Full Text of SB1702 101st General Assembly
SB1702enr 101ST GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning health.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Mental Health and Developmental | 5 | | Disabilities Code is amended by changing Sections 2-108, 2-109, | 6 | | 3-602, 3-603, 3-610, 3-702, 3-703, 3-752, 3-753, and 3-807 and | 7 | | by adding Section 1-101.3 as follows: | 8 | | (405 ILCS 5/1-101.3 new) | 9 | | Sec. 1-101.3. Advanced practice psychiatric nurse. | 10 | | "Advanced practice psychiatric nurse" means a nurse who is | 11 | | licensed to practice as an advanced
practice registered nurse | 12 | | under Section 65-5 of the Nurse Practice Act and has been | 13 | | certified by the American Nurses Credentialing Center as a | 14 | | psychiatric mental health clinical nurse specialist or a | 15 | | psychiatric mental health nurse practitioner.
| 16 | | (405 ILCS 5/2-108) (from Ch. 91 1/2, par. 2-108)
| 17 | | Sec. 2-108. Use of restraint. Restraint may be used only as | 18 | | a therapeutic
measure to prevent a recipient from causing | 19 | | physical harm to himself or
physical abuse to others. Restraint | 20 | | may only be applied by a person who has
been trained in the | 21 | | application of the particular type of restraint to be
utilized. | 22 | | In no event shall restraint be utilized to punish or discipline |
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| 1 | | a
recipient, nor is restraint to be used as a convenience for | 2 | | the staff.
| 3 | | (a) Except as provided in this Section, restraint shall be | 4 | | employed only
upon the written order of a physician, clinical | 5 | | psychologist, clinical social
worker, clinical professional | 6 | | counselor, advanced practice psychiatric nurse, or registered | 7 | | nurse with supervisory responsibilities. No restraint
shall be | 8 | | ordered unless the physician, clinical psychologist, clinical | 9 | | social
worker, clinical professional counselor, advanced | 10 | | practice psychiatric nurse, or registered nurse with | 11 | | supervisory responsibilities, after personally
observing and | 12 | | examining the recipient, is clinically satisfied that the use | 13 | | of
restraint is justified to prevent the recipient from causing | 14 | | physical harm to
himself or others. In no event may restraint | 15 | | continue for longer than 2 hours
unless within that time period | 16 | | a nurse with supervisory responsibilities , advanced practice | 17 | | psychiatric nurse, or a
physician confirms, in writing, | 18 | | following a personal examination of the
recipient, that the | 19 | | restraint does not pose an undue risk to the recipient's
health | 20 | | in light of the recipient's physical or medical condition. The | 21 | | order
shall state the events leading up to the need for | 22 | | restraint and the purposes
for which restraint is employed. The | 23 | | order shall also state the length of time
restraint is to be | 24 | | employed and the clinical justification for that length of
| 25 | | time. No order for restraint shall be valid for more than 16 | 26 | | hours. If
further restraint is required, a new order must be |
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| 1 | | issued pursuant to the
requirements provided in this Section.
| 2 | | (b) In the event there is an emergency requiring the | 3 | | immediate use
of restraint, it may be ordered temporarily by a | 4 | | qualified person only
where a physician, clinical | 5 | | psychologist, clinical social worker, clinical professional | 6 | | counselor, advanced practice psychiatric nurse, or
registered | 7 | | nurse with supervisory responsibilities is not immediately
| 8 | | available. In that event, an order by a nurse, clinical | 9 | | psychologist, clinical
social worker, clinical professional | 10 | | counselor, advanced practice psychiatric nurse, or physician | 11 | | shall be obtained pursuant to the requirements of
this Section | 12 | | as quickly as possible, and the recipient shall be examined by | 13 | | a
physician or supervisory nurse within 2 hours after the | 14 | | initial employment of
the emergency restraint. Whoever orders | 15 | | restraint in emergency situations shall
document its necessity | 16 | | and place that documentation in the recipient's record.
