For those seeking help for addiction, access to more professional

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1 Volume 7 Issue 3 Summer/Fall Inpatient? Outpatient? Both are good choices. Combined they're even better For those seeking help for addiction, access to more professional services and programs in more communities can only be good news. With our new Outpatient Services in Vancouver, Victoria and Seattle, WA, we have expanded our ability to meet the needs of people and families struggling with addiction. While EDGEWOOD has always maintained a good residential inpatient program with good aftercare support is the best option for the effective treatment of addiction, there are many factors that influence the decision to seek help. The individual's level of commitment to make a real change, the severity of their addiction, whether or not there is an underlying (possibly undiagnosed) mental health issue, affordability, and what level of support exists from family and the community all influence the type of care sought. That being said, by providing both residential inpatient care and a broad range of outpatient services we offer people more opportunities to find support, to connect, to learn and to access an appropriate level of help and care. Yes, inpatient treatment yields excellent results, but it also requires a commitment of time and financial resources. This can discourage some from seeking the treatment they need. Presupposing that detoxification is not (or not yet) needed, our Outpatient Services are non-residential and provide a level of flexibility and convenience for someone whose health is not completely compromised by their addiction. Cont'd...page 4 Workplace Addiction ~ Employer Responsibilities The "Duty to Accommodate" clearly rests with the Employer Most people who abuse drugs or alcohol also have jobs. From the assembly line to the boardroom, drug and alcohol abuse costs both time and money through increased absenteeism, replacement labour and job site accidents. (According to Statistics Canada, the cost to our economy due to lost productivity, health care costs and law enforcement in 2002 was about $40 billion.) The Canadian Human Rights Commission recognizes "the inappropriate use of alcohol or drugs can have serious adverse effects on a person's health, job performance and workplace safety". Dependent drug use is also identified, both by the Canadian Human Rights Act and the BC Human Rights, as a disability, and any discrimination on the basis of disability or perceived disability is prohibited. Therefore, if impairment due to drug/alcohol use is a concern, an employer must make an effort to identify and minimize potential safety risks. This includes providing employee assistance programs, drug education and health promotion programs, off-site counselling and referral services and peer or supervisor monitoring." Cont d...page 4 In This Issue Outpatient Services Augmenting Good Inpatient Care Duty to Accommodate Legal requirements for employers Medical Review Officer EDGEWOOD Psychiatrist Certified Alumni INSITE in Vancouver Deals with Relationship in Recovery Best of Times ~ Fun Run 2012 Rain and Plenty of Fun Walking Meditation Eyes Open, Mind Still is published quarterly by EDGEWOOD Holdings Ltd., 2121 Boxwood Road, Nanaimo, BC V9S 4L2 (250) Toll Free

2 Page 2 Two Paths Same Goal EDGEWOOD Intensive Outpatient Program Improves Outcomes The guiding rule at EDGEWOOD is: patient care comes first. To that end, any planning or changes we implement must be in our patients' best interest; this includes the recent introduction of Outpatient Care to EDGEWOOD's spectrum of services. Historically, Outpatient care has been problematic for us. Outcomes from the outpatient models we've studied have not been good. Our view is that the positive results reported do not stand up to close scrutiny. Longitudinal data is in short supply and we believe there is little to no assessment of the severity of the patient's addiction and the studies rarely take into account the dropout rate over the duration of the program. Some Intensive Outpatient Programs (IOP's) appear to have limited understanding of the disease of addiction and little or no aftercare or follow-up. (The successes may have more to do with treating 'abusers' as opposed to the sicker patients suffering from the 'disease' of addiction.) So, how does EDGEWOOD justify having not one, but three Intensive Outpatient Programs with plans to add more in the future? The answer came to us from our Vancouver Outpatient office. Program Director, Patrick Zierten, EMBA, M.A., has been working with individuals and families struggling with substance abuse for more than 14 years and has come across many people who are unwilling, or unable, to attend a residential treatment program. To address this concern, EDGE- WOOD Vancouver introduced its Intensive Outpatient Program in The program has been very well received. We have always maintained that Inpatient treatment for addiction is the best solution. It produces optimum results, but there is a very real need to address the health of those who, for whatever reason, are unable to access it. We recognized that we needed to develop criteria around our Intensive Outpatient Programs that reflected our own principles and beliefs. What are Outpatient Services? EDGEWOOD offers a range of OUTPATIENT SERVICES through our Nanaimo facility and our three satellite offices: