CHAPTER 33. PHENYLKETONURIA, OTHER HERITABLE DISEASES, HYPOTHYROIDISM, AND CERTAIN OTHER DISORDERS

State Codes and Statutes

Statutes > Texas > Health-and-safety-code > Title-2-health > Chapter-33-phenylketonuria-other-heritable-diseases-hypothyroidism-and-certain-other-disorders

HEALTH AND SAFETY CODE

TITLE 2. HEALTH

SUBTITLE B. TEXAS DEPARTMENT OF HEALTH PROGRAMS

CHAPTER 33. PHENYLKETONURIA, OTHER HERITABLE DISEASES,

HYPOTHYROIDISM, AND CERTAIN OTHER DISORDERS

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 33.001. DEFINITIONS. In this chapter:

(1) "Heritable disease" means an inherited disease that may

result in mental or physical retardation or death.

(2) "Hypothyroidism" means a condition that may cause severe

mental retardation if not treated.

(3) "Other benefit" means a benefit, other than a benefit under

this chapter, to which an individual is entitled for the payment

of the costs of services. The term includes:

(A) benefits available under:

(i) an insurance policy, group health plan, or prepaid medical

care plan;

(ii) Title XVIII of the Social Security Act (42 U.S.C. Section

1395);

(iii) Title XIX of the Social Security Act (42 U.S.C. Section

1396);

(iv) the Veterans' Administration;

(v) the Civilian Health and Medical Program of the Uniformed

Services; or

(vi) workers' compensation or any other compulsory employers

insurance program;

(B) a public program created by federal or state law or by

ordinance or rule of a municipality or political subdivision of

the state, except those benefits created by the establishment of

a municipal or county hospital, a joint municipal-county

hospital, a county hospital authority, a hospital district, or by

the facilities of a publicly supported medical school; and

expenses, or a settlement or judgment based on the cause of

action, if the expenses are related to the need for services

provided under this chapter.

(4) "Phenylketonuria" means an inherited condition that may

cause severe mental retardation if not treated.

(5) "Screening test" means a rapid analytical procedure to

determine the need for further diagnostic evaluation.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991.

Sec. 33.002. DETECTION AND TREATMENT PROGRAM ESTABLISHED. (a)

The department shall carry out a program to combat morbidity,

including mental retardation, and mortality in persons who have

phenylketonuria, other heritable diseases, or hypothyroidism.

(b) The board shall adopt rules necessary to carry out the

program, including a rule specifying other heritable diseases

covered by this chapter.

(1) conduct experiments, projects, and other activities

necessary to develop screening or diagnostic tests for the early

detection of phenylketonuria, other heritable diseases, and

hypothyroidism;

(2) develop ways and means or discover methods to be used to

prevent or treat phenylketonuria, other heritable diseases, and

hypothyroidism; and

(3) serve other purposes considered necessary by the department

to carry out the program.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991.

Sec. 33.0021. SICKLE-CELL TRAIT. Notwithstanding any provision

of this chapter, the department shall include sickle-cell trait

in the detection and treatment program established under this

chapter, in the screening for heritable diseases conducted under

Subchapter B, and in the newborn screening services provided

under Subchapter C.

Added by Acts 2009, 81st Leg., R.S., Ch.

179, Sec. 1, eff. May 27, 2009.

Sec. 33.003. COOPERATION OF HEALTH CARE PROVIDERS AND

GOVERNMENTAL ENTITIES. (a) The department may invite all

physicians, hospitals, and other health care providers in the

state that provide maternity and newborn infant care to cooperate

and participate in any program established by the department

under this chapter.

(b) Other boards, agencies, departments, and political

subdivisions of the state capable of assisting the department in

carrying out the program may cooperate with the department and

are encouraged to furnish their services and facilities to the

program.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991.

