PRINTER'S NO. 4109
No. 2700 Session of 2006
INTRODUCED BY TURZAI, TANGRETTI, TRUE, TIGUE, STERN, GRUCELA,
ALLEN, ARGALL, ARMSTRONG, BAKER, BALDWIN, BARRAR, BASTIAN,
BELFANTI, BENNINGHOFF, BIRMELIN, BOYD, BUNT, CALTAGIRONE,
CAPPELLI, CAUSER, CAWLEY, CIVERA, CLYMER, CORRIGAN, CRAHALLA,
CREIGHTON, DALEY, DALLY, DeLUCA, DENLINGER, DiGIROLAMO,
DIVEN, ELLIS, J. EVANS, FABRIZIO, FAIRCHILD, FICHTER,
FLEAGLE, FORCIER, GABIG, GEIST, GERGELY, GINGRICH, GODSHALL,
GOOD, GOODMAN, GRELL, HARRIS, HENNESSEY, HERSHEY, HESS,
HICKERNELL, HUTCHINSON, KAUFFMAN, M. KELLER, KENNEY, KILLION,
KOTIK, LaGROTTA, LEH, MARKOSEK, MARSICO, McILHATTAN,
McNAUGHTON, MELIO, METCALFE, MUSTIO, O'BRIEN, PAYNE,
PETRARCA, PHILLIPS, PICKETT, PYLE, QUIGLEY, RAPP, REED,
ROHRER, SATHER, SCAVELLO, SCHRODER, SIPTROTH, S. H. SMITH,
SOLOBAY, SONNEY, STABACK, STAIRS, R. STEVENSON, T. STEVENSON,
SURRA, E. Z. TAYLOR, J. TAYLOR, WILT, WOJNAROSKI, WRIGHT,
YEWCIC, YUDICHAK, ZUG AND REICHLEY, JUNE 5, 2006
REFERRED TO COMMITTEE ON HEALTH AND HUMAN SERVICES, JUNE 5, 2006
AN ACT
1 Providing for ultrasound test requirements to determine
2 gestational ages of unborn children; establishing the right
3 to view ultrasound image and ultrasound video of unborn child
4 under certain circumstances; providing for powers and duties
5 of the Department of Health and for duties of physicians
6 performing abortions; requiring certain reports to be filed
7 with the Department of Health; and prescribing penalties.
8 The General Assembly of the Commonwealth of Pennsylvania
9 hereby enacts as follows:
10 Section 1. Short title.
11 This act shall be known and may be cited as the Ultrasound
12 Access Law.
13 Section 2. Definitions.
1 The following words and phrases when used in this act shall
2 have the meanings given to them in this section unless the
3 context clearly indicates otherwise:
4 "Abortion." The use of any means to terminate the clinically
5 diagnosable pregnancy of a woman with knowledge that the
6 termination by that means will, with reasonable likelihood,
7 cause the death of the unborn child.
8 "Department." The Department of Health of the Commonwealth.
9 "Gestational age." The age of an unborn child as calculated
10 from the first day of the last menstrual period of the pregnant
11 woman.
12 "Informed consent." The informed consent provided for under
13 18 Pa.C.S. § 3205 (relating to informed consent).
14 "Physician." A person licensed to practice medicine in this
15 Commonwealth. The term includes a medical doctor and doctor of
16 osteopathy.
17 "Pregnancy" and "pregnant." Each term shall mean that female
18 reproductive condition of having a developing fetus in the body
19 and commences with fertilization.
20 "Ultrasound image." An image produced through the use of an
21 ultrasound machine that is of sufficient quality to be used in
22 determining gestational age.
23 "Unborn child" and "fetus." An individual organism of the
24 species homo sapiens from fertilization until live birth.
25 Section 3. Ultrasound test requirements.
26 (a) Ultrasound test and waiting period required.--At least
27 24 hours before an abortion is to be performed, the physician
28 who is to perform the abortion upon the pregnant woman or the
29 referring physician shall perform or cause an ultrasound test to
30 be performed upon the pregnant woman. This 24-hour waiting
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1 period may run concurrently with the waiting period prescribed
2 for the informed consent provision in 18 Pa.C.S. § 3205
3 (relating to informed consent).