Vancouver, Victoria and Seattle. Included are: preliminary services such as pre-assessments, family coaching, intervention services and treatment referrals, as well as post-treatment services like: aftercare groups, recovery drug monitoring, aftercare coaching, relationship and individual counseling. On-going services include: support with employment reintegration, adherence to aftercare plan, referrals for co-occurring disorders and educational seminars on relapse prevention, boundaries, anger management and smoking cessation. Key is our understand of the role IOP plays in a successful sobriety and healthy life for our patients and their families. IOP is a step in the development of a longer term strategy to treating the disease. We must be clear and realistic about this with patients and famlies right from the beginning. For those who participate in an IOP, the understanding is that should they struggle or fail, they and their family will be willing to take the next step, i.e. residential inpatient treatment. It is our policy to always inform patients and their families of the health benefits and value in attending a residential program and that fees paid for the IOP are applied toward the cost of inpatient treatment to offset the cost. Like others in recovery, those subscribing to our Intensive Outpatient program require support and ongoing aftercare to stay healthy; this includes the option of therapeutic monitoring. It should be noted that the recommendation of therapeutic monitoring is not a "penalty", it merely indicates a more intensive kind of treatment would be more effective. I'm happy to say that to date, our IOP's have met our expectations. Some participants have done well in the program, a number have struggled, but many of those have come into our residential treatment program as a result. An unexpected, but happy, outcome of our IOP's is that those who chose Inpatient Treatment engaged with the program sooner and their attitudes and understanding of the disease were further advanced. We believe this may translate into shorter, more effective inpatient treatment stays. The key for us is to be clear about IOP expectations and outcomes, to explain that although our hope is for a healthy recovery, that IOP may be only a step in that direction. With the ultimate goal of helping people and their family recover from this disease we remain true to our principles and continue to do everything in our power within the Intensive Outpatient Program to make it a successful experience for the patient. Lorne Hildebrand, Executive Director EDGEWOOD What is an Intensive Outpatient Program? EDGEWOOD's Intensive Outpatient Programs are short-term programs designed to address the needs of those who may have a problem with substance but do not require inpatient addiction treatment. The Intensive Outpatient Program requires an initial assessment and the client's commitment to the program. They must also commit to maintaining their recovery through weekly aftercare meetings, a relapse contract and the option of drug monitoring over the remainder of the year. * IOP core programming is offered at all of our satellite offices. Additional varied programming such as educational seminars: What is Addiction?; Healthy Boundaries; Anxiety and Relapse Prevention, etc. are offered at individual offices.

3 Page 3 Frontier of Addiction Medicine Treatment EDGEWOOD Psychiatrist Becomes Certified Medical Review Officer In the mid 1980 s, as part of President Ronald Regan s War on Drugs and to prohibit federal employees from using illegal drugs, all US federal agencies were declared drug-free workplaces. Each executive-branch federal agency had to establish a comprehensive drug assistance program that included the following: supervisory training, provision for self-referral to treatment, and provision for detecting illicit drug users including drug testing of federal employees who were in safety sensitive and security critical positions. (The Federal Review Officer s Manual. Page 13). FOCUS OF ATTENTION ON WORKPLACE Adverse effects of alcohol and drug use disorders in the workplace were now the focus of attention. Though still in its infancy with a number of components still to be developed, the process had one important mechanism available to employers for securing a safe, drug-free workplace: drug testing of employees. The challenge, however, was to strike the proper balance between an employer s duty to provide a safe workplace (using the mechanisms at their disposal) and the employees basic human rights and any existing contracts between unions and employers. In a study completed by Statistics Canada in 2006, productivity losses in Canada, due to drug/alcohol use in 2002, amounted to $24.3 billion dollars. PROFESSIONAL REVIEW The interpretation of laboratory testing became crucial in the accurate identification of those employees who were actually using drugs. This led to a very precise standardization of the collection process, primarily involving urine samples for drug testing and breath samples for alcohol. Laboratories also had a specific process that had to be followed. The results then had to be interpreted in terms of their significance. This level of expertise and interpretation required the expertise of a physician trained in the area of addiction and knowledgeable in the field of drug testing. This led to the creation of the role of the Medical Review Officer. To meet government