Sec. 33.004. STUDY ON NEWBORN SCREENING METHODOLOGY AND

EQUIPMENT. (a) Not later than March 1, 2006, the department

shall:

(1) conduct a study to determine the most cost-effective method

of conducting newborn screening, including screening for

disorders listed in the core uniform panel of newborn screening

conditions recommended in the 2005 report by the American College

of Medical Genetics entitled "Newborn Screening: Toward a Uniform

Screening Panel and System" or another report determined by the

department to provide more appropriate newborn screening

guidelines, to protect the health and welfare of this state's

newborns and to maximize the number of newborn screenings that

may be conducted with the funding available for the screening;

(2) determine the disorders to be studied under Subdivision (1)

and ensure the study does not examine screening and services

provided under Chapter 47; and

(3) obtain proposals or information regarding the conduct of

newborn screening and compare the costs of the department

performing newborn screening services to the costs of outsourcing

screening to a qualified laboratory with at least two years'

experience performing newborn screening tests.

(b) In accordance with rules adopted by the executive

commissioner of the Health and Human Services Commission, the

department may implement a newborn screening program.

department's performance of newborn screening services is more

cost-effective than outsourcing newborn screening, the department

shall obtain the use of screening methodologies, including tandem

mass spectrometers, and hire the employees necessary to

administer newborn screening under this chapter.

(d) If the department determines under Subsection (a) that

outsourcing of newborn screening is more cost-effective, the

department shall contract for the resources and services

necessary to conduct newborn screening using a competitive

procurement process.

(e) The department shall periodically review the newborn

screening program as revised under this section to determine the

efficacy and cost-effectiveness of the program and determine

whether adjustments to the program are necessary to protect the

health and welfare of this state's newborns and to maximize the

number of newborn screenings that may be conducted with the

funding available for the screening.

(f) The department may adjust the amounts charged for newborn

screening fees, including fees assessed for follow-up services,

tracking confirmatory testing, and diagnosis.

Added by Acts 2005, 79th Leg., Ch.

940, Sec. 2, eff. September 1, 2005.

SUBCHAPTER B. NEWBORN SCREENING

Sec. 33.011. TEST REQUIREMENT. (a) The physician attending a

newborn child or the person attending the delivery of a newborn

child that is not attended by a physician shall subject the child

to screening tests approved by the department for

phenylketonuria, other heritable diseases, hypothyroidism, and

other disorders for which screening is required by the

department.

(a-1) Except as provided by this subsection and to the extent

funding is available for the screening, the department shall

require newborn screening tests to screen for disorders listed in

the core panel and in the secondary targets of the uniform

newborn screening panel recommended in the 2005 report by the

American College of Medical Genetics entitled "Newborn Screening:

Toward a Uniform Screening Panel and System" or another report

determined by the department to provide more stringent newborn

screening guidelines to protect the health and welfare of this

state's newborns. The department, with the advice of the Newborn

Screening Advisory Committee, may require additional newborn

screening tests under this subsection to screen for other

disorders or conditions. The department may exclude from the

newborn screening tests required under this subsection screenings

for galactose epimerase and galactokinase.

(b) The department may prescribe the screening test procedures

to be used and the standards of accuracy and precision required

for each test.

performed by the laboratory established by the department or by a

laboratory approved by the department under Section 33.016.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991.

Amended by:

Acts 2005, 79th Leg., Ch.

940, Sec. 3, eff. September 1, 2005.

Acts 2009, 81st Leg., R.S., Ch.

1124, Sec. 2, eff. September 1, 2009.

Sec. 33.0111. DISCLOSURE. (a) The department shall develop a

disclosure statement that clearly discloses to the parent,

managing conservator, or guardian of a newborn child subjected to

screening tests under Section 33.011:

(1) that the department or a laboratory established or approved

by the department under Section 33.016 may retain for use by the

department or laboratory genetic material used to conduct the

newborn screening tests and discloses how the material is managed

and used; and

(2) that the parent, managing conservator, or guardian may limit

the use of the genetic material by providing to the department in

accordance with Section 33.0112 a written statement prohibiting

the department or laboratory from retaining the genetic material

or using the genetic material for any purpose other than the

conduct of newborn screening tests authorized under this chapter.