4 (b) Basis of determination.--The ultrasound test shall be
5 used to make an accurate determination of gestational age of the
6 unborn child as provided for in this subsection. Determination
7 of gestational age shall be based upon measurement of the unborn
8 child in a manner consistent with standard ultrasound practice
9 in determining gestational age. When only the gestational sac is
10 visible, gestational age may be based upon measurement of the
11 gestational sac.
12 (c) Documentation of measurements.--A video print of the
13 ultrasound image shall be made to document the measurements that
14 have been taken to determine the gestational age of the unborn
15 child, and a copy of that print shall be maintained in the
16 pregnant woman's medical file at the facility where the abortion
17 is to be performed.
18 (d) Persons who may perform test.--An ultrasound test
19 performed under this section may only be performed by a person
20 who regularly conducts ultrasound tests for medical purposes and
21 meets any additional qualifications that the department may
22 prescribe by regulation.
23 (e) Applicability.--
24 (1) The 24-hour waiting period required under subsection
25 (a) shall not apply if:
26 (i) The ultrasound image which is used to determine
27 gestational age pursuant to this act establishes that the
28 gestational age of the unborn child is less than eight
29 weeks at the time the ultrasound test was performed.
30 (ii) The physician who performs the abortion
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1 completes, signs and dates a statement with the
2 physician's name printed thereon, which shall contain the
3 following information and which shall read substantially
4 as follows:
5 (Insert the name of the pregnant woman) provided
6 me with a duplicate copy of the video print of
7 the ultrasound image of her unborn child which
8 was taken by or at the direction of (insert name
9 of physician who caused the test to be performed)
10 and this video print establishes that the
11 gestational age of the unborn child was less than
12 eight weeks at the time the ultrasound test was
13 performed. (Print and sign physician's name and
14 insert date of signature.)
15 (2) The statement shall be placed in the medical file of
16 the pregnant woman at the facility where the abortion was
17 performed.
18 (f) Physician instructions.--
19 (1) Except in a case of a medical emergency specified in
20 section 10(a) or a case where the physician who provides for
21 the ultrasound test refers the pregnant woman to a facility
22 for the test other than the facility where the abortion is to
23 be performed, the physician who is to provide for the conduct
24 of the ultrasound test shall furnish the pregnant woman with
25 the following materials to take to the person who will
26 conduct that ultrasound test:
27 (i) The appropriate physician direction sheet
28 specified in subsection (g).
29 (ii) The statement to be signed by the pregnant
30 woman after her ultrasound test is completed.
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1 (iii) The statement to be signed by the person
2 conducting the ultrasound test.
3 (2) The physician shall instruct the pregnant woman to
4 furnish the information under paragraph (1) to the person who
5 conducts the ultrasound test and shall also advise the
6 pregnant woman that she will need to take her statement and
7 the statement of the person who performed the ultrasound
8 test, after such person signs the statement, to the physician
9 who is to perform the abortion.
10 (g) Physician direction sheet.--
11 (1) Except as otherwise provided in paragraph (2), the
12 physician direction sheet identified in subsection (f) shall
13 contain the following information and shall read
14 substantially as follows:
15 PHYSICIAN DIRECTION SHEET
16 The person who performs the ultrasound test must:
17 (1) Conduct an ultrasound test that will enable the
18 gestational age of the unborn child to be determined.
19 (2) Position the screen so that the pregnant woman
20 is able to view the ultrasound test in its entirety,
21 with a view of her unborn child, while that test is
22 being conducted to determine gestational age. The
23 pregnant woman is not required to view the screen.
24 (3) Inform the pregnant woman of her right to view
25 the ultrasound test in its entirety while that test
26 is being performed.
27 (4) Provide the pregnant woman with a video print of
28 the ultrasound image that will be used to determine
29 gestational age and a copy of the same video print to
30 give to the physician who is to perform the abortion.
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1 (5) Sign and date the statement required of the
2 person who administers the ultrasound test and
3 indicate the time of day when the ultrasound test was
4 performed.
