Rep. William Davis

Filed: 4/20/2021





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2    AMENDMENT NO. ______. Amend House Bill 1452 by replacing
3everything after the enacting clause with the following:
4    "Section 5. The Emergency Medical Services (EMS) Systems
5Act is amended by changing Sections 3.10, 3.50, and 3.85 as
7    (210 ILCS 50/3.10)
8    Sec. 3.10. Scope of services.
9    (a) "Advanced Life Support (ALS) Services" means an
10advanced level of pre-hospital and inter-hospital emergency
11care and non-emergency medical services that includes basic
12life support care, cardiac monitoring, cardiac defibrillation,
13electrocardiography, intravenous therapy, administration of
14medications, drugs and solutions, use of adjunctive medical
15devices, trauma care, and other authorized techniques and
16procedures, as outlined in the provisions of the National EMS



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1Education Standards relating to Advanced Life Support and any
2modifications to that curriculum specified in rules adopted by
3the Department pursuant to this Act.
4    That care shall be initiated as authorized by the EMS
5Medical Director in a Department approved advanced life
6support EMS System, under the written or verbal direction of a
7physician licensed to practice medicine in all of its branches
8or under the verbal direction of an Emergency Communications
9Registered Nurse.
10    (b) "Intermediate Life Support (ILS) Services" means an
11intermediate level of pre-hospital and inter-hospital
12emergency care and non-emergency medical services that
13includes basic life support care plus intravenous cannulation
14and fluid therapy, invasive airway management, trauma care,
15and other authorized techniques and procedures, as outlined in
16the Intermediate Life Support national curriculum of the
17United States Department of Transportation and any
18modifications to that curriculum specified in rules adopted by
19the Department pursuant to this Act.
20    That care shall be initiated as authorized by the EMS
21Medical Director in a Department approved intermediate or
22advanced life support EMS System, under the written or verbal
23direction of a physician licensed to practice medicine in all
24of its branches or under the verbal direction of an Emergency
25Communications Registered Nurse.
26    (c) "Basic Life Support (BLS) Services" means a basic



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1level of pre-hospital and inter-hospital emergency care and
2non-emergency medical services that includes medical
3monitoring, clinical observation, airway management,
4cardiopulmonary resuscitation (CPR), control of shock and
5bleeding and splinting of fractures, as outlined in the
6provisions of the National EMS Education Standards relating to
7Basic Life Support and any modifications to that curriculum
8specified in rules adopted by the Department pursuant to this
10    That care shall be initiated, where authorized by the EMS
11Medical Director in a Department approved EMS System, under
12the written or verbal direction of a physician licensed to
13practice medicine in all of its branches or under the verbal
14direction of an Emergency Communications Registered Nurse.
15    (d) "Emergency Medical Responder Services" means a
16preliminary level of pre-hospital emergency care that includes
17cardiopulmonary resuscitation (CPR), monitoring vital signs
18and control of bleeding, as outlined in the Emergency Medical
19Responder (EMR) curriculum of the National EMS Education
20Standards and any modifications to that curriculum specified
21in rules adopted by the Department pursuant to this Act.
22    (e) "Pre-hospital care" means those medical services
23rendered to patients for analytic, resuscitative, stabilizing,
24or preventive purposes, precedent to and during transportation
25of such patients to health care facilities.
26    (f) "Inter-hospital care" means those medical services