standards, physicians with an interest in this area are required to become certified. The certification criteria included: Being a physician or doctor of osteopathy, Knowledge about the pharmacology and toxicology of illicit drugs, Knowledge and clinical experience in controlled substance abuse disorders, Knowledge about the federal agency drug testing rules and guidelines under which the MRO operates Training and knowledge necessary to review workplace drug testing results Successful completion of a written examination administered by a recognized MRO CertificationBoard. This represents 61% of the total cost of $39.8 billion to the Canadian economy through direct and indirect costs. Currently, certification can only be completed in the United States. There is no equivalent Canadian certification. Recently I completed the Medical Review Officer training in San Diego, CA and passed the certification examination. I believe this is one more step toward keeping EDGEWOOD at the frontiers of addiction medicine treatment as Dr. Mel Vincent Dir. Psychiatric Services EDGEWOOD we move forward in our commitment to providing the highest quality treatment for our patients. EMPLOYER/EMPLOYEE SUPPORT IMPORTANT According to the National Survey on Drug Use and Health (2005) approximately 75% of current drug users and 80% of current binge and heavy drinkers are employed either fulltime or part-time. Active addiction clearly has a significant and at times life-threatening impact on the workplace; this has been well documented. For 18 years, EDGEWOOD has been actively involved in treating substance use disorders. During this time, we have established relationships with a number of employers and treated hundreds of employed Canadians suffering from the disease of addiction. We work hard to restore the health of those individuals and our expertise in the area of workplace addiction has allowed them to return to work, revitalized and healthy. MEETING NEW REQUIREMENTS EDGEWOOD continues to expand its role in the treatment of substance use disorders. This involves establishing outpatient offices in Vancouver, Victoria and Seattle. Our programs have expanded to include Intensive Outpatient Programs in addition to outpatient assessments and monitoring programs that ensure that patients remain clean and sober following treatment, and are identified as early on in the relapse process as possible to restore their sobriety. In keeping with this direction we continue to enhance our own professional and clinical training and skill development to meet the changing roles and requirements of addiction professionals. Medical Review Officer Dr. Mel Vincent B.A.Sc., M.Sc., MD, FRCP(C) ASAM, Certified MRO Director of Psychiatric Services EDGEWOOD

4 Page 4 Inpatient? Outpatient? Cont d from page 1 Also, the ability to access a range of services including, initial assessment, family coaching, educational programs, and treatment referral, (if required) means our Outpatient Services can be a timely means of early intervention. Our Intensive Outpatient Program, is currently offered at all of our satellite offices as part of our Outpatient Services. The core program requires an initial assessment and the client s commitment to attend regularly scheduled group therapy sessions over the course of the program. Some of the topics covered are: "What is Addiction?", "Healthy Boundaries" and "Anxiety" and "Relapse Prevention". This is followed with a required commitment to maintain their recovery through on-going weekly aftercare meetings, a relapse contract and the option of drug monitoring, over the remainder of the year. So which is the better option? Because each individual has unique needs and available resources, having both inpatient treatment and outpatient programs and services available to the public addresses the full spectrum of need from assessment and early intervention to aftercare support. The two programs can work independently from each other, or in conjunction with each other, to provide an expanded continuum of care that truly is optimal for the best health outcomes. Having both programs available accessible to the public increases the likelihood of effective and timely treatment for addiction while providing a level of flexibility in terms of time, access and cost. That being said, if time and financial resources are sufficient, we have always maintained that committing to residential inpatient care is still advisable. Timely and proper treatment, whether inpatient, outpatient or a combination of both greatly improves the chance for a healthy, substance-free lifestyle. Open House! EDGEWOOD SEATTLE Join us Thursday, October 18th, 2012 at 1200 Westlake Ave., N. Ste. 508 Seattle, WA Come see our new location and services available! RSVP Duty to Accommodate... (Cont'd. page 1) The obligation is referred to as the "duty to accommodate" and under the Employment Equity Act, employers must (with some exceptions)* implement "whatever means necessary to allow its employees to work to the best of their ability." Understandably, it is a sensitive area for employers and employees, and must be handled with tact, diplomacy and goodwill. Both sides of the equation have rights and responsibilities and the courts have supplied clear guidelines for employers and have also identified the corresponding responsibilities of employees. Being presented with this responsibility can feel intimidating and confusing, but achieving resolution