5 (6) Instruct the pregnant woman to sign and date her
6 statement and to take that statement, the signed and
7 dated statement of the person who performed the
8 ultrasound test and a video print of the ultrasound
9 image to the physician who will perform the abortion.
10 (2) In a case where the exemption set forth under
11 section 10(b) or (c) applies, the physician direction sheet
12 shall contain the following information and shall read
13 substantially as follows:
14 PHYSICIAN DIRECTION SHEET WITH EXEMPTIONS
15 The person who performs the ultrasound test must:
16 (1) Conduct the ultrasound test that will enable the
17 gestational age of the unborn child to be determined.
18 (2) Position the screen so that the pregnant woman
19 is able to view the ultrasound test in its entirety,
20 with a view of her unborn child, while that test is
21 being conducted to determine gestational age. The
22 pregnant woman is not required to view the screen.
23 (3) Provide the woman with a sealed envelope that
24 contains the video print that the pregnant woman must
25 provide to the physician who is to perform the
26 abortion.
27 (4) Sign and date the statement required of the
28 person who administers the ultrasound test.
29 (5) Instruct the pregnant woman to sign and date her
30 statement and to take that statement, the signed and
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1 dated statement of the person who performed the
2 ultrasound test and a video print of the ultrasound
3 image to the physician who will perform the abortion.
4 Section 4. Right to view ultrasound image of unborn child.
5 (a) General rule.--Unless an exemption set forth under
6 section 10 applies, the person performing the ultrasound test
7 required under section 3 shall:
8 (1) Inform the pregnant woman of her right to view the
9 ultrasound test in its entirety while that test is being
10 performed to determine gestational age.
11 (2) Provide the pregnant woman with a copy of the video
12 print of the ultrasound image made under section 3(c).
13 (3) Comply with subsection (c) and the appropriate
14 physician direction sheet, if applicable.
15 (4) Position the ultrasound screen so that the pregnant
16 woman is able to view the ultrasound test, with an ultrasound
17 view of her unborn child, in its entirety while that test is
18 being performed to determine gestational age.
19 (b) Written statement from pregnant woman.--
20 (1) Unless an exemption set forth under section 10
21 applies, the pregnant woman shall sign a statement that reads
22 as follows:
23 I was provided with an opportunity to view the
24 ultrasound test in its entirety while that test was
25 being performed and I (insert "accepted" or
26 "declined") this opportunity. I was given a video
27 print of the ultrasound image. (Print and sign name
28 of pregnant woman and insert date of signature.)
29 (2) The statement shall be in bold print of at least
30 ten-point type and the paper containing such statement shall
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1 only include material that is necessary to carry out the
2 purpose of this subsection.
3 (3) A copy of the statement, signed and dated by the
4 woman and with the woman's name printed thereon, shall be
5 maintained in the pregnant woman's medical file at the
6 facility where the abortion is performed.
7 (c) Written statement from person performing ultrasound
8 test.--
9 (1) Except as otherwise provided under paragraph (2),
10 the person performing the ultrasound test required under
11 section 3 shall sign a statement that reads as follows:
12 I performed an ultrasound test on (insert name of
13 pregnant woman) on (insert date) at (insert name of
14 facility where ultrasound test was performed). The
15 ultrasound screen was positioned so that the pregnant
16 woman would be able to view the screen in its
17 entirety while the test was being performed to
18 determine gestational age. I informed her of her
19 right to view the ultrasound screen in its entirety
20 while the test was being performed and I provided her
21 with a video print of the ultrasound image that will
22 be used to determine gestational age. (Print and sign
23 name of person performing ultrasound test and insert
24 date of signature and the time of day the test was
25 performed.)
26 (2) If an applicable exemption under section 10 applies,
27 the person performing the ultrasound test required under
28 section 3 shall sign a statement that reads as follows:
29 I performed the ultrasound test on (insert name of
30 pregnant woman) on (insert date) at (insert name of
20060H2700B4109 - 8 -
1 facility where the ultrasound test was performed).
2 (Print and sign name of person performing the
3 ultrasound test and insert date of signature.)