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1rendered to patients for analytic, resuscitative, stabilizing,
2or preventive purposes, during transportation of such patients
3from one hospital to another hospital.
4    (f-5) "Critical care transport" means the pre-hospital or
5inter-hospital transportation of a critically injured or ill
6patient by a vehicle service provider, including the provision
7of medically necessary supplies and services, at a level of
8service beyond the scope of the Paramedic. When medically
9indicated for a patient, as determined by a physician licensed
10to practice medicine in all of its branches, an advanced
11practice registered nurse, or a physician's assistant, in
12compliance with subsections (b) and (c) of Section 3.155 of
13this Act, critical care transport may be provided by:
14        (1) Department-approved critical care transport
15    providers, not owned or operated by a hospital, utilizing
16    Paramedics with additional training, nurses, or other
17    qualified health professionals; or
18        (2) Hospitals, when utilizing any vehicle service
19    provider or any hospital-owned or operated vehicle service
20    provider. Nothing in Public Act 96-1469 requires a
21    hospital to use, or to be, a Department-approved critical
22    care transport provider when transporting patients,
23    including those critically injured or ill. Nothing in this
24    Act shall restrict or prohibit a hospital from providing,
25    or arranging for, the medically appropriate transport of
26    any patient, as determined by a physician licensed to



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1    practice in all of its branches, an advanced practice
2    registered nurse, or a physician's assistant.
3    (g) "Non-emergency medical services" means the provision
4of, and all actions necessary before and after the provision
5of, Basic Life Support (BLS) Services, Advanced Life Support
6(ALS) Services, and critical care transport medical care,
7clinical observation, or medical monitoring rendered to
8patients whose conditions do not meet this Act's definition of
9emergency, before, after, or during transportation of such
10patients to or from health care facilities visited for the
11purpose of obtaining medical or health care services which are
12not emergency in nature, using a vehicle regulated by this Act
13and personnel licensed under this Act.
14    (g-5) The Department shall have the authority to
15promulgate minimum standards for critical care transport
16providers through rules adopted pursuant to this Act. All
17critical care transport providers must function within a
18Department-approved EMS System. Nothing in Department rules
19shall restrict a hospital's ability to furnish personnel,
20equipment, and medical supplies to any vehicle service
21provider, including a critical care transport provider.
22Minimum critical care transport provider standards shall
23include, but are not limited to:
24        (1) Personnel staffing and licensure.
25        (2) Education, certification, and experience.
26        (3) Medical equipment and supplies.



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1        (4) Vehicular standards.
2        (5) Treatment and transport protocols.
3        (6) Quality assurance and data collection.
4    (h) The provisions of this Act shall not apply to the use
5of an ambulance or SEMSV, unless and until emergency or
6non-emergency medical services are needed during the use of
7the ambulance or SEMSV.
8(Source: P.A. 99-661, eff. 1-1-17; 100-513, eff. 1-1-18.)
9    (210 ILCS 50/3.50)
10    Sec. 3.50. Emergency Medical Services personnel licensure
12    (a) "Emergency Medical Technician" or "EMT" means a person
13who has successfully completed a course in basic life support
14as approved by the Department, is currently licensed by the
15Department in accordance with standards prescribed by this Act
16and rules adopted by the Department pursuant to this Act, and
17practices within an EMS System. A valid Emergency Medical
18Technician-Basic (EMT-B) license issued under this Act shall
19continue to be valid and shall be recognized as an Emergency
20Medical Technician (EMT) license until the Emergency Medical
21Technician-Basic (EMT-B) license expires.
22    (b) "Emergency Medical Technician-Intermediate" or "EMT-I"
23means a person who has successfully completed a course in
24intermediate life support as approved by the Department, is
25currently licensed by the Department in accordance with



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1standards prescribed by this Act and rules adopted by the
2Department pursuant to this Act, and practices within an
3Intermediate or Advanced Life Support EMS System.
4    (b-5) "Advanced Emergency Medical Technician" or "A-EMT"
5means a person who has successfully completed a course in
6basic and limited advanced emergency medical care as approved
7by the Department, is currently licensed by the Department in
8accordance with standards prescribed by this Act and rules
9adopted by the Department pursuant to this Act, and practices
10within an Intermediate or Advanced Life Support EMS System.
11    (c) "Paramedic (EMT-P)" means a person who has
12successfully completed a course in advanced life support care
13as approved by the Department, is licensed by the Department
14in accordance with standards prescribed by this Act and rules
15adopted by the Department pursuant to this Act, and practices
16within an Advanced Life Support EMS System. A valid Emergency
17Medical Technician-Paramedic (EMT-P) license issued under this
18Act shall continue to be valid and shall be recognized as a
19Paramedic license until the Emergency Medical
20Technician-Paramedic (EMT-P) license expires.
21    (c-5) "Emergency Medical Responder" or "EMR (First
22Responder)" means a person who has successfully completed a
23course in emergency medical response as approved by the
24Department and provides emergency medical response services
25prior to the arrival of an ambulance or specialized emergency
26medical services vehicle, in accordance with the level of care



