Public Act 099-0270
 
HB1335 EnrolledLRB099 08955 JLK 29128 b

    AN ACT concerning health.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 1. Short title. This Act may be cited as the Right
to Try Act.
 
    Section 5. Findings. The General Assembly finds that the
process of approval for investigational drugs, biological
products, and devices in the United States often takes many
years, and a patient with a terminal illness does not have the
luxury of waiting until such drug, product, or device receives
final approval from the United States Food and Drug
Administration. As a result, the standards of the United States
Food and Drug Administration for the use of investigational
drugs, biological products, and devices may deny the benefits
of potentially life-saving treatments to terminally ill
patients. A patient with a terminal illness has a fundamental
right to attempt to preserve his or her own life by accessing
investigational drugs, biological products, and devices.
Whether to use available investigational drugs, biological
products, and devices is a decision that rightfully should be
made by the patient with a terminal illness in consultation
with his or her physician and is not a decision to be made by
the government.
 
    Section 10. Definitions. For the purposes of this Act:
    "Accident and health insurer" has the meaning given to that
term in Section 126.2 of the Illinois Insurance Code.
    "Eligible patient" means a person who:
        (1) has a terminal illness;
        (2) has considered all other treatment options
    approved by the United States Food and Drug Administration;
        (3) has received a prescription or recommendation from
    his or her physician for an investigational drug,
    biological product, or device;
        (4) has given his or her informed consent in writing
    for the use of the investigational drug, biological
    product, or device or, if he or she is a minor or lacks the
    mental capacity to provide informed consent, a parent or
    legal guardian has given informed consent on his or her
    behalf; and
        (5) has documentation from his or her physician
    indicating that he or she has met the requirements of this
    Act.
    "Investigational drug, biological product, or device"
means a drug, biological product, or device that has
successfully completed Phase I of a clinical trial, but has not
been approved for general use by the United States Food and
Drug Administration.
    "Phase I of a clinical trial" means the stage of a clinical
trial where an investigational drug, biological product, or
device has been tested in a small group for the first time to
evaluate its safety, determine a safe dosage range, and
identify side effects.
    "Terminal illness" means a disease that, without
life-sustaining measures, can reasonably be expected to result
in death in 24 months or less.
 
    Section 15. Availability of drugs, biological products,
and devices.
    (a) A manufacturer of an investigational drug, biological
product, or device may make available such drug, product, or
device to eligible patients. Nothing in this Act shall be
construed to require a manufacturer to make available any drug,
product, or device.
    (b) A manufacturer may:
        (1) provide an investigational drug, biological
    product, or device to an eligible patient without receiving
    compensation; or
        (2) require an eligible patient to pay the costs of or
    associated with the manufacture of the investigational
    drug, biological product, or device.
 
    Section 20. Insurance coverage. An accident and health
insurer may choose to provide coverage for the cost of an
investigational drug, biological product, or device. Nothing
in this Act shall be construed to require an accident and
health insurer to provide coverage for the cost of any
investigational drug, biological product, or device.
 
    Section 25. Penalty. Any official, employee, or agent of
the State who blocks or attempts to block access by an eligible
patient to an investigational drug, biological product, or
device shall be guilty of a misdemeanor, punishable by a fine
not to exceed $1,500.
 
    Section 80. The Nursing Home Care Act is amended by
changing Section 2-104 as follows:
 
