJxwm8hshpXL0B4HqTGbMXYjdRy8F9j+RLH/dcuWT7bex49k6ry8qL75dEXTw56UUpL0wjDVqsfrWqnTgMy1NzVCl9hcBUHSgLPEifrSzXhIcqCr3Eie+NK/lvgRkuAk1YK0mkKO1DzOPqtCqY8jNms5Ofr46bL7knsoLtgz80o9jIMAg08V1jznVJfR48IAIk6gHUFy38ArXmSVcP0+nQfyuCFCGqBkL6y+FZQ361E4YZhfppmQzSWnU0romxWZVj4I89tvA6OIB34zGLojNIxwq3kaYB/Q5gY0klg5RWuiK96HPMA4vnVdaSvw0M5262RyHmOkfePmCfu1aMbJuQrqJHGRdXdN4gZ9RYFgxZEeDLUnuJPbc6aKSP37gcvdgzfvq8zOfvhLml+L58GWn0IkwV17kqEimSyAEniXjS3swgfujkMKgeE8GfnRdjkstM9945TVXBFg1NSiYQpiBb9zJiuIWOFLWVFz6tPEbfTmRR4DUOCPJANW8m5XEAglgkdEdCXTnw9rf5zr2Lu2H73lFbOPcNPdTZ1zT5oZLOkVgJKmXvcJIDybNB1SF/52SwrVFr5DvzrWcZmdf939F/BH2MUA4nk/6r6PixxsBvr1e86tfHyWVm2SWnfkYQF3XzzyjaMFzmuEhobgqBNuM6xjAgjsWdIlD5JbpHzJvs3IjZmLUj19qoYRuYsMq60MenEHqR3sIOqO92DXIlcXMpt+7Hh7ePVQPU71B0tJelMzHLTze1QHuFWh+YmV36n/USYeFM2be56Fo4XBWBrcgn7nE8QgrE+/rFb+YPBdO9po9oNDaivUwK/mA6H0uEhhGO7+i9c2r4FO3HVIwWYjLqOh34E/gXm00Mq5T0+lG+mGBVi6xTXAkFE9kzSX/Sqbd9A9+qEgmlIIyB2GU3kDZWn2DayTKTVp/uHZTCUazhkoeAdQjaYxBDvVLVI2A9YpOO4xcF19Dkv/+qQLmWKWKefJAtrAru1nWxT9kaTvPrhq9U837OJGCMhynwOXla6GmsEMnS7c5fZIecx3HnF+QTHsjgI2gFcFQFiI71AYaXB5v0/SOpDNKBlbNYK1KHYa49kdMUSnzxIqMYPcm/aO9rTUK7Kl3Ko3WgiQ4UAsp+ov8+4CIFQz+Prteou0YkEr7r8rIAzapd39+zFiM3fZBncOOgu5+2LyA29mWkIFkANIfmUmlYDIj8Nk9jasLtFvtuTr6ZAbm3xuxcAak1u/GfDUz8hb7ukNghmqXM6dJJ9S/RbZnWL5Sn1dUORxv5CM6MD0I0TZeOmp/6bZwjfxgEReApLYw0jwC0s6WnZduZVhmL+M17Ok79tB3DH5UN99JzH5+zve0yemxcheC+hzFcSF/cbktfCxL5WigFwzz1YhpNOvVwohR+VaQkASTTJNXd1zlLGjtRJvi75nkgLIXlos/p5W9U7T5EeXdqQgQjGZ3/1gDjg8uzUvcV6ZGWiHG+r3NM1HGd016f9oywSawD5Sra/u0qOl4dRhSMmQEYbVZ2K0bBilAUGi9OgQc4CXz/KMmcdsCozYbxYw3rqDC2IN7JXfyg+ypPgg6YHCowu9nf6reZEgYCOhROgJf3alR9Ah2IITGtylcV6DwpH8AMvjUXzrjdkVR8+3qWZhaU/29OKBkkmDeI6r++ajsrKkMuGxpquzmSOVElayGf89TgRgPWt8w91f44f0S5fCa92a5fm+mL7FahBE/lbTSkL4xD+FNM8vHM0i1MrFt0cUlgU6rC7uw8bVIA5pg6rSrSk26M4CXMte9GSeT7mHPB3rcf1FCDB0eloTIeyL8u2jF1e6UNFiA37XXz4YR/MN0Z92fhQyWuPWkRx8XUcrHe/fWBTIbrWrsGQEud2OPamTxdTjG9+KZvcvJatTqHc+hCGfiyOy8gndVcfCuETdeT3J06Q71/E+6NpzyHszijP/BciZM6C79jdkR9U9GSKXnWU7XRhjNXZX5Pq2D+EpgYSSHgur9aqmou0suIvrEl4H+WNhoLjNnlQYrPn8jImmcp27LoBfzK8204nMNZM0XTr+xEx0UQ9/bgNDsCOtLL24gqWtCU/wUOLYrO2aM9CP7RZFoEosd3QEFy9Iu6ZsqCizJxuZ+vmRsvu7NFKivl4tHezc2br0vF40drqlwGCUm229UPojDy6f0w05qT85O0FwvnwOrUDJhak41LzV0WAKnReP7ii2REzKTB06cth5Blnt5501zcWpa81n7kxGGgYG9x1O+62/s6zh1ui9DVR0ZCtx1FXYDMjTtHgWmE/WZMCPAM5WGyc/cLzVJz6DfmcJfcjYmqgub3Q/n1YVnb1jliDHqaM9SVRjky1zXISkixuKw5d0jOsEhYLkXc8k/JYugvLOPXZQpRWfdKMwx3Sd/UJPjaZZrurSw1MlZgGu6nD22rOmC37S1b3KNCoepPsrGWEO+lzh0thMmUGL3c6MFFoSdCfCyMUJWL5OCEMW1A0zBY3emb2