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1established by the National EMS Educational Standards
2Emergency Medical Responder course as modified by the
3Department, or who . An Emergency Medical Responder who
4provides services as part of an EMS System response plan shall
5comply with the applicable sections of the Program Plan, as
6approved by the Department, of that EMS System. The Department
7shall have the authority to adopt rules governing the
8curriculum, practice, and necessary equipment applicable to
9Emergency Medical Responders.
10    On August 15, 2014 (the effective date of Public Act
1198-973), a person who is licensed by the Department as a First
12Responder and has completed a Department-approved course in
13first responder defibrillator training based on, or equivalent
14to, the National EMS Educational Standards or other standards
15previously recognized by the Department shall be eligible for
16licensure as an Emergency Medical Responder upon meeting the
17licensure requirements and submitting an application to the
18Department. A valid First Responder license issued under this
19Act shall continue to be valid and shall be recognized as an
20Emergency Medical Responder license until the First Responder
21license expires.
22    (c-10) All EMS Systems and licensees shall be fully
23compliant with the National EMS Education Standards, as
24modified by the Department in administrative rules, within 24
25months after the adoption of the administrative rules.
26    (d) The Department shall have the authority and



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1responsibility to:
2        (1) Prescribe education and training requirements,
3    which includes training in the use of epinephrine, for all
4    levels of EMS personnel except for EMRs, based on the
5    National EMS Educational Standards and any modifications
6    to those curricula specified by the Department through
7    rules adopted pursuant to this Act.
8        (2) Prescribe licensure testing requirements for all
9    levels of EMS personnel, which shall include a requirement
10    that all phases of instruction, training, and field
11    experience be completed before taking the appropriate
12    licensure examination. Candidates may elect to take the
13    appropriate National Registry examination in lieu of the
14    Department's examination, but are responsible for making
15    their own arrangements for taking the National Registry
16    examination. In prescribing licensure testing requirements
17    for honorably discharged members of the armed forces of
18    the United States under this paragraph (2), the Department
19    shall ensure that a candidate's military emergency medical
20    training, emergency medical curriculum completed, and
21    clinical experience, as described in paragraph (2.5), are
22    recognized.
23        (2.5) Review applications for EMS personnel licensure
24    from honorably discharged members of the armed forces of
25    the United States with military emergency medical
26    training. Applications shall be filed with the Department



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1    within one year after military discharge and shall
2    contain: (i) proof of successful completion of military
3    emergency medical training; (ii) a detailed description of
4    the emergency medical curriculum completed; and (iii) a
5    detailed description of the applicant's clinical
6    experience. The Department may request additional and
7    clarifying information. The Department shall evaluate the
8    application, including the applicant's training and
9    experience, consistent with the standards set forth under
10    subsections (a), (b), (c), and (d) of Section 3.10. If the
11    application clearly demonstrates that the training and
12    experience meet such standards, the Department shall offer
13    the applicant the opportunity to successfully complete a
14    Department-approved EMS personnel examination for the
15    level of license for which the applicant is qualified.
16    Upon passage of an examination, the Department shall issue
17    a license, which shall be subject to all provisions of
18    this Act that are otherwise applicable to the level of EMS
19    personnel license issued.
20        (3) License individuals as an EMR, EMT, EMT-I, A-EMT,
21    or Paramedic who have met the Department's education,
22    training and examination requirements.
23        (4) Prescribe annual continuing education and
24    relicensure requirements for all EMS personnel licensure
25    levels.
26        (5) Relicense individuals as an EMD, EMR, EMT, EMT-I,