| 17 | | (c) The person who orders restraint shall inform the | 18 | | facility director or
his designee in writing of the use of | 19 | | restraint within 24 hours.
| 20 | | (d) The facility director shall review all restraint orders | 21 | | daily and shall
inquire into the reasons for the orders for | 22 | | restraint by any person who
routinely orders them.
| 23 | | (e) Restraint may be employed during all or part of one 24 | 24 | | hour
period, the period commencing with the initial application | 25 | | of the
restraint. However, once restraint has been employed | 26 | | during one 24 hour
period, it shall not be used again on the |
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| 1 | | same recipient during the next
48 hours without the prior | 2 | | written authorization of the facility director.
| 3 | | (f) Restraint shall be employed in a humane and therapeutic | 4 | | manner and
the person being restrained shall be observed by a | 5 | | qualified person as often
as is clinically appropriate but in | 6 | | no event less than once every 15 minutes.
The qualified person | 7 | | shall maintain a record of the observations.
Specifically, | 8 | | unless there is an immediate danger that the recipient
will | 9 | | physically harm himself or others, restraint shall be loosely
| 10 | | applied to permit freedom of movement. Further, the recipient | 11 | | shall be
permitted to have regular meals and toilet privileges | 12 | | free from the
restraint, except when freedom of action may | 13 | | result in physical harm to
the recipient or others.
| 14 | | (g) Every facility that employs restraint shall provide | 15 | | training in the
safe and humane application of each type of | 16 | | restraint employed.
The facility shall not authorize the use of | 17 | | any type of restraint by an
employee who has not received | 18 | | training in the safe and humane application
of that type of | 19 | | restraint. Each facility in which restraint is used shall
| 20 | | maintain records detailing which employees have been trained | 21 | | and are
authorized to apply restraint, the date of the training | 22 | | and the type of
restraint that the employee was trained to use.
| 23 | | (h) Whenever restraint is imposed upon any recipient whose | 24 | | primary mode
of communication is sign language, the recipient | 25 | | shall be permitted to have
his hands free from restraint for | 26 | | brief periods each hour, except
when freedom may result in |
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| 1 | | physical harm to the recipient or others.
| 2 | | (i) A recipient who is restrained may only be secluded at | 3 | | the same time
pursuant to an explicit written authorization as | 4 | | provided in Section 2-109
of this Code. Whenever a recipient is | 5 | | restrained, a member of the facility
staff shall remain with | 6 | | the recipient at all times unless the recipient has
been | 7 | | secluded. A recipient who is restrained and secluded shall be
| 8 | | observed by a qualified person as often as is clinically | 9 | | appropriate but in
no event less than every 15 minutes.
| 10 | | (j) Whenever restraint is used, the recipient shall be | 11 | | advised of his
right, pursuant to Sections 2-200 and 2-201 of | 12 | | this Code, to have any
person of his choosing, including the | 13 | | Guardianship and Advocacy Commission
or the agency designated | 14 | | pursuant to the Protection and Advocacy for
Persons with | 15 | | Developmental Disabilities Act notified of the restraint. A | 16 | | recipient
who is under guardianship may request that any person | 17 | | of his choosing be
notified of the restraint whether or not the | 18 | | guardian approves of the notice.
Whenever the Guardianship and | 19 | | Advocacy Commission is notified that a recipient
has been | 20 | | restrained, it shall contact that recipient to determine the
| 21 | | circumstances of the restraint and whether further action is | 22 | | warranted.
| 23 | | (Source: P.A. 98-137, eff. 8-2-13; 99-143, eff. 7-27-15.)
| 24 | | (405 ILCS 5/2-109) (from Ch. 91 1/2, par. 2-109)
| 25 | | Sec. 2-109. Seclusion. Seclusion may be used only as a |
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| 1 | | therapeutic
measure to prevent a recipient from causing | 2 | | physical harm to himself or
physical abuse
to others. In no | 3 | | event shall seclusion be utilized to punish or discipline
a | 4 | | recipient, nor is seclusion to be used as a convenience for the | 5 | | staff.