through cooperation and respect must remain the goal. EDGEWOOD has a long, successful tradition of providing educational programming, presentations and support to employers, supervisors and employees who are attempting to address addiction in the workplace. *If accommodation imposes a hardship on the person or service having to accommodate the needs (i.e., risk of health and safety to that person/or other persons or if the cost of accommodation threatens the ability of the organization to continue or changes its essential nature, accommodation may be denied. Sources: The B.C. Human Rights Coalition The Canadian Human Rights Commission "Employers can require employees who work in safety-sensitive positions to disclose current use of alcohol and drugs, as well as a history of alcohol or drug abuse within the last five or six years for alcohol dependency, and six years for drug dependency... Automatic dismissal or refusal to employ someone based on a disclosure of past or present dependency on drugs or alcohol is contrary to the Canadian Human Rights Act." Source: Canadian Human Rights Commission's Policy on Alcohol and Drug Testing Revised October 2009

5 Page 5 EDGEWOOD Alumni INSITE in Vancouver Successful 5-Day Progam Deals Specifically with Recovery Relationship Issues Patrick Zierten, EDGEWOOD Vancouver's Program Director, is a happy man. When we opened up the new office in Vancouver, one of my priorities was to bring Insite to Vancouver. Not the Insite as developed for family members living with an addicted loved one, but one specifically designed for individuals in recovery from substance dependence." He goes on to describe the plans he implemented in Vancouver, "I met with Dale Mac- Intyre, EDGEWOOD's Family Program Supervisor, and we went to work revising some of the components of the program so that it was more applicable for folks in recovery. Dale was kind enough to come over to Vancouver and he ran our first INSITE Program in October We now hold an INSITE Program once every three months." Patrick talks of his own experience with INSITE. Fifteen years ago, I was having all kinds of problems in my recovery. I was complacent, unhappy, lacked meaning and purpose and my relationship life was in shambles. I thought I was about ready to relapse. I didn t know what to do until a good friend of mine suggested I go to this INSITE program over at Edgewood, in Nanaimo. "I really didn t want to go but I was at one of those places where if things didn t change I thought I was going to go crazy. I had no idea what to expect. Boy, was I more than pleasantly surprise! It literally transformed my recovery process. I realized that being in recovery was not just about staying sober one day at a time, it meant that I had to change how I responded to people, how to draw boundaries and how to take care of myself. The Alumni INSITE program as offered in Vancouver, is designed specifically for the person with a year of substance dependence recovery, who is facing ever-increasing challenges in their relationships with others. Much of the curriculum is taken from the original Insite program but is modified to deal more specifically with early recovery relationship issues. "The wonderful thing about this program is that many of our Alumni INSITE graduates have gone on to our INSITE Aftercare group. We have two of our original graduates that still attend Insite Aftercare. Patrick Zierten, Program Director, Edgewood Vancouver Here is what some of our Alumni are saying about Insite: After completing one year of inpatient aftercare, I now regularly attend Insite aftercare. This has taken my recovery to a greater place than I ever could have imagined...and the pieces of the puzzle are fitting together more comfortably. I can't imagine my recovery without it. Sue G. Edgewood got me sober. AA probably helps keep me sober. But Insite held up a mirror I could not turn away from...and it is Insite Aftercare, without a doubt, that stops me from picking up when my addiction comes calling like a bad boyfriend from the past, his hair cut, wearing a sharp suit, carrying a bunch of flowers and telling me that I have changed and he has changed and it will all be different this time, and can we give it one more shot? Thanks to Insite, I will never be able to forget what that Jane in the mirror looks like. Jane E. Alumni INSITE Program includes: Defining and drawing healthy boundaries, Expressing emotions appropriately, Resolving intimacy issues, Learning self-care. Group process (similar to inpatient morning group) What am I doing that keeps people from getting close? ( The Wall exercise). This 5 day program starts on Monday at noon and ends on Saturday by 2:00 pm. Both treatment as an inpatient and Insite have been life-changing experiences for me. I feel that I'm better equipped to live a healthy life than many people who are apparently 'free' of addiction or who have no connection to a loved one who is struggling with alcoholism/addiction. The staff I've worked with at Edgewood in Nanaimo and Vancouver are fantastic: experienced, knowledgeable, and compassionate. What I appreciated the most in both programs were their honesty and suggestions; not always easy to hear but definitely always promoting the most growth! Val W. Participants of the program are people in recovery from addiction who share similar issues. The Alumni INSITE program is open to anyone in recovery, not just Alumni from Edgewood.