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1    A-EMT, PHRN, PHAPRN, PHPA, or Paramedic every 4 years,
2    based on their compliance with continuing education and
3    relicensure requirements as required by the Department
4    pursuant to this Act. Every 4 years, a Paramedic shall
5    have 100 hours of approved continuing education, an EMT-I
6    and an advanced EMT shall have 80 hours of approved
7    continuing education, and an EMT shall have 60 hours of
8    approved continuing education. An Illinois licensed EMR,
9    EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN, PHPA, PHAPRN, or
10    PHRN whose license has been expired for less than 36
11    months may apply for reinstatement by the Department.
12    Reinstatement shall require that the applicant (i) submit
13    satisfactory proof of completion of continuing medical
14    education and clinical requirements to be prescribed by
15    the Department in an administrative rule; (ii) submit a
16    positive recommendation from an Illinois EMS Medical
17    Director attesting to the applicant's qualifications for
18    retesting; and (iii) pass a Department approved test for
19    the level of EMS personnel license sought to be
20    reinstated.
21        (6) Grant inactive status to any EMR, EMD, EMT, EMT-I,
22    A-EMT, Paramedic, ECRN, PHAPRN, PHPA, or PHRN who
23    qualifies, based on standards and procedures established
24    by the Department in rules adopted pursuant to this Act.
25        (7) Charge a fee for EMS personnel examination,
26    licensure, and license renewal.



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1        (8) Suspend, revoke, or refuse to issue or renew the
2    license of any licensee, after an opportunity for an
3    impartial hearing before a neutral administrative law
4    judge appointed by the Director, where the preponderance
5    of the evidence shows one or more of the following:
6            (A) The licensee has not met continuing education
7        or relicensure requirements as prescribed by the
8        Department;
9            (B) The licensee has failed to maintain
10        proficiency in the level of skills for which he or she
11        is licensed;
12            (C) The licensee, during the provision of medical
13        services, engaged in dishonorable, unethical, or
14        unprofessional conduct of a character likely to
15        deceive, defraud, or harm the public;
16            (D) The licensee has failed to maintain or has
17        violated standards of performance and conduct as
18        prescribed by the Department in rules adopted pursuant
19        to this Act or his or her EMS System's Program Plan;
20            (E) The licensee is physically impaired to the
21        extent that he or she cannot physically perform the
22        skills and functions for which he or she is licensed,
23        as verified by a physician, unless the person is on
24        inactive status pursuant to Department regulations;
25            (F) The licensee is mentally impaired to the
26        extent that he or she cannot exercise the appropriate



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1        judgment, skill and safety for performing the
2        functions for which he or she is licensed, as verified
3        by a physician, unless the person is on inactive
4        status pursuant to Department regulations;
5            (G) The licensee has violated this Act or any rule
6        adopted by the Department pursuant to this Act; or
7            (H) The licensee has been convicted (or entered a
8        plea of guilty or nolo contendere nolo-contendere) by
9        a court of competent jurisdiction of a Class X, Class
10        1, or Class 2 felony in this State or an out-of-state
11        equivalent offense.
12        (9) Prescribe education and training requirements in
13    the administration and use of opioid antagonists for all
14    levels of EMS personnel based on the National EMS
15    Educational Standards and any modifications to those
16    curricula specified by the Department through rules
17    adopted pursuant to this Act.
18    (d-5) An EMR, EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN,
19PHAPRN, PHPA, or PHRN who is a member of the Illinois National
20Guard or an Illinois State Trooper or who exclusively serves
21as a volunteer for units of local government with a population
22base of less than 5,000 or as a volunteer for a not-for-profit
23organization that serves a service area with a population base
24of less than 5,000 may submit an application to the Department
25for a waiver of the fees described under paragraph (7) of
26subsection (d) of this Section on a form prescribed by the