    (210 ILCS 45/2-104)  (from Ch. 111 1/2, par. 4152-104)
    Sec. 2-104. (a) A resident shall be permitted to retain the
services of his own personal physician at his own expense or
under an individual or group plan of health insurance, or under
any public or private assistance program providing such
coverage. However, the facility is not liable for the
negligence of any such personal physician. Every resident shall
be permitted to obtain from his own physician or the physician
attached to the facility complete and current information
concerning his medical diagnosis, treatment and prognosis in
terms and language the resident can reasonably be expected to
understand. Every resident shall be permitted to participate in
the planning of his total care and medical treatment to the
extent that his condition permits. No resident shall be
subjected to experimental research or treatment without first
obtaining his informed, written consent. The conduct of any
experimental research or treatment shall be authorized and
monitored by an institutional review board appointed by the
Director. The membership, operating procedures and review
criteria for the institutional review board shall be prescribed
under rules and regulations of the Department and shall comply
with the requirements for institutional review boards
established by the federal Food and Drug Administration. No
person who has received compensation in the prior 3 years from
an entity that manufactures, distributes, or sells
pharmaceuticals, biologics, or medical devices may serve on the
institutional review board.
    The institutional review board may approve only research or
treatment that meets the standards of the federal Food and Drug
Administration with respect to (i) the protection of human
subjects and (ii) financial disclosure by clinical
investigators. The Office of State Long Term Care Ombudsman and
the State Protection and Advocacy organization shall be given
an opportunity to comment on any request for approval before
the board makes a decision. Those entities shall not be
provided information that would allow a potential human subject
to be individually identified, unless the board asks the
Ombudsman for help in securing information from or about the
resident. The board shall require frequent reporting of the
progress of the approved research or treatment and its impact
on residents, including immediate reporting of any adverse
impact to the resident, the resident's representative, the
Office of the State Long Term Care Ombudsman, and the State
Protection and Advocacy organization. The board may not approve
any retrospective study of the records of any resident about
the safety or efficacy of any care or treatment if the resident
was under the care of the proposed researcher or a business
associate when the care or treatment was given, unless the
study is under the control of a researcher without any business
relationship to any person or entity who could benefit from the
findings of the study.
    No facility shall permit experimental research or
treatment to be conducted on a resident, or give access to any
person or person's records for a retrospective study about the
safety or efficacy of any care or treatment, without the prior
written approval of the institutional review board. No nursing
home administrator, or person licensed by the State to provide
medical care or treatment to any person, may assist or
participate in any experimental research on or treatment of a
resident, including a retrospective study, that does not have
the prior written approval of the board. Such conduct shall be
grounds for professional discipline by the Department of
Financial and Professional Regulation.
    The institutional review board may exempt from ongoing
review research or treatment initiated on a resident before the
individual's admission to a facility and for which the board
determines there is adequate ongoing oversight by another
institutional review board. Nothing in this Section shall
prevent a facility, any facility employee, or any other person
from assisting or participating in any experimental research on
or treatment of a resident, if the research or treatment began
before the person's admission to a facility, until the board
has reviewed the research or treatment and decided to grant or
deny approval or to exempt the research or treatment from
ongoing review.
    The institutional review board requirements of this
subsection (a) do not apply to investigational drugs,
biological products, or devices used by a resident with a
terminal illness as set forth in the Right to Try Act.
    (b) All medical treatment and procedures shall be
administered as ordered by a physician. All new physician
orders shall be reviewed by the facility's director of nursing
or charge nurse designee within 24 hours after such orders have
been issued to assure facility compliance with such orders.
    All physician's orders and plans of treatment shall have
the authentication of the physician. For the purposes of this
subsection (b), "authentication" means an original written
signature or an electronic signature system that allows for the
verification of a signer's credentials. A stamp signature, with
or without initials, is not sufficient.
    According to rules adopted by the Department, every woman
resident of child-bearing age shall receive routine
obstetrical and gynecological evaluations as well as necessary
prenatal care.
    (c) Every resident shall be permitted to refuse medical
treatment and to know the consequences of such action, unless
such refusal would be harmful to the health and safety of
others and such harm is documented by a physician in the
resident's clinical record. The resident's refusal shall free
the facility from the obligation to provide the treatment.
    (d) Every resident, resident's guardian, or parent if the
resident is a minor shall be permitted to inspect and copy all
his clinical and other records concerning his care and
maintenance kept by the facility or by his physician. The
facility may charge a reasonable fee for duplication of a
record.
(Source: P.A. 96-1372, eff. 7-29-10; 97-179, eff. 1-1-12.)
 
    Section 90. The Medical Practice Act of 1987 is amended by
changing Section 22 as follows:
 