aVaGnvD+aeCv53bJIhAF9NJf04OXI4583n4Ci3oHsYWlNq3gWpF32cqNJzOk4Wz9cfndLKT2stnwpCaobWPoXtTL6ldRke/ZT27h86M428S6zx2ca1D9pv88vAzdHGwMM1SwXzVtSz/CiUKhQ4h4anbeBc7CF/uvbbq1kN0VsGZb9AAXh1sdM4xYLff2GfWgBc3aUyjAtGNQK5v+PlWPt6gJv8opXmpsdD5zoZLW3JapxAoA4aDp9aT0615RunTvveEP52cuJQE23mqQT13SIBBssv4IbA6OseorXKiyRnrArzFScFKr5LBWYKEOROEMEObm6P+5Gcvzo701jdJsOHWL4ayMXIs0bm0ghuHGW5Z427E3W70Ix7A1bKI41xS9W/JIwSIqU/+Y7KJcelYGxbalouvuqRdwMQMzyvK31AlXibka6OeLRhCkJcQk+VRy3YyC6u1MMWD492bky6ZVZmWM5WYUZNVOQ8pQGARWsQQc2OcnIe6GoSrS0UNTAV50ZprmRsicIzf2h0k+Q5qgx9mDD9tNILuEgy/vIt7gRYp4xGg+SoDs/6tTzTPGernC4ZpuYQ5I15O5Z8E+HCCLhAlyNk3FgqB1iP4HZ3WIDJkKZ8E25Byj2gnRbNsayDevggPYj61G5B10PPDX7nze6l/CBL8r/ha79vgIonKx+HwPc1dI5VLwunEW5XVKlc5gW66vOVLET3rt7h0aNZ7ijMLhJmsB0yorRunHTw2zG73GpVDs3wAvz5AgX/jtTYrjsbAegZHUd6c5SaprCRFSBS5jrAt+Uczip+lq1v0w3TDBIKTGC9XP98EyqnOBUdS3QmFdsBzLx2lMCrqbTE/Kph5HKxyxDZfqAr4Ojg84pr6t0jN8w7wta8lEs5xaJf1xwxfC4XnIR4y8J85q79tR2hRu8oxnwpyesZqCvkPTMUCTqtqY7N5rWf9TIAmEy1Py6nUq2IQdpWcuF1SK4VHnGKXSvIsrgZ8whzPCHZZMu/uwrvBYPrU5ogtr+zFGauJBTpmCtD8j8K9ihme9g19zcEA+l9oLg457uh7zBw72g8a/jppayJr9hoRIQxxlFYADnsTUKa3Ja1ZJfOUlu1EjzzaeikePOZhxcaXOAvgy0r/ov5G5VdgcpBJyK8pOVj37OnwDq3awk3BSw6JFRvkFa9wbq+05GrOB7h/jH6kC4YY6Q/MQJRn8cOqK5V1Ni1+wRd6LAyKns3MRUGM11cgfdeLXLztSDoTpkebMLoQ+SrhCxLf/ig54o6fNFdUyhNRqYvSi6+gQGDVeDS0HcfiorD0b6P4rEh6aYUCEu2noI1+ISHU66OVJlDJBZmTvbTnfsc0rDOTp4a9qzSibH9UmX6tLLyaJSdwKBWW4nWLByP2wx8DH5GZvw2cSvWmpydoqyFCGdx/Ve4+CnTe5+kfZPrfFUKdTKNh/NXyr3dx8ACNv+Qf2JC3VdV3aHm7xCQJ05QdEv5FmueCV4AJ9kbSHq319XqfJYYrwzwNawJlgI+mI7LI3GJmBkoRwIJA8Kz8bATqtguC2egyu0fhEVkPp48S+bH2KAj+l/aaWeRpOq0XISLVBEORdlRfGIJIB7mcySdErf0uqhSHgl6kkRIJ9WPhUm+kDrNb0cGP9J+B5ufYn8gCcJ6xneJls83M5J3WDOlcr+LO+PNr3QvC96zDJkeX2fj9kwwq8fJNk5rE+sxQkIp4ulJlVcxrGJVxq9KQUPahbMqaapjOp6tsDEeyMDV1YSivCNVS0iT5jNc6ntjSWmHkuguS6Vzw2VlJc2lwfm1G6eSvRkllfowL81TQdO/HgBpZIJunyYxYdE9LyxNYU7C+UwZn2SGBPLsY98g2CQmFnL/B2C2LRKhVtlEt9n+rKsLhOz1gTc/15fNybCalHAYy8CHJlSYrWIzlhRbgzimyNoMhXoAPV4Zm15Vi5OVowISKPpvY4EWXup6yeM1zivT6we0jQgzf4D+sKjEWui7h4kYJkpE8kjKSGUXGBuF6KHCwgHSG4EImAf10rY38qoVVXxe8cArqZh3r1ej0Sk+swlaqdv/FGmjf1sfe21Tv4oB0NmZ9vVXTOX0dVOQKyRfkzmGHw0MKrNfZSeCRw7jJssA+yYcs6ZLBuZsHVruWgonRM6rc+Y2tO6sNHte625fu7ZR0Mwk4Juz8U3rH1EZy5kmcpW/Zb/SHD95v17h0f268vlULN7U8Z3FYrqFbtJ8oMfwUiNc+4oFaJtcR/T8Jz+7m8wmDy0lbaAKV/vf1GsJyQsbMBRA6/j7uxWtAVUYZFeLalbkVt8aORZpSVbU6JurZDzn0wR9IA5nEL2HJAZTYbkIhi/4x8LBypHs1LjlWiI0A85BPct+qocDyw1M5OcWwWR8d3CWdaL36KzUbRZhvSPHqQik3XItKl6Wb9qDc52hpV8agK0QHkK7yfCVMhKIwxO5XIOoEWEM3dLsh1cUOjZLFnlgYSPllP9uswgCJXMkx