4 (3) A copy of the applicable statement shall be
5 maintained in the pregnant woman's medical file at the
6 facility where the abortion is performed.
7 Section 5. Ultrasound video.
8 (a) Physician duties.--
9 (1) If the abortion is not performed within 14 days of
10 the performance of the ultrasound required in section 3, the
11 physician who performs the abortion shall:
12 (i) Inform the pregnant woman of the probable
13 gestational age of the unborn child at the time the
14 abortion is performed.
15 (ii) Offer her an opportunity to view an ultrasound
16 video which accurately depicts an unborn child at the
17 stage in pregnancy when her abortion is performed.
18 (2) The duties required under paragraph (1) shall be
19 fulfilled by providing the woman with an opportunity to view
20 an appropriate ultrasound video, approved by the department,
21 on site or by providing her with the list of Internet
22 websites identified by the department pursuant to this
23 section, that show ultrasound videos which meet with the
24 approval of the department.
25 (b) Written statement.--If subsection (a) is applicable:
26 (1) The pregnant woman shall sign a statement that
27 contains the following information and shall read
28 substantially as follows:
29 I was informed of the probable gestational age of my
30 unborn child at the time the abortion was performed.
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1 I (insert "accepted" or "declined") an opportunity to
2 view an ultrasound video which accurately depicted an
3 unborn child at the same stage in pregnancy when the
4 abortion was performed. (Print and sign name of
5 pregnant woman and insert date of signature.)
6 (2) The physician who performs the abortion shall
7 provide the pregnant woman with the information required by
8 this section and shall sign a statement that contains the
9 following information and shall read substantially as
10 follows:
11 Prior to performing an abortion on (insert name of
12 pregnant woman) at (insert name of facility), I
13 informed her of the probable gestational age of her
14 unborn child and I provided her with an opportunity
15 to view an ultrasound video which accurately depicted
16 an unborn child at the same stage of pregnancy when
17 the abortion was performed and she (insert "accepted"
18 or "declined") this opportunity. (Print and sign name
19 of physician and insert date of signature.)
20 (c) Documentation.--A copy of the signed and dated
21 statements required under subsection (b) shall be maintained in
22 the pregnant woman's medical file at the facility where the
23 abortion is to be performed.
24 (d) Internet websites.--The department shall prepare a list
25 of Internet websites and ultrasound videos that link the
26 department's Internet website to others that it determines
27 provide accurate ultrasound video images of unborn children in
28 weekly stages, or as close thereto as possible, that are
29 suitable for pregnant women to view to determine what an unborn
30 child's development will be like at the time of the scheduled
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1 abortion and that satisfy the requirements of this section.
2 (e) Suitability of ultrasound videos.--If the department is
3 unable to identify any ultrasound videos that meet the
4 requirements of this section, it shall provide for the
5 preparation of an ultrasound video that meets those
6 requirements.
7 (f) Commencement.--The duties imposed under subsections (a),
8 (b) and (c) shall commence 30 days after the department first
9 approves an appropriate ultrasound video, prepares an ultrasound
10 video or provides the list of approved Internet websites,
11 whichever occurs first.
12 Section 6. Duties of department.
13 (a) General rule.--The department shall:
14 (1) Obtain from physicians any information necessary to
15 prepare the report required under section 8.
16 (2) Prepare forms for all statements and reports
17 required under this act and place the forms on a departmental
18 Internet website. The requirements of this act shall not be
19 deemed inoperative prior to the preparation of such forms by
20 the department.
21 (3) Establish such procedures and requirements and such
22 rules and regulations as may be necessary to carry out the
23 purposes of this act.
24 (b) Annual notice to physicians performing abortions.--
25 Annually, the department shall notify each referring physician
26 and each physician performing an abortion listed in a report
27 filed pursuant to 18 Pa.C.S. § 3214(a) (relating to reporting)
28 during the preceding calendar year of the requirements of this
29 act. The notice shall include a conspicuous statement advising
30 physicians that all relevant forms are available or will be
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1 available on the department's Internet website. The initial
2 notice to each physician specified in this subsection shall be
3 sent within 60 days after the effective date of this subsection.