    (225 ILCS 60/22)  (from Ch. 111, par. 4400-22)
    (Section scheduled to be repealed on December 31, 2015)
    Sec. 22. Disciplinary action.
    (A) The Department may revoke, suspend, place on probation,
reprimand, refuse to issue or renew, or take any other
disciplinary or non-disciplinary action as the Department may
deem proper with regard to the license or permit of any person
issued under this Act, including imposing fines not to exceed
$10,000 for each violation, upon any of the following grounds:
        (1) Performance of an elective abortion in any place,
    locale, facility, or institution other than:
            (a) a facility licensed pursuant to the Ambulatory
        Surgical Treatment Center Act;
            (b) an institution licensed under the Hospital
        Licensing Act;
            (c) an ambulatory surgical treatment center or
        hospitalization or care facility maintained by the
        State or any agency thereof, where such department or
        agency has authority under law to establish and enforce
        standards for the ambulatory surgical treatment
        centers, hospitalization, or care facilities under its
        management and control;
            (d) ambulatory surgical treatment centers,
        hospitalization or care facilities maintained by the
        Federal Government; or
            (e) ambulatory surgical treatment centers,
        hospitalization or care facilities maintained by any
        university or college established under the laws of
        this State and supported principally by public funds
        raised by taxation.
        (2) Performance of an abortion procedure in a wilful
    and wanton manner on a woman who was not pregnant at the
    time the abortion procedure was performed.
        (3) A plea of guilty or nolo contendere, finding of
    guilt, jury verdict, or entry of judgment or sentencing,
    including, but not limited to, convictions, preceding
    sentences of supervision, conditional discharge, or first
    offender probation, under the laws of any jurisdiction of
    the United States of any crime that is a felony.
        (4) Gross negligence in practice under this Act.
        (5) Engaging in dishonorable, unethical or
    unprofessional conduct of a character likely to deceive,
    defraud or harm the public.
        (6) Obtaining any fee by fraud, deceit, or
    misrepresentation.
        (7) Habitual or excessive use or abuse of drugs defined
    in law as controlled substances, of alcohol, or of any
    other substances which results in the inability to practice
    with reasonable judgment, skill or safety.
        (8) Practicing under a false or, except as provided by
    law, an assumed name.
        (9) Fraud or misrepresentation in applying for, or
    procuring, a license under this Act or in connection with
    applying for renewal of a license under this Act.
        (10) Making a false or misleading statement regarding
    their skill or the efficacy or value of the medicine,
    treatment, or remedy prescribed by them at their direction
    in the treatment of any disease or other condition of the
    body or mind.
        (11) Allowing another person or organization to use
    their license, procured under this Act, to practice.
        (12) Adverse action taken by another state or
    jurisdiction against a license or other authorization to
    practice as a medical doctor, doctor of osteopathy, doctor
    of osteopathic medicine or doctor of chiropractic, a
    certified copy of the record of the action taken by the
    other state or jurisdiction being prima facie evidence
    thereof. This includes any adverse action taken by a State
    or federal agency that prohibits a medical doctor, doctor
    of osteopathy, doctor of osteopathic medicine, or doctor of
    chiropractic from providing services to the agency's
    participants.
        (13) Violation of any provision of this Act or of the
    Medical Practice Act prior to the repeal of that Act, or
    violation of the rules, or a final administrative action of
    the Secretary, after consideration of the recommendation
    of the Disciplinary Board.
        (14) Violation of the prohibition against fee
    splitting in Section 22.2 of this Act.
        (15) A finding by the Disciplinary Board that the
    registrant after having his or her license placed on
    probationary status or subjected to conditions or
    restrictions violated the terms of the probation or failed
    to comply with such terms or conditions.
        (16) Abandonment of a patient.
        (17) Prescribing, selling, administering,
    distributing, giving or self-administering any drug
    classified as a controlled substance (designated product)
    or narcotic for other than medically accepted therapeutic
    purposes.
        (18) Promotion of the sale of drugs, devices,
    appliances or goods provided for a patient in such manner
    as to exploit the patient for financial gain of the
    physician.
        (19) Offering, undertaking or agreeing to cure or treat
    disease by a secret method, procedure, treatment or
    medicine, or the treating, operating or prescribing for any
    human condition by a method, means or procedure which the
    licensee refuses to divulge upon demand of the Department.
        (20) Immoral conduct in the commission of any act
    including, but not limited to, commission of an act of
    sexual misconduct related to the licensee's practice.
        (21) Wilfully making or filing false records or reports