| 6 | | (a) Seclusion shall be employed only upon the written order | 7 | | of a
physician, clinical psychologist, clinical social worker, | 8 | | clinical professional counselor, advanced practice psychiatric | 9 | | nurse, or registered
nurse with supervisory responsibilities. | 10 | | No seclusion shall be ordered
unless the physician, clinical | 11 | | psychologist, clinical social worker, clinical professional | 12 | | counselor, advanced practice psychiatric nurse, or
registered | 13 | | nurse with supervisory responsibilities, after personally
| 14 | | observing and examining the recipient, is clinically satisfied | 15 | | that the use
of seclusion is justified to prevent the recipient | 16 | | from causing physical
harm to himself or others. In no event | 17 | | may seclusion continue for longer
than 2 hours unless within | 18 | | that time
period a nurse with supervisory responsibilities , | 19 | | advanced practice psychiatric nurse, or a physician confirms in
| 20 | | writing, following a personal examination of the recipient, | 21 | | that the
seclusion does not pose an undue risk to the | 22 | | recipient's health in light of
the recipient's physical or | 23 | | medical condition. The order
shall state the events leading up | 24 | | to the need for seclusion and the
purposes for which seclusion | 25 | | is employed. The order shall also
state the length of time | 26 | | seclusion is to be employed and the clinical
justification for |
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| 1 | | the length of time. No order for seclusion shall be
valid for | 2 | | more than 16 hours. If further seclusion is required, a new
| 3 | | order must be issued pursuant to the requirements
provided in | 4 | | this Section.
| 5 | | (b) The person who orders seclusion shall inform the | 6 | | facility
director or his designee in writing of the use of | 7 | | seclusion within 24
hours.
| 8 | | (c) The facility director shall review all seclusion orders | 9 | | daily and
shall inquire into the reasons for the orders for | 10 | | seclusion by any
person who routinely orders them.
| 11 | | (d) Seclusion may be employed during all or part of one 16 | 12 | | hour
period, that period commencing with the initial | 13 | | application of the
seclusion. However, once seclusion has been | 14 | | employed during one 16 hour
period, it shall not be used again | 15 | | on the same recipient during the next
48 hours without the | 16 | | prior written authorization of the facility director.
| 17 | | (e) The person who ordered the seclusion shall assign a | 18 | | qualified
person to observe the recipient at all times.
A | 19 | | recipient who is restrained and secluded shall be observed by a | 20 | | qualified
person as often as is clinically appropriate but in | 21 | | no event less than once
every 15 minutes.
| 22 | | (f) Safety precautions shall be followed to prevent | 23 | | injuries to the
recipient in the seclusion room. Seclusion | 24 | | rooms shall be adequately
lighted, heated, and furnished. If a | 25 | | door is locked, someone with a key
shall be in constant | 26 | | attendance nearby.
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| 1 | | (g) Whenever seclusion is used, the recipient shall be | 2 | | advised of his
right, pursuant to Sections 2-200 and 2-201 of | 3 | | this Code, to have any
person of his choosing, including the | 4 | | Guardianship and Advocacy Commission
notified of the | 5 | | seclusion. A person who is under guardianship may request
that | 6 | | any person of his choosing be notified of the seclusion whether | 7 | | or not
the guardian approves of the notice. Whenever the | 8 | | Guardianship and
Advocacy Commission is notified that a | 9 | | recipient has been secluded, it shall
contact that recipient to | 10 | | determine the circumstances of the seclusion and
whether | 11 | | further action is warranted.
| 12 | | (Source: P.A. 98-137, eff. 8-2-13.)
| 13 | | (405 ILCS 5/3-602) (from Ch. 91 1/2, par. 3-602)
| 14 | | Sec. 3-602.