4 Section 7. Duties of physicians performing abortion and
5 abortion facilities.
6 (a) Prerequisites.--Except insofar as an exemption set forth
7 under section 3(e) or 10 is applicable, no abortion shall be
8 performed unless:
9 (1) The physician performing the abortion possesses a
10 copy of the video print of the ultrasound image required by
11 section 3(c) and possesses copies of the statements required
12 by section 4(b) and (c) and, if applicable, has obtained
13 copies of the statements required by section 5.
14 (2) At least 24 hours have elapsed between the time when
15 the ultrasound test required under section 3 was performed,
16 as indicated in the statement required under section 4(c),
17 and the time the abortion was performed upon the pregnant
18 woman.
19 (b) Physician statement.--In each case where an exemption
20 under section 3(e) or 10 applies, the physician who performs the
21 abortion shall sign and date the applicable statement set forth
22 below with the physician's name printed thereon which shall
23 include one of the following:
24 (1) The exemption set forth in section 10(a) applies to
25 the abortion that I performed upon (insert name of pregnant
26 woman). (Print and sign physician's name and insert date of
27 signature.)
28 (2) The exemption set forth in section 10(b) applies to
29 the abortion that I performed upon (insert name of pregnant
30 woman). (Print and sign physician's name and insert date of
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1 signature.)
2 (3) The rape or incest exemption set forth in section
3 10(c) applies to the abortion that I performed upon (insert
4 name of pregnant woman). (Print and sign physician's name and
5 insert date of signature.)
6 (4) The exemption set forth in section 3(e) applies to
7 the abortion that I performed upon (insert name of pregnant
8 woman). (Print and sign physician's name and insert date of
9 signature.)
10 (c) Recordkeeping.--The physician statement required by
11 subsection (b) shall be placed in the medical file of the
12 pregnant woman at the facility where the abortion is performed.
13 An abortion facility that receives a statement or other
14 information pursuant to this act shall preserve the statement
15 and information for a period of not less than five years.
16 Section 8. Reports.
17 (a) Duty of physicians to file.--Each physician who performs
18 an abortion shall file a report with the department. The report
19 forms shall not identify the individual patient by name and
20 shall include the following information:
21 (1) The name of the physician who caused the ultrasound
22 test to be performed, the name of the person who performed
23 the ultrasound test and the facility where the ultrasound
24 test was performed.
25 (2) The date the ultrasound test was performed.
26 (3) The name of the physician who performed the abortion
27 and the facility where the abortion was performed.
28 (4) The date the abortion was performed.
29 (5) The gestational age of the unborn child as
30 determined by the ultrasound image required under section 3.
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1 (6) Whether the pregnant woman declined the opportunity
2 to view the ultrasound image referred to under section 3.
3 (7) The basis for the medical judgment of the physician
4 that the exemption in section 10(b) applies if such exemption
5 is claimed.
6 (8) The basis for the medical judgment of the physician
7 that a medical emergency existed.
8 (9) Whether an exemption was claimed for rape or whether
9 an exemption was claimed for incest, if such exemption is
10 claimed.
11 (10) Whether section 5 applied to the pregnant woman and
12 whether she declined the opportunity to view the video.
13 (11) Whether an exemption was claimed under section
14 3(e).
15 (b) Filing deadline.--The reports shall be completed and
16 signed by the physician who performed the abortion and
17 transmitted to the department within 15 days after the end of
18 each reporting month.
19 (c) Annual report to General Assembly.--The department shall
20 prepare an annual report for the General Assembly on or before
21 March 31 of each year based upon the information obtained
22 pursuant to this act for the preceding calendar year which shall
23 be filed with the President pro tempore of the Senate and the
24 Speaker of the House of Representatives. The report shall be
25 available for public inspection and copying and shall include
26 the following information for the preceding calendar year:
27 (1) The gestational ages of unborn children as
28 determined by ultrasound image referred to under section 3
29 and set forth in categories beginning with those under five
30 weeks and proceeding forward in two-week increments.
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1 (2) The number of pregnant women who declined the
2 opportunity to view the ultrasound image referred to under
3 section 3.