    in his or her practice as a physician, including, but not
    limited to, false records to support claims against the
    medical assistance program of the Department of Healthcare
    and Family Services (formerly Department of Public Aid)
    under the Illinois Public Aid Code.
        (22) Wilful omission to file or record, or wilfully
    impeding the filing or recording, or inducing another
    person to omit to file or record, medical reports as
    required by law, or wilfully failing to report an instance
    of suspected abuse or neglect as required by law.
        (23) Being named as a perpetrator in an indicated
    report by the Department of Children and Family Services
    under the Abused and Neglected Child Reporting Act, and
    upon proof by clear and convincing evidence that the
    licensee has caused a child to be an abused child or
    neglected child as defined in the Abused and Neglected
    Child Reporting Act.
        (24) Solicitation of professional patronage by any
    corporation, agents or persons, or profiting from those
    representing themselves to be agents of the licensee.
        (25) Gross and wilful and continued overcharging for
    professional services, including filing false statements
    for collection of fees for which services are not rendered,
    including, but not limited to, filing such false statements
    for collection of monies for services not rendered from the
    medical assistance program of the Department of Healthcare
    and Family Services (formerly Department of Public Aid)
    under the Illinois Public Aid Code.
        (26) A pattern of practice or other behavior which
    demonstrates incapacity or incompetence to practice under
    this Act.
        (27) Mental illness or disability which results in the
    inability to practice under this Act with reasonable
    judgment, skill or safety.
        (28) Physical illness, including, but not limited to,
    deterioration through the aging process, or loss of motor
    skill which results in a physician's inability to practice
    under this Act with reasonable judgment, skill or safety.
        (29) Cheating on or attempt to subvert the licensing
    examinations administered under this Act.
        (30) Wilfully or negligently violating the
    confidentiality between physician and patient except as
    required by law.
        (31) The use of any false, fraudulent, or deceptive
    statement in any document connected with practice under
    this Act.
        (32) Aiding and abetting an individual not licensed
    under this Act in the practice of a profession licensed
    under this Act.
        (33) Violating state or federal laws or regulations
    relating to controlled substances, legend drugs, or
    ephedra as defined in the Ephedra Prohibition Act.
        (34) Failure to report to the Department any adverse
    final action taken against them by another licensing
    jurisdiction (any other state or any territory of the
    United States or any foreign state or country), by any peer
    review body, by any health care institution, by any
    professional society or association related to practice
    under this Act, by any governmental agency, by any law
    enforcement agency, or by any court for acts or conduct
    similar to acts or conduct which would constitute grounds
    for action as defined in this Section.
        (35) Failure to report to the Department surrender of a
    license or authorization to practice as a medical doctor, a
    doctor of osteopathy, a doctor of osteopathic medicine, or
    doctor of chiropractic in another state or jurisdiction, or
    surrender of membership on any medical staff or in any
    medical or professional association or society, while
    under disciplinary investigation by any of those
    authorities or bodies, for acts or conduct similar to acts
    or conduct which would constitute grounds for action as
    defined in this Section.
        (36) Failure to report to the Department any adverse
    judgment, settlement, or award arising from a liability
    claim related to acts or conduct similar to acts or conduct
    which would constitute grounds for action as defined in
    this Section.
        (37) Failure to provide copies of medical records as
    required by law.
        (38) Failure to furnish the Department, its
    investigators or representatives, relevant information,
    legally requested by the Department after consultation
    with the Chief Medical Coordinator or the Deputy Medical
    Coordinator.
        (39) Violating the Health Care Worker Self-Referral
    Act.
        (40) Willful failure to provide notice when notice is
    required under the Parental Notice of Abortion Act of 1995.
        (41) Failure to establish and maintain records of
    patient care and treatment as required by this law.
        (42) Entering into an excessive number of written
    collaborative agreements with licensed advanced practice
    nurses resulting in an inability to adequately
    collaborate.
        (43) Repeated failure to adequately collaborate with a
    licensed advanced practice nurse.
        (44) Violating the Compassionate Use of Medical
    Cannabis Pilot Program Act.
        (45) Entering into an excessive number of written
    collaborative agreements with licensed prescribing
    psychologists resulting in an inability to adequately
    collaborate.
        (46) Repeated failure to adequately collaborate with a
    licensed prescribing psychologist.
    Except for actions involving the ground numbered (26), all