The petition shall be accompanied by a | 15 | | certificate executed
by a physician, qualified examiner, | 16 | | psychiatrist, advanced practice psychiatric nurse, or clinical | 17 | | psychologist which states
that the respondent is subject to | 18 | | involuntary admission on an inpatient basis and requires | 19 | | immediate
hospitalization. The certificate shall indicate that | 20 | | the physician, qualified
examiner, psychiatrist, advanced | 21 | | practice psychiatric nurse, or clinical psychologist | 22 | | personally examined the respondent not
more than 72 hours prior | 23 | | to admission. It shall also contain the physician's,
qualified | 24 | | examiner's, psychiatrist's, advanced practice psychiatric | 25 | | nurse's, or clinical psychologist's clinical observations,
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| 1 | | other factual information relied upon in reaching a diagnosis, | 2 | | and a statement
as to whether the respondent was advised of his | 3 | | rights under Section 3-208.
| 4 | | (Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.)
| 5 | | (405 ILCS 5/3-603) (from Ch. 91 1/2, par. 3-603)
| 6 | | Sec. 3-603.
(a) If no physician, qualified examiner, | 7 | | psychiatrist, advanced practice psychiatric nurse, or clinical
| 8 | | psychologist
is immediately available or it is not possible | 9 | | after a diligent effort to
obtain the certificate provided for | 10 | | in Section 3-602, the respondent may
be detained for | 11 | | examination in a mental health facility upon presentation
of | 12 | | the petition alone pending the obtaining of such a certificate.
| 13 | | (b) In such instance the petition shall conform to the | 14 | | requirements of
Section 3-601 and further specify that:
| 15 | | 1. the petitioner believes, as a result of his personal | 16 | | observation, that
the respondent is subject to involuntary | 17 | | admission on an inpatient basis;
| 18 | | 2. a diligent effort was made to obtain a certificate;
| 19 | | 3. no physician, qualified examiner, psychiatrist, or | 20 | | clinical psychologist could be
found who has examined or | 21 | | could examine the respondent; and
| 22 | | 4. a diligent effort has been made to convince the | 23 | | respondent to appear
voluntarily for examination by a | 24 | | physician, qualified examiner, psychiatrist, or clinical
| 25 | | psychologist, unless the petitioner reasonably believes |
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| 1 | | that effort would
impose a risk of harm to the respondent | 2 | | or others.
| 3 | | (Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.)
| 4 | | (405 ILCS 5/3-610) (from Ch. 91 1/2, par. 3-610)
| 5 | | Sec. 3-610.
As soon as possible but not later than 24 | 6 | | hours, excluding
Saturdays, Sundays and holidays, after | 7 | | admission of a respondent pursuant
to this Article, the | 8 | | respondent shall be personally examined by a psychiatrist. The
| 9 | | psychiatrist may be a member of the staff of the facility but | 10 | | shall not
be the person who executed the first certificate. If | 11 | | a certificate has already been completed by a psychiatrist | 12 | | following the respondent's admission, the respondent shall be | 13 | | examined by another psychiatrist or by a physician, clinical | 14 | | psychologist, advanced practice psychiatric nurse, or | 15 | | qualified examiner. If, as a result of this second examination, | 16 | | a certificate is executed, the certificate shall be promptly | 17 | | filed with the court. If the certificate states that the | 18 | | respondent is subject to involuntary admission but not in need | 19 | | of immediate hospitalization, the respondent may remain in his | 20 | | or her place of residence pending a hearing on the petition | 21 | | unless he or she voluntarily agrees to inpatient treatment. If | 22 | | the respondent is
not examined or if the psychiatrist, | 23 | | physician, clinical psychologist, advanced practice | 24 | | psychiatric nurse, or qualified examiner does not execute a | 25 | | certificate pursuant
to Section 3-602, the respondent shall be |
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| 1 | | released forthwith. For
the purpose of this Section, a personal | 2 | | examination includes an
examination performed in real time | 3 | | (synchronous examination)
via an Interactive Telecommunication | 4 | | System as defined in 89
Ill. Adm. Code 140.403(a)(5). An | 5 | | examination via an Interactive
Telecommunication System may | 6 | | only be used for certification
under this Section when a | 7 | | psychiatrist is not on-site within
the time period set forth in | 8 | | this Section. If the examination
is performed via an | 9 | | Interactive Communication System, that fact
shall be noted on | 10 | | the certificate.