5sBkklBcnSCjzWUJ/vT3NECYenikYX0VImT5XwlpJFgm95RurIN0hp8Kv8B3vSe9+3aoGLzuKZAQEii/HwzyBCj0p65GgMgJZOw2FfvA0jzO6iNoKLEmLKacB3xgbfuSdia3XK/aXEQ+cErHXHvhF2YSLIf7P6ovU87TKJ83gdFRa6xWOkypVDUU79Wk3R0JEaU7TnZjwUVLXV9G8shjKqlpEOO2X0WVrPZd+fRdw+/dBKlc3JLiydYNcLOkgkZHNgdy5AfGlFDHWS1rwURqyjsj/nlOonVLnc2nxQ76BUidMEYDx5KuSTclu8reRQxyvAxPQQ8LmozTU5mtIwVh0PWsXGrZqrp3AaIzS6VzE40soLhvkkmf3SsedTpS6h6PkjWhHuadu2/mYnr7hB2Sgvd/xNUg7vB5O43t+esFYbfYtN75jF6i8j/Q+EhOmxmQHsckZoF+IskvyTvXlNxszIgSIr0j/sjMBwmUkzIKr2FBb+ytBiDaI+kKvVqvsWotNLbIuUL5xpEqhrxJxOFxPgaJc45tzDtEDjQG+bVDDUOXIQXomFxskd5DzbkB6qDECDM0e4HHjbOqWHPkHSUnOe7ZzoyvpJaYKox8WlIEb26SFdY9iX+vrAbOvYWUGEBcoNfZCr/i4WOGqFi7pg0GH+uF176+FJDFtOmPjNCCac+r5pNSWzx57qld1Q+BbANI4kkv9fq9b/StZjG6mNKb6tdBv5RQzOC1V5Mqthxgdva8OKiYibggmOw/dbubaJ++S098L2iHZ5WZnmRkZTQ5eBCRejUVfgiKjd1Ys/ZPumgpu6cZi7evVzKCJtIDEAkDw9cJUt0QuFxB0hjQMqXkfBoOhhbktkDolArjHQzWYPHj5fQmAN2zL0cBRm/KROk5xyqKkQrZ+VMoimMJWjXzm7dsEgOzxJ5s3HgR+UGmwtz3nXdluP86XoUZAsqxH1OO2Y8UINpv4aAlaigpxHq0YWc85LXmPwbH6PRtFGdcko5w3d6e0sc8TNsgzwUCdBUHZU7QZi+IjClTUsv1z0uA9CjhzwZipMhDtup2oRf3w3vDXescvyrZRRPF/ubFbxKCNwKzuMlOFlztW1XuuXmOKYJkfvbmfhaCxgBx9g5KyVqVHf2EUuTIi9ResFZqHlHsjAmx1tKvoLL8EXp6gEejjOb0hcLbl7XfQ3zAgkBJO7WD4S/bm0Nekb7uZvaU575utBxVqwewaXbGIaM+4F94O04M2ui0Fl6kQa5z1vm0rgSEVE0q+IK+rk+XTk1giUADfoITHxMQME+0etM2zJbW4p1weOWu/xhg1t64B3pZK8AVpzhIOH0izdTWErjFa8StA49f8w7c5yG6lkU3TmRj80AqmIMkzkh0FeN6L3Midd3PyxSiZ2UwIVfyXzbX/1+jITjV9yHQ2v/xlA/eGLamWWURH9Wmueuwwt12VCzwx4WMw0A+rWSseLUfHEFg1sxU9WIH4+twzkVUfY87Jykqd6LbtNk+D0uVUmxk00gGlzlw7ksPrKbrGp5+TOaJxq6KOD1P5AGRyTfDioisOfwmuRVb/gVVJnJ7CCrcCe4DNmhEgOQzUsQa0R/aMJqSnFsTZDhN7+/sDuJKoMnxnJspDjgZ6Y+kc95Bd1/s4ZiAf6hTI/DGjiC8tdjB5sO+nVIQgp4WOG/qlySEzdFoucBJiT1iQEE9LSECy+UWc+KyiQCT8hL5rfL8RdtkoR+u0oz6tOfxFIsapMT+om9c6DA1EkOMlSZjC5dYWm/V5SvEYcT4IS6AcQI9x6YVptbYgNC3cZp0rVu1nLH2MEdqJnuqhEE7pSZdLjqob5i5F73xV5ORcPP1QGUbITa55CXUKq08HxJTHkmC8IHdqKdq76npQjGOjALFaMT+x3aThrPTCXriWCMBztbp2OO7UbW+BQ0PYkjuvqBlcJAVNsXfV+qXoWbx08PPKeiwm+Q5YMb0ytqd5SHB7yUI8CKotBil7tP1Ypl/R+lv9nQkzR5TkJIfUiFeYlJlXfmcoqF4eisudaUCXmAqsunpBBiZiqj+Oovz5YWHQmgFEVfW/4a1pOGjeW2+IE9b7nzJN+p//I6UqMojAzJFrO+8gLMYjErCKLdNRRMHwTKSCMrjn3J+HJc+Ax6JD7beVh/tn/glVo7xypO6zAtgGWsZXWmrNgAPU++4JHQkcv//KyiopOWpH9N/BcrrxqH5pSsJeSzTS+5gg5CpwARSZEHGm4pHJxNJ7z2OX6VdeHYpd4/rp4YXVrMZOgWsFsx7im0s1vXC6jUNMwmJ/w4k9K6KqlCp2uc1lUKAxbYsix6HvAwSS4KuePYUM97FIWk/aBvYqqqLZNdTd4RLvtWlxR011/t14AAjExn3vC+JDo084NLhghE6Q4yDcDSwqYLQ++1I06BRUTBfD4rpgliDN5sKVY3v3z0EcpgzB02z9VzWi9z80CtlI+P2wQlk8BAQc10OmXWortdA01ReMq1+7lc2SMQ7DLLCUzkssqTm7zPg749Vkwquy7F3r9SF0IXxrDJAihkxF74SRQTRmI8zgkmm7yelVIyzQOZinRg4yC2HWyBzaZkL27JjJMODZYra2FV65bktUo/Jp+/myb5GJckWVLi7PO3IC9m8gAz8//0yH+9qC/BjfIQLpaX1WvtX2Y6fqgEsq0sGPt4j0bdA8a9U4eVqrfi6SzCTUcFx/d8VKldYDkcAkubYP4B4LM8PtI+W875PDsap9v3+ZQpEcdz8HVCCu3unxj8RDaR3hust0BKyRasDxL+vhX0iFMYevVYILI2lHgjG5BpycaYJLcjR/5dwAuhtuu7Ap4WOGvZgAUI5F6T8H0xgBsmU1vQCYv7SWLiH2F19H/7WDjAWqZrcp1krjeVVINlXcqxpnJpJU1sEbJRXQGQDUPbOnSmjB9qZv4eSX3KEK+zT1Sdvav7JWO91DZ1FwR3r8dzaI1cnm+GrY33J8KrXwqnvydT2LMZsQxRQuO4e9a6SKMzKf+fWnUd4ySEWfPC4BoRbECry/6rJbSconn7BV1yhwfM6t3FkHI1HhPo7csaFKF5enzhgw5GYCHZsbwCc+QF8HJZMYVMRsy+wFLYZmEIytzThk+l8f7pkGGF8Xk0b8SgG0SCTCOZNvj/NAbI+2T7q5phdv+Nk+NfVFU8LsO/PhOAnTXJuJHcanLy1725aUOgM2R6kK2WNFQrHr1KaM7OvLiXCtGvFXxsfQ1En3owMjXsPnUcLM/xzzs/UCxQy+iM/gHfxWONfxUIVoVSWySemWwSlXaz14cicdxNU715BDjobT51ArdIAQAwZRXCDYh12e6pEtoaRBCJrn6QgzD8/UiJdsTboG640d9iQsiR886IHFEFVxoYw+zchVlV853v4CYf4DpBnaSeJPB5tqKmYYivZwJfYAfNWo2oLg66MBb26zotv54nr5JR/3Rd6ZHuLBW1e13mont8FcGFAHKnGoQqMFLn+k0AgVKfTxDoUS5kov8hu6GGDAb/XdixOyQlIvcCZ6xne4/fP/XEvUFkmulGv9fG+vUiyVfqn+EGsSxd2xvNDl70T4oH+Fqt57lSPknN76xopC0/V0dbHmvcQI9g4SqMoKg6syqNcV2BVgQggyHZz/R24RAc3+bH2XGiJYyBopDy5na/VDoMqN1OPsctAABycJDQ6i7+VYaTnyvWeQOUj650svKaG4xNi0rbf34N2wdHLIjtBIyxgsO1QVrq030kUQUGMxESksATT/nhk7ApsB7S5+a/1fduMcqj+bL1PjXkaREKvY5oqHYKPJXdQ4B3/5Y2sdZ+hR+wN0q/2E/9xdq7GDYVYHbtrXrOXebbGudhte6kZsU9b0A2qe6LMPJvvLyThbddernAUvxB76JYQ6ioMm4S42RfjTD+g+pSNbfHtGdJsTvkW5JPpQ4veS5cFX9xpSWa2MXE771FW/gP29qiWO6vbUL8mJq0qq78PmfCsy4hTvbZBZalpyxAlsFBCc7srA2ZCyYCDD4fXXqwi/73Lxpj2mW7lldWykc6lWJGtHR6CHjEURkfJqDnqgZPjdSsDLfacnaAT6+GHYeJXlM8Ztv3WjSTU2xUgntpDoK7hm+odhnGzeq7l8ZQDWBa1OypDxBg6S6/MAWBA5NPlYTeKoLquxF8cO3MbHZ0BEy1iSMjx1PgBCArveVb3s/cayWfvU7VDt/wX3cNUW5HOxSi77zUhrYy7y+gAQRgdOJ0xxudTXULBlivgu/cNtiS4bZhhABgx9CRfUa+KnDSCzXS2SffMgRBlt6pWAGdhxeTv3HVvAFNCWfkIr7HBp5CECDKvHFJjz0jWf/i7+fZuwN/cUBYMKu4avV4HopH8awRl74E9bkLkFcZ9nqFbuHu/Lt9VP9r7nD5gSFGLj+ZhfekRKgba4zLQeHOqO+kzevwx4VyQuizmWZN5DRSL2b1l+yq0pXo+cV3/1Wyt8eaMyW01d4zI4mif6sBqhkx9PKOjQwMuVMWcwQWMW9RCukbj8JqkAwVt1tHtcar6hV597HO+a7BXqciK0sd9YdSgGbNzyAWO5lr1NO8qmfy2irJaEybgtRolRuwLtaOaRutl4sfBv/A7p8ReMt8JxONx0JFyy6awtF9IS4Xt5eFl4kzAzvx6GhLbeCJYACq/soVUBqAprtrS+QWT2Kgc2b2yIqX2GEFlLIpKWWeiQIVqjdJPIkLqk3GA9aCDxDXQtNez/htnHlZOOaOl41dkqAr5Wy9NWQAWbbcNH7ZebF2GE3u/PiynmVXMwD7r37+BudPOB/DWK7HFthkuRV/NqjCzm4LUDt54Vdk7v55vVKCOmbFYyFwABG4r0AxAi6/dEDInw4wkFEgPZHEjTqBktgFSykkNMYgHL7Vmmg+De0hLL/HwGUfL9l7yG+K3p01HUZHN8KiQgturmanUcSaEvUCqgL3hm/9BFiDjwbyGrHaNzZAJXJ66oW0gv/go+XVVS2zT11f1