proceedings to suspend, revoke, place on probationary status,
or take any other disciplinary action as the Department may
deem proper, with regard to a license on any of the foregoing
grounds, must be commenced within 5 years next after receipt by
the Department of a complaint alleging the commission of or
notice of the conviction order for any of the acts described
herein. Except for the grounds numbered (8), (9), (26), and
(29), no action shall be commenced more than 10 years after the
date of the incident or act alleged to have violated this
Section. For actions involving the ground numbered (26), a
pattern of practice or other behavior includes all incidents
alleged to be part of the pattern of practice or other behavior
that occurred, or a report pursuant to Section 23 of this Act
received, within the 10-year period preceding the filing of the
complaint. In the event of the settlement of any claim or cause
of action in favor of the claimant or the reduction to final
judgment of any civil action in favor of the plaintiff, such
claim, cause of action or civil action being grounded on the
allegation that a person licensed under this Act was negligent
in providing care, the Department shall have an additional
period of 2 years from the date of notification to the
Department under Section 23 of this Act of such settlement or
final judgment in which to investigate and commence formal
disciplinary proceedings under Section 36 of this Act, except
as otherwise provided by law. The time during which the holder
of the license was outside the State of Illinois shall not be
included within any period of time limiting the commencement of
disciplinary action by the Department.
    The entry of an order or judgment by any circuit court
establishing that any person holding a license under this Act
is a person in need of mental treatment operates as a
suspension of that license. That person may resume their
practice only upon the entry of a Departmental order based upon
a finding by the Disciplinary Board that they have been
determined to be recovered from mental illness by the court and
upon the Disciplinary Board's recommendation that they be
permitted to resume their practice.
    The Department may refuse to issue or take disciplinary
action concerning the license of any person who fails to file a
return, or to pay the tax, penalty or interest shown in a filed
return, or to pay any final assessment of tax, penalty or
interest, as required by any tax Act administered by the
Illinois Department of Revenue, until such time as the
requirements of any such tax Act are satisfied as determined by
the Illinois Department of Revenue.
    The Department, upon the recommendation of the
Disciplinary Board, shall adopt rules which set forth standards
to be used in determining:
        (a) when a person will be deemed sufficiently
    rehabilitated to warrant the public trust;
        (b) what constitutes dishonorable, unethical or
    unprofessional conduct of a character likely to deceive,
    defraud, or harm the public;
        (c) what constitutes immoral conduct in the commission
    of any act, including, but not limited to, commission of an
    act of sexual misconduct related to the licensee's
    practice; and
        (d) what constitutes gross negligence in the practice
    of medicine.
    However, no such rule shall be admissible into evidence in
any civil action except for review of a licensing or other
disciplinary action under this Act.
    In enforcing this Section, the Disciplinary Board or the
Licensing Board, upon a showing of a possible violation, may
compel, in the case of the Disciplinary Board, any individual
who is licensed to practice under this Act or holds a permit to
practice under this Act, or, in the case of the Licensing
Board, any individual who has applied for licensure or a permit
pursuant to this Act, to submit to a mental or physical
examination and evaluation, or both, which may include a
substance abuse or sexual offender evaluation, as required by
the Licensing Board or Disciplinary Board and at the expense of
the Department. The Disciplinary Board or Licensing Board shall
specifically designate the examining physician licensed to
practice medicine in all of its branches or, if applicable, the
multidisciplinary team involved in providing the mental or
physical examination and evaluation, or both. The
multidisciplinary team shall be led by a physician licensed to
practice medicine in all of its branches and may consist of one
or more or a combination of physicians licensed to practice
medicine in all of its branches, licensed chiropractic
physicians, licensed clinical psychologists, licensed clinical
social workers, licensed clinical professional counselors, and
other professional and administrative staff. Any examining
physician or member of the multidisciplinary team may require
any person ordered to submit to an examination and evaluation
pursuant to this Section to submit to any additional
supplemental testing deemed necessary to complete any
examination or evaluation process, including, but not limited
to, blood testing, urinalysis, psychological testing, or
neuropsychological testing. The Disciplinary Board, the
Licensing Board, or the Department may order the examining
physician or any member of the multidisciplinary team to
provide to the Department, the Disciplinary Board, or the
Licensing Board any and all records, including business
records, that relate to the examination and evaluation,
including any supplemental testing performed. The Disciplinary
Board, the Licensing Board, or the Department may order the