| 11 | | (Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.)
| 12 | | (405 ILCS 5/3-702) (from Ch. 91 1/2, par. 3-702)
| 13 | | Sec. 3-702.
(a) The petition may be accompanied by the | 14 | | certificate
of a physician, qualified examiner, psychiatrist, | 15 | | advanced practice psychiatric nurse, or clinical psychologist | 16 | | which certifies
that the respondent is subject to involuntary | 17 | | admission on an inpatient basis and which contains
the other | 18 | | information specified in Section 3-602.
| 19 | | (b) Upon receipt of the petition either with or without a | 20 | | certificate,
if the court finds the documents are in order, it | 21 | | may make such orders pursuant
to Section 3-703 as are necessary | 22 | | to provide for examination of the respondent.
If the petition | 23 | | is not accompanied by 2 certificates executed pursuant to
| 24 | | Section 3-703, the court may order the respondent to present | 25 | | himself for
examination at a time and place designated by the |
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| 1 | | court.
If the petition is accompanied by 2 certificates | 2 | | executed pursuant to Section
3-703 and the court finds the | 3 | | documents are in order, it shall set the matter
for hearing.
| 4 | | (Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.)
| 5 | | (405 ILCS 5/3-703) (from Ch. 91 1/2, par. 3-703)
| 6 | | Sec. 3-703.
If no certificate was filed, the respondent | 7 | | shall be examined
separately by a physician, or clinical | 8 | | psychologist, advanced practice psychiatric nurse, or | 9 | | qualified examiner
and by a psychiatrist. If a certificate | 10 | | executed by a psychiatrist was
filed, the respondent shall be | 11 | | examined by a physician, clinical psychologist,
qualified | 12 | | examiner, advanced practice psychiatric nurse, or | 13 | | psychiatrist. If a certificate executed by a qualified
| 14 | | examiner, clinical psychologist, advanced practice psychiatric | 15 | | nurse, or a physician who is not a psychiatrist
was filed, the | 16 | | respondent shall be examined by a psychiatrist. The
examining | 17 | | physician, clinical psychologist, qualified examiner , advanced | 18 | | practice psychiatric nurse, or
psychiatrist may interview by | 19 | | telephone or in person any witnesses or other
persons listed in | 20 | | the petition for involuntary admission. If, as a
result of an | 21 | | examination, a certificate is executed, the certificate shall
| 22 | | be promptly filed with the court. If a certificate is executed, | 23 | | the
examining physician, clinical psychologist, qualified | 24 | | examiner , advanced practice psychiatric nurse, or
psychiatrist | 25 | | may also submit for filing with the court a report in which
his |
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| 1 | | findings are described in detail, and may rely upon such | 2 | | findings for
his opinion that the respondent is subject to | 3 | | involuntary admission on an inpatient basis.
Copies of the | 4 | | certificates shall be made available to the attorneys for the
| 5 | | parties upon request prior to the hearing. A certificate | 6 | | prepared in compliance with this Article shall state whether or | 7 | | not the respondent is in need of immediate hospitalization. | 8 | | However, if both the certificates state that the respondent is | 9 | | not in need of immediate hospitalization, the respondent may | 10 | | remain in his or her place of residence pending a hearing on | 11 | | the petition unless he or she voluntarily agrees to inpatient | 12 | | treatment.
| 13 | | (Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.)