(b) The disclosure statement required by Subsection (a) must be

included on the form developed by the department to inform

parents about newborn screening. The disclosure statement must:

(1) be on a separate sheet of the form;

(2) be presented together with the written statement described

by Subsection (a)(2) in a format that allows a parent, managing

conservator, or guardian of a newborn child to either:

(A) sign, detach, and mail a portion of the form to the

department to require the department or laboratory to destroy the

genetic material on completion of the newborn screening tests; or

(B) check a box and sign next to the box on the form a statement

indicating the parent, managing conservator, or guardian is

requiring the department or laboratory to destroy the genetic

material on completion of the newborn screening tests;

(3) include instructions on how to complete the portions of the

form described by Subdivisions (2)(A) and (B);

(4) include the department's mailing address; and

(5) be made available to a parent, managing conservator, or

guardian of a newborn child through alternative sources.

under Section 33.011, the physician attending a newborn child or

the person attending the delivery of a newborn child that is not

attended by a physician shall provide the parent, managing

conservator, or guardian of a newborn child a copy of the written

disclosure statement developed by the department under this

section.

(d) The department shall establish procedures for a physician

attending a newborn child or the person attending the delivery of

a newborn child to provide verification to the department that

the physician or person has provided the parent, managing

conservator, or guardian of the newborn child the disclosure

required under this section.

Added by Acts 2009, 81st Leg., R.S., Ch.

179, Sec. 2, eff. May 27, 2009.

Sec. 33.0112. STATEMENT PROHIBITING RETENTION OF GENETIC

MATERIAL. (a) A parent, managing conservator, or guardian of a

newborn child may file with the department a signed written

statement prohibiting the department or a laboratory established

or approved by the department from retaining any genetic material

related to the newborn screening tests conducted under this

chapter or using the genetic material for any purpose other than

the conduct of the newborn screening tests. A parent, managing

conservator, or guardian may file the written statement on a form

provided by the department.

(b) Not later than the 60th day after the department receives

the written statement, the department or laboratory shall destroy

the genetic material used in the screening tests.

statement instructing the department or a laboratory established

or approved by the department to destroy any genetic material of

the individual that is retained and used under this chapter.

Added by Acts 2009, 81st Leg., R.S., Ch.

179, Sec. 2, eff. May 27, 2009.

Sec. 33.012. EXEMPTION. (a) Screening tests may not be

administered to a newborn child whose parents, managing

conservator, or guardian objects on the ground that the tests

conflict with the religious tenets or practices of an organized

church of which they are adherents.

(b) If a parent, managing conservator, or guardian objects to

the screening tests, the physician or the person attending the

newborn child that is not attended by a physician shall ensure

that the objection of the parent, managing conservator, or

guardian is entered into the medical record of the child. The

parent, managing conservator, or guardian shall sign the entry.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991.

Sec. 33.013. LIMITATION ON LIABILITY. A physician, technician,

or other person administering the screening tests required by

this chapter is not liable or responsible because of the failure

or refusal of a parent, managing conservator, or guardian to

consent to the tests for which this chapter provides.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991.

Sec. 33.014. DIAGNOSIS; FOLLOW-UP. (a) If, because of an

analysis of a specimen submitted under Section 33.011, the

department reasonably suspects that a newborn child may have

phenylketonuria, another heritable disease, hypothyroidism, or

another disorder for which the screening tests are required, the

department shall notify the person who submits the specimen that

the results are abnormal and provide the test results to that

person. The department may notify one or more of the following

that the results of the analysis are abnormal and recommend

further testing when necessary:

(1) the physician attending the newborn child or the physician's

designee;

(2) the person attending the delivery of the newborn child that

was not attended by a physician;

(3) the parents of the newborn child;

(4) the health authority of the jurisdiction in which the

newborn child was born or in which the child resides, if known;

(5) physicians who are cooperating pediatric specialists for the

program.