examining physician or any member of the multidisciplinary team
to present testimony concerning this examination and
evaluation of the licensee, permit holder, or applicant,
including testimony concerning any supplemental testing or
documents relating to the examination and evaluation. No
information, report, record, or other documents in any way
related to the examination and evaluation shall be excluded by
reason of any common law or statutory privilege relating to
communication between the licensee, permit holder, or
applicant and the examining physician or any member of the
multidisciplinary team. No authorization is necessary from the
licensee, permit holder, or applicant ordered to undergo an
evaluation and examination for the examining physician or any
member of the multidisciplinary team to provide information,
reports, records, or other documents or to provide any
testimony regarding the examination and evaluation. The
individual to be examined may have, at his or her own expense,
another physician of his or her choice present during all
aspects of the examination. Failure of any individual to submit
to mental or physical examination and evaluation, or both, when
directed, shall result in an automatic suspension, without
hearing, until such time as the individual submits to the
examination. If the Disciplinary Board or Licensing Board finds
a physician unable to practice following an examination and
evaluation because of the reasons set forth in this Section,
the Disciplinary Board or Licensing Board shall require such
physician to submit to care, counseling, or treatment by
physicians, or other health care professionals, approved or
designated by the Disciplinary Board, as a condition for
issued, continued, reinstated, or renewed licensure to
practice. Any physician, whose license was granted pursuant to
Sections 9, 17, or 19 of this Act, or, continued, reinstated,
renewed, disciplined or supervised, subject to such terms,
conditions or restrictions who shall fail to comply with such
terms, conditions or restrictions, or to complete a required
program of care, counseling, or treatment, as determined by the
Chief Medical Coordinator or Deputy Medical Coordinators,
shall be referred to the Secretary for a determination as to
whether the licensee shall have their license suspended
immediately, pending a hearing by the Disciplinary Board. In
instances in which the Secretary immediately suspends a license
under this Section, a hearing upon such person's license must
be convened by the Disciplinary Board within 15 days after such
suspension and completed without appreciable delay. The
Disciplinary Board shall have the authority to review the
subject physician's record of treatment and counseling
regarding the impairment, to the extent permitted by applicable
federal statutes and regulations safeguarding the
confidentiality of medical records.
    An individual licensed under this Act, affected under this
Section, shall be afforded an opportunity to demonstrate to the
Disciplinary Board that they can resume practice in compliance
with acceptable and prevailing standards under the provisions
of their license.
    The Department may promulgate rules for the imposition of
fines in disciplinary cases, not to exceed $10,000 for each
violation of this Act. Fines may be imposed in conjunction with
other forms of disciplinary action, but shall not be the
exclusive disposition of any disciplinary action arising out of
conduct resulting in death or injury to a patient. Any funds
collected from such fines shall be deposited in the Medical
Disciplinary Fund.
    All fines imposed under this Section shall be paid within
60 days after the effective date of the order imposing the fine
or in accordance with the terms set forth in the order imposing
the fine.
    (B) The Department shall revoke the license or permit
issued under this Act to practice medicine or a chiropractic
physician who has been convicted a second time of committing
any felony under the Illinois Controlled Substances Act or the
Methamphetamine Control and Community Protection Act, or who
has been convicted a second time of committing a Class 1 felony
under Sections 8A-3 and 8A-6 of the Illinois Public Aid Code. A
person whose license or permit is revoked under this subsection
B shall be prohibited from practicing medicine or treating
human ailments without the use of drugs and without operative
surgery.
    (C) The Department shall not revoke, suspend, place on
probation, reprimand, refuse to issue or renew, or take any
other disciplinary or non-disciplinary action against the
license or permit issued under this Act to practice medicine to
a physician based solely upon the recommendation of the
physician to an eligible patient regarding, or prescription
for, or treatment with, an investigational drug, biological
product, or device.
    (D) (C) The Disciplinary Board shall recommend to the
Department civil penalties and any other appropriate
discipline in disciplinary cases when the Board finds that a
physician willfully performed an abortion with actual
knowledge that the person upon whom the abortion has been
performed is a minor or an incompetent person without notice as
required under the Parental Notice of Abortion Act of 1995.
Upon the Board's recommendation, the Department shall impose,
for the first violation, a civil penalty of $1,000 and for a
second or subsequent violation, a civil penalty of $5,000.
(Source: P.A. 97-622, eff. 11-23-11; 98-601, eff. 12-30-13;
98-668, eff. 6-25-14; 98-1140, eff. 12-30-14.)