W5+KQgtphmOz91ROh19oJn94fNw12G9dq+jNtXvmvPDgX9eWw3O+j3RBGoFhdPoHq7ruN0+ozn2awa3oIexGPmptLHPGQfM5esSY9RyAGui0YYJq3hWAPT1mB0c6/vMZ/gwx/lV3MsIiaTJxV4GwoukImD/qgTtAj7aHcJ82xHv7Ez2U4zk4z8rc5uj/mwZ8yc4vWpyLs+krafcMP8dUrEnPbHotqOyp8roX9vZK2P2Nta/Y3r8/J/nrn/iUvwKgnwF2uWSVJmHM50cspDf0reKRfbBCsX75TfK/cAiBVqIom3eln4fQCppFTTqGLgXYkE3d/XSqz/YwyK6wIV2FiVpENSdB+T4TsXxqtuDCx38YqCccTGVg7MBSuWx4X8QRf4GM511Bo3es0W/cmHLW1TwqRsi4LLdhEAqdepB94pz4iWuvv9RE0ua2ZLMqerymtzO4AFqD3gFQjhzCsKwIwVXDpWwTRILd/dD3iiic/yYnUa4zM0a6dc+MuKY6bVBN818ssTilhPwQCKSWwr6AKAwJjrEUVIjbw4c5UmVyUSvgGMPZ/HFwX+tkNYs0JrzciAu4GFY01viEjWJNj8ZMvzOWoh95PIYnL/sM7jlpfQgf9ZzWZuPeasvFOGSGOZssvQ0NTX5iPOtIxcs9lid+Bdxd+0p4LmIZMjG2Q8HrwwLuJBj/5IiRmOAULbnj8wcx0M9eMj7B1U85nvSg5Gz0ixgYxSHQXYiimKZ2ZA6/dlu4oFkJPMSHtOfJCY3hUW5hZFa6Gko2wRTixnaug8/62ZsVp7PKXvM55Zn5x62mPxneNcLg3jm9xrHog9r7dN17Ti4s1tMM/UKpIAA3sbIHI9Iqpuy/gjXtJ++oqHgLM9COkKK2EI+Z2NplJk7jnEsYzoZcFxpmufptPsmMY80nGYotOLhlzs7fqIoFB+tqb1UL3/wQjZwHFvyRr8rJc2JDdsef5W5d98ggsfo+55x4K/SqDNdg1JM0ABj2i1RqJxOVAKGWTqRYIfGgye+wcO0yclx4EfS6/0uS2IlVYtNNB1wDkP7DfOkythwufAJnRfFRK+fHv3xeQxrKMnUykq/ZxLgeKI67IUMf4V1PhAKYBkru4S6sHbGI2XweXuRkCaIS9TzEZ70P+3QnKygMbU05P17cuWSe+dl/sdKyNyKcTS1S9c3A7FZV3OTLQaDk3z6kJxvWpaX33moFX82EirQgwTHkaF0sN5+3LBHnG+PGAqyPsrL6OJLaJdZXom6YCF2WCDebcR5umt9GXxgtfX8JV9lmGeTa18Fao/Q9BpWKCgt6xuOqgEWvESVjxQ0SwX2S7i4TDYd+xRTMJUAvxQppwUGhBMaANKflKDNGGPkFQxULPDOXB1il2arnl6fEIq0bQXRbzE3hnb8joxoB4VjiAMkFkO7YHcOqkQeQ/6gfBAAUUXrP6YEcS1I4Nt3+jVJYojF1RaHtzG1clA698JpZPWXX1Dsi0uv1hOl6FCDYR5UWpYBGJwIMPEX+dq/51BQO/vJ6+s+nF8c+1PJkjaoNhTmtFSR2aIUOa+b+WCL5Nmv86yuVZHP6LZ2qOoOK1uryMveG+llrdWGbb0yFEXNxlpAv5oTHAclWajK4/TNUHggv5DlHkxhPKKjGKWiCqzCFrXrtl0SNJZEHj+5gC2MqJSU6Q/VOw5f9e+vYnMLyyr+nBEYbGa6MGMHVxP9ia0Zi/c7t0ku3cNEqYpNaiA8jJFDWsRTlV/rlvxMGacAEcRh1oS96nMWtpZL3B7U+GOI4Kk97YDYKngX+HN9QAGZ+vNMuWPK6agYPHunaRN4pTK8Nv6eGwVd3XGfWUiuyOmHvFfRY9bH20lqdHfxCEIuGVQ9Msi9P6SipKen47VDsNo9TaJbtVZbwnDpiLdFUOgAw3dgM1omu6bRvOBXS/Z0BkOPkwVGi/9UzFtvw2+Oir+YEiNZ8P7fOoU77TGIku5/cBBSXjy0HiYr6OWURVPBgs7Ip58DsDUOWUTEPLMApeNjvNKBg6PFms0nMZ8V44QUiFVtj9NXy+5cbd0BuYJ138IIp0nEi2KI44MxxIyiJR4ok3a8pZ9nx+qQpd1svcJzcZEl+R6K04s9yOQwdzu+50Jqb9Wbu2g5LqpXNItmgZ3i8wUQ32oRKn5M6XT+LBV1O803/m2gH2tlt72H5y9M/pnI91bg7Qw2P34F825oWH+FsRyt5l51gqqI7Ellb/5i2vGk+e4qMtVH2enyP84S4Gks9+heTc/1oSMdmNzkLhOt6KPbNutC5d9LWwCNcNU8YOkZbju0Sw8DYdj8k3hlmDTUuQDwfXh56CSpGmrMMQ/cdvTXig0rHcBnPEGPLX8y92CkKDFn+Hxn3xiEiWxwNl4P5i/5vD6qtaYbDML8422naZGRUb7ppICb162BpOPEGuAyplunjj7x9t2tWyTAwsMM9wv9izbgZS9kETbstHIBIbIzd2T/GRGUklgeYCvq06zvjMlnGU025G9SNLEKvxZVjKM1/1mMQwFSE3llf7UyJLKFzbt4TTgAEbGowi2JRJGsS/PmrqQizxRSrjNj1UqbBDyyocl5TUcSQLhChaeFcXx6jslWrIn6vHxCDYUkb8lO8VbAWdiThsSgHW6lbitmkJh6lUY3KViLQddm8YL6m/nawEBwyJfm6Aaqq+a0AWTxL3Xg3eeOjeiR8hzS4o4UboZH0cIYHwcWrKy8E+s0Wgs8XUdZCBbwXvDSlM8lcG0mFrFgTAB79FPq5r1KvlsuEWffKT4fjhQSy/OXrkBj9xQJl4KNDl2YTr4LttGvjEscLVgt4HH9TV63xIyiCOUEtugbwnFjNw6l+FcO/VQw+n0zhFZ5lyNbOuTty1YQurACsYTST8o0xzQnU96oAq9Aef8clr9KIjUSWkowW3vY6lWJD7JW60tA73QWg5HoZeUWf+yGirVFBAkrKlzdjHf9aL2FNm15XCqzPG99mxrOgEqAjzPsdYvr1XxLnmBYEbUORNj+gYyyoEoZW5whQBDR4LjGdXXGijba14z4SEKPE6vvTYRwtloS9+/t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					Military Health Conference Opens with Call to Come Together as One
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						Ashish S. Vazirani, performing theduties of the under secretary of defense for personnel and readiness., delivers opening remarks at the 2024 MHS Conference in Portland, Oregon, April 10, 2024.  (credit: Robert Hammer/Military Health System)
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						4/9/2024
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						<span id="pagecolumns_0_newscontent_0_itemList_ctl00_articleAuthorByText">By:
							Robert Hammer/MHS Communications 
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				<p>Ashish S. Vazirani, performing the duties of the undersecretary of defense for personnel and readiness, launched the 2024 Military Health System Conference—back after a decade-long hiatus—with a powerful message of personal anecdotes, and his commitment to changing the system to stabilize, strengthen, and modernize the MHS.</p><p>“As a veteran who advocates for military families, and the father of a currently serving Marine—I know the importance and the value of the Military Health System,” he said during his opening remarks at the conference in Portland, Oregon, April 9.</p><p>
Addressing more than 2,100 personnel from across the MHS, he said, “I know for all of you, this is more than just a job. It's a mission.</p><p>”Vazirani asked those in attendance to commit to the National Defense Strategy and MHS <a href="/Reference-Center/Publications/2023/12/15/MHS_Strategic_Plan_FY24_29" target="_blank" title="view or download the document">Strategy</a> to face change head-on and to embrace the opportunities those changes offer.</p><p>
The conference focused on the ongoing efforts to stabilize, strengthen, and modernize the MHS, especially within the Defense Health Agency.