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2    The education requirements prescribed by the Department
3under this Section must allow for the suspension of those
4requirements in the case of a member of the armed services or
5reserve forces of the United States or a member of the Illinois
6National Guard who is on active duty pursuant to an executive
7order of the President of the United States, an act of the
8Congress of the United States, or an order of the Governor at
9the time that the member would otherwise be required to
10fulfill a particular education requirement. Such a person must
11fulfill the education requirement within 6 months after his or
12her release from active duty.
13    (e) In the event that any rule of the Department or an EMS
14Medical Director that requires testing for drug use as a
15condition of the applicable EMS personnel license conflicts
16with or duplicates a provision of a collective bargaining
17agreement that requires testing for drug use, that rule shall
18not apply to any person covered by the collective bargaining
20    (f) At the time of applying for or renewing his or her
21license, an applicant for a license or license renewal may
22submit an email address to the Department. The Department
23shall keep the email address on file as a form of contact for
24the individual. The Department shall send license renewal
25notices electronically and by mail to a licensee all licensees
26who provides provide the Department with his or her email



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1address. The notices shall be sent at least 60 days prior to
2the expiration date of the license.
3(Source: P.A. 100-1082, eff. 8-24-19; 101-81, eff. 7-12-19;
4101-153, eff. 1-1-20; revised 12-3-19.)
5    (210 ILCS 50/3.85)
6    Sec. 3.85. Vehicle Service Providers.
7    (a) "Vehicle Service Provider" means an entity licensed by
8the Department to provide emergency or non-emergency medical
9services in compliance with this Act, the rules promulgated by
10the Department pursuant to this Act, and an operational plan
11approved by its EMS System(s), utilizing at least ambulances
12or specialized emergency medical service vehicles (SEMSV).
13        (1) "Ambulance" means any publicly or privately owned
14    on-road vehicle that is specifically designed, constructed
15    or modified and equipped, and is intended to be used for,
16    and is maintained or operated for the emergency
17    transportation of persons who are sick, injured, wounded
18    or otherwise incapacitated or helpless, or the
19    non-emergency medical transportation of persons who
20    require the presence of medical personnel to monitor the
21    individual's condition or medical apparatus being used on
22    such individuals.
23        (2) "Specialized Emergency Medical Services Vehicle"
24    or "SEMSV" means a vehicle or conveyance, other than those
25    owned or operated by the federal government, that is



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1    primarily intended for use in transporting the sick or
2    injured by means of air, water, or ground transportation,
3    that is not an ambulance as defined in this Act. The term
4    includes watercraft, aircraft and special purpose ground
5    transport vehicles or conveyances not intended for use on
6    public roads.
7        (3) An ambulance or SEMSV may also be designated as a
8    Limited Operation Vehicle or Special-Use Vehicle:
9            (A) "Limited Operation Vehicle" means a vehicle
10        which is licensed by the Department to provide basic,
11        intermediate or advanced life support emergency or
12        non-emergency medical services that are exclusively
13        limited to specific events or locales.
14            (B) "Special-Use Vehicle" means any publicly or
15        privately owned vehicle that is specifically designed,
16        constructed or modified and equipped, and is intended
17        to be used for, and is maintained or operated solely
18        for the emergency or non-emergency transportation of a
19        specific medical class or category of persons who are
20        sick, injured, wounded or otherwise incapacitated or
21        helpless (e.g. high-risk obstetrical patients,
22        neonatal patients).
23            (C) "Reserve Ambulance" means a vehicle that meets
24        all criteria set forth in this Section and all
25        Department rules, except for the required inventory of
26        medical supplies and durable medical equipment, which