(b) If a screening test indicates that a newborn child is at

high risk, the department shall recommend that the child be

placed under the medical care of a licensed physician for

diagnosis and provide the name of a consultant pediatric

specialist in the child's geographic area.

pediatric specialist may follow up a positive test with the

attending physician or with a parent of the newborn child if the

child was not attended by a physician at birth.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991.

Amended by:

Acts 2005, 79th Leg., Ch.

940, Sec. 4, eff. September 1, 2005.

Sec. 33.015. REPORTS; RECORD KEEPING. (a) Each physician,

health authority, or other individual who has the information of

a confirmed case of a disorder for which a screening test is

required that has been detected by a mechanism other than

identification through a screening of a specimen by the

department's diagnostic laboratory shall report the confirmed

case to the department.

(b) The department may collect data to derive incidence and

prevalence rates of disorders covered by this chapter from the

information on the specimen form submitted to the department for

screening determinations.

this state who have been diagnosed as having one of the disorders

for which the screening tests are required.

(d) The department may cooperate with other states in the

development of a national roster of individuals who have been

diagnosed as having one of the disorders for which the screening

tests are required if:

(1) participation in the national roster encourages systematic

follow-up in the participating states;

(2) incidence and prevalence information is made available to

participating newborn screening programs in other states; and

(3) each participating newborn screening program subscribes to

an agreement to protect the identity and diagnosis of the

individuals whose names are included in the national roster.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991.

Sec. 33.016. APPROVAL OF LABORATORIES. (a) The department may

develop a program to approve any laboratory that wishes to

perform the tests required to be administered under this chapter.

To the extent that they are not otherwise provided in this

chapter, the board may adopt rules prescribing procedures and

standards for the conduct of the program.

(b) The department may prescribe the form and reasonable

requirements for the application and the procedures for

processing the application.

employed and the standards of accuracy and precision required for

each test.

(d) The department may extend or renew any approval in

accordance with reasonable procedures prescribed by the board.

(e) The department may for good cause, after notice to the

affected laboratory and a hearing if requested, restrict,

suspend, or revoke any approval granted under this section.

(f) Hearings under this section shall be conducted in accordance

with the hearing rules adopted by the board and the applicable

provisions of Chapter 2001, Government Code.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991; Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff. Sept. 1,

1995.

Text of section as added by Acts 2009, 81st Leg., R.S., Ch.

179, Sec. 3

For text of section as added by Acts 2009, 81st Leg., R.S., Ch.

1124, Sec. 3, see other Sec. 33.017.

Sec. 33.017. CONFIDENTIALITY. (a) Reports, records, and

information obtained or developed by the department under this

chapter are confidential and are not subject to disclosure under

Chapter 552, Government Code, are not subject to subpoena, and

may not otherwise be released or made public except as provided

by this section.

(b) Notwithstanding other law, reports, records, and information

obtained or developed by the department under this chapter may be

disclosed:

(1) for purposes of diagnosis or follow-up authorized under

Section 33.014;

(2) with the consent of each identified individual or an

individual authorized to consent on behalf of an identified

child;

(3) as authorized by court order;

(4) to a medical examiner authorized to conduct an autopsy on a

child or an inquest on the death of a child; or

(5) to public health programs of the department for public

health research purposes provided that the disclosure is approved

by an institutional review board or privacy board of the

department as authorized by the federal privacy requirements

adopted under the Health Insurance Portability and Accountability

Act of 1996 (Pub. L. No. 104-191) contained in 45 C.F.R. Part 160

and 45 C.F.R. Part 164, Subparts A and E.

that do not identify a child or the family of a child may be

released without consent if the disclosure is for:

(1) statistical purposes;

(2) purposes related to obtaining or maintaining certification,

approval, or quality assurance for the department's laboratory or

a public or private laboratory to perform newborn screening

tests;

(3) purposes relating to review, quality assurance, or

improvement of the department's newborn screening under this

chapter or the department's newborn screening program services

under Subchapter C;

(4) research purposes, provided that the disclosure is approved

by an institutional review board or privacy board of the

department; or

(5) quality assurance related to equipment and supplies,

provided that:

(A) the assessment is performed by a person who is not a

laboratory;

(B) only newborn screening specimens are disclosed; and

or privacy board of the department.