</p><p>
“It's imperative that we operate as an integrated system of health and readiness that empowers and enables you to continue to deliver safe, high-quality, innovative care and support of our nation's military mission, anytime, anywhere at a moment's notice,” said Vazirani. “We must be integrated, innovative, and ready. And while we must be ready today, we also need to look forward and ensure that our MHS is resilient and ready to address the opportunities and challenges of the future.</p><p>Vazirani said that his office is focused on four areas for the MHS that support the <a rel="noopener noreferrer" href="https://media.defense.gov/2021/Mar/04/2002593656/-1/-1/0/SECRETARY-LLOYD-J-AUSTIN-III-MESSAGE-TO-THE-FORCE.PDF" target="_blank" title="view or download the Defense.gov PDF">Department of Defense secretary’s three priorities</a>:
</p><ul>
    <li>Changing the culture to prevent behaviors across a continuum of harm, while promoting an environment where everyone can serve with dignity and respect
    </li>
    <li>Promoting the health, well-being and safety of the force and families</li>
    <li>Cultivating talent management</li>
    <li>Advancing strategic readiness</li>
</ul><p>
“The department requires a joint force that is lethal, resilient, sustainable, survivable, agile, and responsive,” said Vazirani. “We must provide care for 7.1 million beneficiaries in a manner like many civilian health systems, while at the same time delivering care for 2.5 million service members and generating military medical readiness. We have a system that must do both, and we have an obligation to do both.”
</p><p>
He acknowledged that in this unique health care environment, change is not going to be easy but is required to enhance and modernize the MHS.
</p><p>
“This change requires courage to break from the status quo,” said Vazirani. “To take a hard look at what is necessary to achieve our objectives. I'd like to commend the leaders across the national health services, health affairs, Defense Health Agency, military services, and the joint staff who are working together and showing the courage to undertake this change.</p><p>”He noted two major key lines of effort for this change.</p><ul>
    <li>Establishing requirements for both medical and manpower: “We will take a deliberative approach to understanding, codifying and communicating our requirements. We must know what we need in very specific terms so that we can make informed decisions, risk recommendations and action plans,” Vazirani said.
    </li>
    <li>Improving capacity, starting with understanding current capacity and identifying gaps: To address those gaps, Vazirani noted that the MHS must improve staffing, military and civilian, at military hospitals and clinics.
    </li>
</ul><p>
“That includes revamping our approach to civilian hiring to be more competitive and timelier to address the requirements and ensure adequate and predictable staffing levels. We are also implementing changes to the uniform personnel management process,” he said.
</p><p>
“These changes are necessary to achieve our major objective – that of reattracting patients whose care has shifted to the private care network over the past several years,” said Vazirani. “Bringing patients back to the <span tabindex="0" class="TooltipLink"><span class="TooltipContent"><a href="javascript:void(0);"><span class="visiblyHidden">Click to close</span><span class="cancelButton"></span></a><span class="DefinitionTerm">Direct Care</span>Direct care refers to military hospitals and clinics, also known as “military treatment facilities” and “MTFs.”</span>direct care</span> system is essential as it ensures they continue to receive high-quality care, and our medical force remains mission ready.
</p><p>
“Let's move out of our comfort zone to embrace the opportunities and potential that this moment of change offers us,” he emphasized. “Realizing the benefits of these changes will require commitment.”
</p><p>
He closed with his ongoing support and dedication to creating change within the MHS.
</p><p>
“The MHS is quite simply the lifeblood of the men and women who go into harm's way to defend the nation,” said Vazirani. “What we do here today—how we transform the system—will determine the health and well-being of countless Americans who serve our country with honor and courage.” </p><figure style="width: 270px; font-size: 12px; margin-left: 10px; float: right;"><img src="/-/media/Images/MHS/DVIDS/Photo-Items/image8343908.ashx?h=180&w=270&la=en&hash=DF7A5FDD23EC22898B3C43C062FFA22B49611A16" style="height: 180px; width: 270px; float: right;" alt="Military Health Conference Opens with Call to Come Together as One">Dr. Lester Martinez-Lopez, the assistant secretary of defense for health affairs, shared his vision for change and for the future of the Military Health System, where he encouraged everyone from across the MHS to work as one for the same goal. Martinez addressed more than 2,100 participants at the 2024 MHS Conference in Portland, Oregon, April 10, 2024.</figure><p>
He noted his gratitude for MHS personnel “and the energy, enthusiasm, intellect and leadership you bring to this integrated, innovative and ready MHS.</p><p>”Following Vazirani’s opening session, Dr. Lester Martinez- López, the assistant secretary of defense for health affairs, shared his vision for the future of the MHS.</p><p>
He emphasized that the MHS is an integrated system. It is a system of health and readiness that depends on the strengths ofeach part, including the DHA, USUHS, and the services.