| 14 | | (405 ILCS 5/3-752) | 15 | | Sec. 3-752. Certificate. | 16 | | (a) The petition may be accompanied by the certificate of a | 17 | | physician, qualified examiner, psychiatrist, advanced practice | 18 | | psychiatric nurse, or clinical psychologist which certifies | 19 | | that the respondent is subject to involuntary admission on an | 20 | | outpatient basis. The certificate shall indicate that the | 21 | | physician, qualified examiner, advanced practice psychiatric | 22 | | nurse, or clinical psychologist personally examined the | 23 | | respondent not more than 72 hours prior to the completion of | 24 | | the certificate. It shall also contain the physician's, | 25 | | qualified examiner's, advanced practice psychiatric nurse's, |
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| 1 | | or clinical psychologist's clinical observations, other | 2 | | factual information relied upon in reaching a diagnosis, and a | 3 | | statement as to whether the respondent was advised of his or | 4 | | her rights under Section 3-208. | 5 | | (b) Upon receipt of the petition either with or without a | 6 | | certificate, if the court finds the
documents are in order, it | 7 | | may make such orders pursuant to Section 3-753 as are necessary | 8 | | to
provide for examination of the respondent. If the petition | 9 | | is not accompanied by 2 certificates
executed pursuant to | 10 | | Section 3-753, the court may order the respondent to present | 11 | | himself or herself for
examination at a time and place | 12 | | designated by the court. If the petition is accompanied by 2
| 13 | | certificates executed pursuant to Section 3-753 and the court | 14 | | finds the documents are in order, the court
shall set the | 15 | | matter for hearing.
| 16 | | (Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.) | 17 | | (405 ILCS 5/3-753) | 18 | | Sec. 3-753. Examination. If no certificate was filed, the | 19 | | respondent shall be examined separately by a physician, or | 20 | | clinical
psychologist , advanced practice psychiatric nurse, or | 21 | | qualified examiner and by a psychiatrist. If a certificate | 22 | | executed by a
psychiatrist was filed, the respondent shall be | 23 | | examined by a physician, clinical psychologist,
qualified | 24 | | examiner, advanced practice psychiatric nurse, or | 25 | | psychiatrist. If a certificate executed by a qualified |
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| 1 | | examiner, clinical
psychologist, advanced practice psychiatric | 2 | | nurse, or a physician who is not a psychiatrist was filed, the | 3 | | respondent shall be examined
by a psychiatrist. The examining | 4 | | physician, clinical psychologist, qualified examiner , advanced | 5 | | practice psychiatric nurse, or
psychiatrist may interview by | 6 | | telephone or in person any witnesses or other persons listed in | 7 | | the
petition for involuntary admission. If, as a result of an | 8 | | examination, a certificate is executed, the
certificate shall | 9 | | be promptly filed with the court. If a certificate is executed, | 10 | | the examining
physician, clinical psychologist, qualified | 11 | | examiner , advanced practice psychiatric nurse, or psychiatrist | 12 | | may also submit for filing
with the court a report in which his | 13 | | or her findings are described in detail, and may rely upon such
| 14 | | findings for his opinion that the respondent is subject to | 15 | | involuntary admission. Copies of the
certificates shall be made | 16 | | available to the attorneys for the parties upon request prior | 17 | | to the
hearing.
| 18 | | (Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.) | 19 | | (405 ILCS 5/3-807) (from Ch. 91 1/2, par. 3-807) | 20 | | Sec. 3-807. No respondent may be found subject to | 21 | | involuntary admission
on an inpatient or outpatient basis | 22 | | unless at least one psychiatrist, clinical social worker, | 23 | | clinical
psychologist, advanced practice psychiatric nurse, or | 24 | | qualified examiner who has examined the respondent testifies in | 25 | | person at the hearing. The
respondent may waive the requirement |
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| 1 | | of the testimony subject to the
approval of the court. | 2 | | (Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10; | 3 | | 97-121, eff. 7-14-11.)
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