(d) A state officer or employee, a department contractor, or a

department contractor's employee, officer, director, or

subcontractor may not be examined in a civil, criminal, special,

or other judicial or administrative proceeding as to the

existence or contents of records, reports, or information made

confidential by this section unless disclosure is authorized by

this section.

Added by Acts 2009, 81st Leg., R.S., Ch.

179, Sec. 3, eff. May 27, 2009.

Text of section as added by Acts 2009, 81st Leg., R.S., Ch.

1124, Sec. 3

For text of section as added by Acts 2009, 81st Leg., R.S., Ch.

179, Sec. 3, see other Sec. 33.017.

Sec. 33.017. NEWBORN SCREENING ADVISORY COMMITTEE. (a) The

department shall establish the Newborn Screening Advisory

Committee.

(b) The advisory committee consists of members appointed by the

commissioner of state health services. The advisory committee

must include the following members:

(1) health care providers;

(2) a hospital representative;

(3) persons who have family members affected by a condition for

which newborn screening is or may be required under this

subchapter; and

(4) persons who are involved in the delivery of newborn

screening services, follow-up, or treatment in this state.

strategic planning, policy, rules, and services related to

newborn screening and additional newborn screening tests.

(d) The advisory committee shall adopt bylaws governing the

committee's operations.

(e) The advisory committee may appoint subcommittees.

(f) The advisory committee shall meet at least three times each

year and at other times at the call of the commissioner of state

health services.

(g) A member of the advisory committee is not entitled to

compensation, but is entitled to reimbursement for travel or

other expenses incurred by the member while conducting the

business of the advisory committee, as provided by the General

Appropriations Act.

(h) The advisory committee is not subject to Chapter 2110,

Government Code.

Added by Acts 2009, 81st Leg., R.S., Ch.

1124, Sec. 3, eff. September 1, 2009.

SUBCHAPTER C. NEWBORN SCREENING PROGRAM SERVICES

Sec. 33.031. COORDINATION WITH CHILDREN WITH SPECIAL HEALTH CARE

NEEDS SERVICES. (a) All newborn children and other individuals

under 21 years of age who have been screened, have been found to

be presumptively positive through the newborn screening program

for phenylketonuria, other heritable diseases, hypothyroidism, or

another disorder for which the screening tests are required, and

may be financially eligible may be referred to the department's

services program for children with special health care needs.

(b) An individual who is determined to be eligible for services

under the services program for children with special health care

needs shall be given approved services through that program. An

individual who does not meet that eligibility criteria shall be

referred to the newborn screening program for a determination of

eligibility for newborn screening program services.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991; Acts 1999, 76th Leg., ch. 1505, Sec. 3.11, eff. Sept. 1,

1999.

Amended by:

Acts 2005, 79th Leg., Ch.

940, Sec. 5, eff. September 1, 2005.

Sec. 33.032. PROGRAM SERVICES. (a) Within the limits of funds

available for this purpose and in cooperation with the

individual's physician, the department may provide services

directly or through approved providers to individuals of any age

who meet the eligibility criteria specified by board rules on the

confirmation of a positive test for phenylketonuria, other

heritable diseases, hypothyroidism, or another disorder for which

the screening tests are required.

(b) The board may adopt:

(1) rules specifying the type, amount, and duration of program

services to be offered;

(2) rules establishing the criteria for eligibility for

services, including the medical and financial criteria;

(3) rules establishing the procedures necessary to determine the

medical, financial, and other eligibility of the individual;

(4) substantive and procedural rules for applying for program

services and processing those applications;

(5) rules for providing services according to a sliding scale of

financial eligibility;

(6) substantive and procedural rules for the denial,

modification, suspension, and revocation of an individual's

approval to receive services; and

(7) substantive and procedural rules for the approval of

providers to furnish program services.

criteria in the board's rules.