6 Page 6 It was the Best of Times Weather and Technical Glitches No Match for Good Spirits and Fun! T he sun shone brilliantly earlier in the day, but during the event...not so much. We weren't going to let a little inclement weather stand in our way, so on June 22nd (possibly the coldest, rainiest day of our cool, wet spring) some 215 runners, joggers, and walkers hit the soggy 6 km trail. Some ran in little pink tutus, others sported false moustaches and questionable leggings, but all happily jogged under dripping cedars and through puddles in support of the Edgewood Foundation s 2nd Annual Fun Run for Addiction Awareness. (Some even elected to add an optional 4 km onto their run and completed a total of 10 km to finish.) All along the sodden trail, the Vancouver Island Raiders football team coached, cajoled and bellowed encouragement until the very last participant crossed the finish line in triumph. EDGEWOOD staff organized and ran the event, with help from our Extended Care Patients, patiently dealing with all of the challenges the day could throw at them. The unexpected glitches always make the best stories, and forty-four minutes into the event our generator up and died. Horrors! Some- IT WAS EPIC! one produced a smart phone and carried on recording the time. A rough shake of the generator dislodged the offending air pocket and with a small burp, the machine roared back to life. The time clock resumed ticking and our finish line re-inflated to its former glory. We carried on, because what else can one do? And all who participated graciously forgave us the set back. None of this did a single thing to dampen the fun! Prizes were awarded for the fastest runners male, female, youth and child. For collecting the most in individual pledges, EDGEWOOD s Terry Ketteringham took a prize home too. Our Silent Auction netted nearly $5,000 in bids with the total amount raised from the Fun Run 2012 reaching $24, A big thank you to all our participants, sponsors and donors. We couldn't have done it without you! Corporate Sponsors:TD Bank The Wave The Running Room Central Drugs Kwikkopy Design & Print Centre The Wolf Impact Visual Communications Nanaimo Daily News Intraworks Island Business Print Group Ltd. Communication Connections Morneau Shepell Corporate Teams: G&G Roofing Harbour City Fitness(x2) Intraworks Parkway Automotive Team Remax (x2) Lakeside Dental New Society Publishers Huggins & Company Hayes Stewart Little & Company Donors: Able Body Consulting Able Trophies and Giftware Alberni Outpost Aloyd Fitness Equipment Alsco BC Lions Barry Kerfoot The Bay Lancome The Bay Fragrances Beban Pitch & Putt Body Glo Tanning Salon City of Nanaimo Parks & Recreation Cantebury Coffee Catwalk Nanaimo Chemainus Theatre Club Sun Tanning Studio Chrissandra Unger Columbia Fuels Costco Coast Hotels E. Madill Office Supplies EDGEWOOD Elizabeth Stetar Fairwinds Golf Club G&G Roofing GW Cement Contracting Georgina s Hair Design Germana Health Systems Grower s Direct Harbour City Fitness Center House of Indigo Jentri Esthetics and Permanent Makeup Ken Evans Ford Keller s Jewellers Harbour Air Island Natural Jardine Lloyd Thompson Learn To Fly Lobelia s Lair Long Lake Nurseries McLaren Lighting Marshall Plumbing Mayco Mix Meyers Norris Penny Mid-Island Co-op Minnoz~Coast Bastion Inn Moksha Yoga Mr. Lube Nanaimo Bakery Nanaimo Golf Club Nanaimo s Health Shop Neon Nail Studio Northridge Health Performance Center NYLA Boutique Pampered Chef (Cheryl Wilson) Paris Jewellers Remax of Nanaimo Romper Room Indoor Rock Climbing Centre ScanDesign Silpada Jewellery (Danika Bazant) St. John s Ambulance Starbucks Sun Life Willowshack Studio World Folk Art Zougla Restaurant

7 Page 7 The Labyrinth A Walking Meditation Eyes Open Mind Still OUR NEXT SESSION Nov. 16,17 & 18, 2012 This 3-day retreat includes: Teachings on the Labyrinth Guided Meditation Labyrinth Walks Quiet Reflection Cost: $ (plus HST) (meals included) For information or to register please call or The image of meditating is usually of a person seated in the lotus positon, eyes closed. Information on 'how to meditate' often includes instructions on how to maintain a straight back, a tilted pelvis, and 'stacked' vertebrae. Once you've managed this balancing act you're instructed to "relax". You might wonder if there's a way to get into a meditative state that is a little easier but just