</p><p>
“We have to start thinking of ourselves as a system—the Military Health System. That’s our primary identity,” said Martinez. “We have to think of everything we do, every decision we make, in terms of its impact on the system, not just on the immediate component.”
</p><p>
Martinez encouraged this team mentality when he talked about what it’s going to take to improve the system, and spoke briefly about how the system got to its current state.
</p><p>
A shrinking provider force, both civilian and military, patients moving to the private sector, and the readiness of the medical force are all elements that need to be addressed, according to Martinez.
</p><p>
“Some of these situations have been years in the making, based on past assumptions that have not proven true,” Martinez said.
</p><p>
“For example, it was assumed that it would cost less to send patients to the private sector—not true. That the network had sufficient capacity to take on the additional patient load—not true. And that in a post-war era, we could afford to reduce military medical manpower—not true.”
</p><p>
He said with steady progress, needed changes can be made to solidify the MHS to meet the needs of its 9.5 million beneficiaries for decades to come.
</p><p>
“The time that I’ve spent on the road, visiting our facilities and talking with our people gives me confidence that although our challenges are great, we can meet them and deliver the readiness the American people deserve in their armed forces.”</p>
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    <h3 class="feedItemTitle"><a target="_self" href="/News/Articles/2021/08/19/New-Flag-and-Patch-Symbolize-Growth-at-the-Defense-Health-Agency">New Flag and Patch Symbolize Growth at the Defense Health Agency</a></h3>            
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                <p>The DHA will reveal a new flag and seal in a ceremony August 20 to signify the unity of all services under one joint combat support agency.</p>
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    <span class="dateStamp">Aug 18, 2021</span>
    <h3 class="feedItemTitle"><a target="_self" href="/News/Articles/2021/08/18/Ready-Reliable-Care-and-Innovation">Ready Reliable Care Framework is Improving MHS Patient Care</a></h3>            
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                <p>The Military Health System's Ready Reliable Care framework helps ensure high-quality health care for all service members, veterans and their families. </p>
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    <span class="dateStamp">Aug 16, 2021</span>
    <h3 class="feedItemTitle"><a target="_self" href="/News/Articles/2021/08/16/Reform-COVID19-Have-Been-Catalysts-for-Change-in-Military-Medicine">Reform, COVID-19 Have Been Catalysts for Change in Military Medicine</a></h3>            
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                <p>Healthcare is about taking care of people, so no amount of change or innovation is ever sufficient if modernization does not lead to helping patients, says acting ASDHA at HIMSS21 in Las Vegas.</p>
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    <h3 class="feedItemTitle"><a target="_self" href="/News/Articles/2021/08/13/DODs-Whole-of-Government-Approach-to-COVID-is-Working-Says-Adirim">DOD's Whole of Government Approach to COVID is Working, Says Adirim</a></h3>            
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                <p>Dr. Terry Adirim, said she has been impressed by the DOD’s COVID-19 response since taking over as ASDHA, and that adaptation and innovation have played key parts in that response.</p>
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    <span class="dateStamp">Aug 6, 2021</span>
    <h3 class="feedItemTitle"><a target="_self" href="/News/Articles/2021/08/06/Puget-Sound-Military-Health-System-Certified-by-Defense-Health-Agency">Puget Sound Military Health System Certified by Defense Health Agency</a></h3>            
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                <p>The Puget Sound market leaders are responsible for managing all health care for its military population within Western Washington.</p>
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                <p>The Defense Health Agency continues to establish new health care markets across the U.S. Markets are designed to increase access to care for beneficiaries and improve coordination, standardization, and best practices across the MHS. Watch this month's MHS Minute to learn more!</p>
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    <span class="dateStamp">Jul 27, 2021</span>
    <h3 class="feedItemTitle"><a target="_self" href="/News/Articles/2021/07/27/New-Markets-MHS-Transformation-and-You-What-Does-it-All-Mean">New Markets, MHS Transformation and You: What Does it All Mean?</a></h3>            
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                <p>With ten new markets launching, U.S. Public Health Service Capt. Tracy Farrill, talks about what this means for beneficiaries.</p>
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    <span class="dateStamp">Jul 19, 2021</span>
    <h3 class="feedItemTitle"><a target="_self" href="/News/Articles/2021/07/19/San-Antonio-Market-to-Standardize-Optimize-Local-Healthcare">San Antonio Market to Standardize, Optimize Local Healthcare</a></h3>            
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                <p>The Defense Health Agency’s San Antonio Market is the seventh market to stand up over the past year, and is designed to standardize, optimize local healthcare. </p>
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    <span class="dateStamp">Jul 1, 2021</span>
    <h3 class="feedItemTitle"><a target="_self" href="/News/Articles/2021/07/01/Changes-ahead-for-BJACH-with-DHA-Market-Transition">Changes ahead for BJACH with DHA Market Transition</a></h3>            
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                <p>DHA was established in 2013 to provide a host of shared health services across the MHS and BJACH will transition within the next 30 days</p>
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    <span class="dateStamp">Jun 24, 2021</span>
    <h3 class="feedItemTitle"><a target="_self" href="/News/Articles/2021/06/24/Defense-Health-Agency-Continues-Transformation-with-Colorado-Market">Defense Health Agency Continues Transformation with Colorado Market</a></h3>            
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                <p>The Colorado Military Health System officially stood up June 22.</p>
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