(d) The board may charge fees for the provision of services,

except that services may not be denied to an individual because

of the individual's inability to pay the fees.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991.

Amended by:

Acts 2005, 79th Leg., Ch.

940, Sec. 6, eff. September 1, 2005.

Sec. 33.033. CONSENT. The department may not provide services

without the consent of the individual or, if the individual is a

minor, the minor's parent, managing conservator, or guardian.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991.

Sec. 33.034. DENIAL, MODIFICATION, SUSPENSION, AND REVOCATION OF

APPROVAL TO PROVIDE SERVICES. (a) After notice and an

opportunity for a fair hearing, the department may deny the

approval or modify, suspend, or revoke the approval of a person

to provide services under this chapter.

(b) Notice shall be given and the hearing shall be conducted in

accordance with the department's informal hearing procedures.

and hearing required by this section.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991; Acts 1995, 74th Leg., ch. 76, Sec. 5.95(66), eff. Sept. 1,

1995.

Amended by:

Acts 2005, 79th Leg., Ch.

728, Sec. 9.001, eff. September 1, 2005.

Sec. 33.035. INDIVIDUALS ELIGIBLE FOR SERVICES. (a) An

individual is not eligible to receive the services authorized by

this chapter at no cost or reduced cost to the extent that the

individual or the parent, managing conservator, guardian, or

other person with a legal obligation to support the individual is

eligible for some other benefit that would pay for all or part of

the services.

(b) The department may waive ineligibility under Subsection (a)

if the department finds that:

(1) good cause for the waiver is shown; and

(2) enforcement of the requirement would tend to defeat the

purpose of this chapter or disrupt the administration or prevent

the provision of services to an otherwise eligible recipient.

that an individual is eligible for or receiving services, the

applicant or recipient shall inform the department of any other

benefit to which the applicant, recipient, or person with a legal

obligation to support the applicant or recipient may be entitled.

(d) The board by rule shall provide criteria for actions taken

under this section.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991.

Sec. 33.036. DENIAL, MODIFICATION, SUSPENSION, AND REVOCATION OF

ELIGIBILITY TO RECEIVE SERVICES. (a) After notice to the

individual or, if the individual is a minor, the individual's

parent, managing conservator, or guardian and an opportunity for

a fair hearing, the department may deny, modify, suspend, or

revoke the determination of a person's eligibility to receive

services at no cost or at reduced cost under this chapter.

(b) Notice shall be given and the hearing shall be conducted in

accordance with the department's informal hearing procedures.

and hearing required by this section.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991; Acts 1995, 74th Leg., ch. 76, Sec. 5.95(66), eff. Sept. 1,

1995.

Sec. 33.037. REIMBURSEMENT. (a) The board may require an

individual or, if the individual is a minor, the minor's parent,

managing conservator, or guardian, or other person with a legal

obligation to support the individual to pay or reimburse the

department for all or part of the cost of the services provided.

(b) The recipient or the parent, managing conservator, guardian,

or other person with a legal obligation to support an individual

who has received services from the department that are covered by

some other benefit shall, when the other benefit is received,

reimburse the department for the cost of services provided.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991.

Sec. 33.038. RECOVERY OF COSTS. (a) The department is entitled

to recover an expenditure for services provided under this

chapter from:

(1) a person who does not reimburse the department as required

by this chapter; or

(2) a third party with a legal obligation to pay other benefits

and who has received prior written notice of the department's

interests in the other benefits.

(b) This section creates a separate and distinct cause of

action, and the commissioner may request the attorney general to

bring suit in the appropriate court of Travis County on behalf of

the department.

award attorney fees, court costs, and interest accruing from the

date on which the department provides the service to the date on

which the department is reimbursed.

(d) The board by rule shall provide criteria for actions taken

under this section.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1,

1991.

State Codes and Statutes

State Codes and Statutes

State Codes and Statutes

State Codes and Statutes

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