as effective. There is, and it's as easy as putting one foot in front of another. Obviously, the main difference between a sitting meditation and a walking meditation is that in the latter you are up and moving about. But another difference is that in a walking meditation you are not asked to withdraw your attention from the outside world. In fact, it's better if you are conscious of those things outside yourself that you might trip over or collide with. This awareness is something we already do naturally when we're walking, so we have the basics in place to fully explore and experience the practice of a walking meditation without any special posture or preparation. Human beings were designed to move, and the very act of moving sends particular signals to your body. Joggers and athletes learn to listen to these signals to strengthen their experience and enjoy peak performance. It's the same for a walking meditation, you learn how to focus your attention on your body signals. In doing this, your mind grows quiet and your meditation experience both strengthens and deepens. Walking the labyrinth is an ideal way to explore your ability to meditate. There's no magic involved unless you count the resulting feeling of serenity and joy. This is a practice that is accessible to anyone who wants to develop a state of mindful awareness and disengage the noisy, busy part of the thinking brain and engage the deep quiet of the "being" brain. Paying close attention to our body while walking does tend to quiet the mind. Thoughts inevitably surface, but that's natural; releasing them instead of dwelling on them helps to bring the focus of attention back to the present moment. It's in the full experience of the moment that we are practicing meditation. Walking meditation is a discipline but the very act of putting one foot infront of the other creates a naturally meditative state. It is a simple, yet elegant introduction to mindfulness that, like many things worth doing, starts with small steps. New Addition well underway! What was previously a parking lot is being transformed into a new facility for EDGEWOOD patients and staff. So exciting to see the framing going up on our new facility. Work is proceeding on schedule and the weather is cooperating. We`re looking forward with great anticipation to having a completed facility this fall.

8 Page 8 5-Day Intensive Addiction Training for Physicians March 11th to15th 2013 EDGEWOOD CALENDAR A unique patient-based program introducing physicians to current addictions medicine theory. This intense and practical learning experience provides direct observation of group therapy sessions plus an opportunity (with supervision) to practice interview and assessment skills. For more information or to register for our next session call or 4 Day Conference Coming This Fall! Healing & Treating Trauma, Addictions & Related Disorders November 28-30, 2012 Coast Edmonton Plaza Hotel th Street, EDMONTON, AB For more information or to register please visit: or call: The Next Steps On the Journey to Authenticity Next Steps in Kelowna # Appaloosa Road Kelowna BC Oct , 2012 Next Steps in Vancouver 1525 West 7th Ave., Vancouver, BC Nov , 2012 Session Times: Fri. 6:00-9:00pm; Sat. 9:00am-5:00pm Sun. 9:00am-3:00pm For more information or to register, contact Bonnie Bartlett at EDGEWOOD Toll Free: The Labyrinth: A Walking Meditation EDGEWOOD-Nanaimo Nov , 2012 EDGEWOOD Seattle Grand Opening Seattle, WA October 18, 2012 Dates to Note: Alumni Spaghetti Dinner December 11, 2012 Christmas Cake Night December 18, 2012 Santa's Workshop and Gift Wrap December 20, 2012 moving? Don t forget to let us know, we d like to stay in touch! Call so we can update our records. is available by . Please call and let us know your preference. Next Cake Night EDGEWOOD 7:00 PM October 23rd, 2012 Upcoming Cake Nights November 27, 2012 December 18, 2012 FALL SESSIONS Oct , 2012 Nov. 29-Dec. 2, 2012 Call to Register bounce back An Educational Support Program for Children EDGEWOOD offers sessions in our popular Bounce Back educational program for children. Help your child to understand alcoholism and addiction, and give them the gift of health. Give the Gift of Hope Celebrate your sobriety by helping someone else. To make a donation please contact: Ms. Colleen Ward The Edgewood Foundation

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