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1        may be rapidly transferred from a fully functional
2        ambulance to a reserve ambulance without the use of
3        tools or special mechanical expertise.
4    (b) The Department shall have the authority and
5responsibility to:
6        (1) Require all Vehicle Service Providers, both
7    publicly and privately owned, to function within an EMS
8    System.
9        (2) Require a Vehicle Service Provider utilizing
10    ambulances to have a primary affiliation with an EMS
11    System within the EMS Region in which its Primary Service
12    Area is located, which is the geographic areas in which
13    the provider renders the majority of its emergency
14    responses. This requirement shall not apply to Vehicle
15    Service Providers which exclusively utilize Limited
16    Operation Vehicles.
17        (3) Establish licensing standards and requirements for
18    Vehicle Service Providers, through rules adopted pursuant
19    to this Act, including but not limited to:
20            (A) Vehicle design, specification, operation and
21        maintenance standards, including standards for the use
22        of reserve ambulances;
23            (B) Equipment requirements;
24            (C) Staffing requirements; and
25            (D) License renewal at intervals determined by the
26        Department, which shall be not less than every 4



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1        years.
2        The Department's standards and requirements with
3    respect to vehicle staffing must allow for an alternative
4    rural staffing models that include an EMR who drives an
5    ambulance with a licensed EMT, EMT-I, A-EMT, Paramedic, or
6    PHRN, as appropriate, in the patient compartment providing
7    care to the patient pursuant to protocols developed by the
8    EMS Director for an EMS System model for those vehicle
9    service providers that serve a rural or semi-rural
10    population of 10,000 or fewer inhabitants and exclusively
11    uses volunteers, paid-on-call, or a combination thereof.
12        (4) License all Vehicle Service Providers that have
13    met the Department's requirements for licensure, unless
14    such Provider is owned or licensed by the federal
15    government. All Provider licenses issued by the Department
16    shall specify the level and type of each vehicle covered
17    by the license (BLS, ILS, ALS, ambulance, SEMSV, limited
18    operation vehicle, special use vehicle, reserve
19    ambulance).
20        (5) Annually inspect all licensed vehicles operated by
21    Vehicle Service Providers.
22        (6) Suspend, revoke, refuse to issue or refuse to
23    renew the license of any Vehicle Service Provider, or that
24    portion of a license pertaining to a specific vehicle
25    operated by the Provider, after an opportunity for a
26    hearing, when findings show that the Provider or one or



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1    more of its vehicles has failed to comply with the
2    standards and requirements of this Act or rules adopted by
3    the Department pursuant to this Act.
4        (7) Issue an Emergency Suspension Order for any
5    Provider or vehicle licensed under this Act, when the
6    Director or his designee has determined that an immediate
7    and serious danger to the public health, safety and
8    welfare exists. Suspension or revocation proceedings which
9    offer an opportunity for hearing shall be promptly
10    initiated after the Emergency Suspension Order has been
11    issued.
12        (8) Exempt any licensed vehicle from subsequent
13    vehicle design standards or specifications required by the
14    Department, as long as said vehicle is continuously in
15    compliance with the vehicle design standards and
16    specifications originally applicable to that vehicle, or
17    until said vehicle's title of ownership is transferred.
18        (9) Exempt any vehicle (except an SEMSV) which was
19    being used as an ambulance on or before December 15, 1980,
20    from vehicle design standards and specifications required
21    by the Department, until said vehicle's title of ownership
22    is transferred. Such vehicles shall not be exempt from all
23    other licensing standards and requirements prescribed by
24    the Department.
25        (10) Prohibit any Vehicle Service Provider from
26    advertising, identifying its vehicles, or disseminating



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1    information in a false or misleading manner concerning the
2    Provider's type and level of vehicles, location, primary
3    service area, response times, level of personnel,
4    licensure status or System participation.
5        (10.5) Prohibit any Vehicle Service Provider, whether
6    municipal, private, or hospital-owned, from advertising
7    itself as a critical care transport provider unless it
8    participates in a Department-approved EMS System critical
9    care transport plan.
10        (11) Charge each Vehicle Service Provider a fee per
11    transport vehicle, due annually at time of inspection. The
12    fee per transport vehicle shall be set by administrative
13    rule by the Department and shall not exceed 100 vehicles
14    per provider.
15(Source: P.A. 97-333, eff. 8-12-11; 97-1014, eff. 1-1-13;
1698-452, eff. 1-1-14.)".