4 (3) The number of instances when the ultrasound test
5 referred to under section 3 was performed at the facility
6 where the abortion was performed.
7 (4) The number of instances when exemptions were claimed
8 under section 10(a), (b) and (c), listed separately by the
9 type of exemption and under section 3(e).
10 (5) The number of pregnant women to whom section 5
11 applied and the number of pregnant women who declined the
12 opportunity to view the video.
13 (d) Confidentiality.--The reports filed pursuant to this
14 section shall not contain any information which discloses the
15 identity of a pregnant woman.
16 Section 9. Penalties.
17 (a) Unprofessional conduct.--A physician who knowingly
18 violates this act shall be guilty of unprofessional conduct and
19 shall be subject to suspension or revocation of the physician's
20 license or other appropriate disciplinary action in accordance
21 with the provisions of the act of October 5, 1978 (P.L.1109,
22 No.261), known as the Osteopathic Medical Practice Act, or the
23 act of December 20, 1985 (P.L.457, No.112), known as the Medical
24 Practice Act of 1985, whichever is applicable.
25 (b) Prohibited conduct.--
26 (1) A physician and any other person acting in that
27 person's capacity as a health care provider including any
28 person who performs the ultrasound test required under this
29 act, who knowingly violates section 3, 4, 5 or 7 for the
30 first offense shall be guilty of a misdemeanor of the third
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1 degree.
2 (2) A person commits a misdemeanor of the third degree
3 if the person makes any written statement required by this
4 act which such person does not believe to be true.
5 (c) Penalty for disclosure of woman's identity.--
6 (1) No person who learns of the identity of a woman
7 seeking an abortion or receiving an ultrasound test required
8 under section 3, in that person's capacity as a health care
9 provider, including any person who is involved with the
10 performance of the ultrasound test, or as a public employee
11 or official, may disclose her identity in connection
12 therewith, except in cases where such disclosure is
13 appropriate to carry out the purposes of this act or is made
14 with the consent of the woman.
15 (2) A person who knowingly violates this subsection
16 commits a misdemeanor of the second degree.
17 Section 10. Exemptions.
18 (a) Medical emergencies.--Compliance with the requirements
19 of sections 3 and 4 shall be excused where a medical emergency,
20 as defined in 18 Pa.C.S. § 3203 (relating to definitions),
21 exists.
22 (b) Severe impact on physical or mental health.--Compliance
23 with the requirements of section 4(a)(1) or (2), (b) or 5 or
24 with the 24-hour waiting period under section 3(a) shall be
25 excused if the physician can demonstrate, by a preponderance of
26 the evidence, that the physician reasonably believed that
27 compliance with those provisions would have resulted in a
28 severely adverse effect on the physical or mental health of the
29 pregnant woman.
30 (c) Rape or incest.--Compliance with the requirements of
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1 section 4(a)(1) or (2), (b) or 5 and the 24-hour waiting period
2 in section 3(a) shall be excused if the physician performing the
3 abortion has received a signed statement from the pregnant woman
4 that she was a victim of rape or has received a signed statement
5 from the pregnant woman that she was a victim of incest and has
6 placed the statement in her medical file at the facility where
7 the abortion is performed.
8 Section 11. Construction.
9 Nothing in this act shall be deemed:
10 (1) To eliminate any application of the 24-hour waiting
11 period required under 18 Pa.C.S. § 3205 (relating to informed
12 consent) or to limit or repeal any provision of 18 Pa.C.S.
13 Ch. 32 (relating to abortion).
14 (2) To require a pregnant woman to view an ultrasound
15 image of her unborn child or a video image referred to in
16 section 5.
17 Section 12. Severability.
18 The provisions of this act are severable. If any provision of
19 this act or its application to any person or circumstance is
20 held invalid, the invalidity shall not affect other provisions
21 or applications of this act which can be given effect without
22 the invalid provision or application.
23 Section 13. Effective date.
24 This act shall take effect as follows:
25 (1) Section 6(b) shall take effect immediately.
26 (2) This section shall take effect immediately.
27 (3) The remainder of this act shall take effect in 90
28 days.
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