1.1                          A bill for an act 
  1.2             relating to health; providing for the isolation and 
  1.3             detention of persons with active tuberculosis who pose 
  1.4             an endangerment to the public health; establishing 
  1.5             standards and procedures for isolation and detention; 
  1.6             requiring reporting by licensed health professionals; 
  1.7             appropriating money; proposing coding for new law in 
  1.8             Minnesota Statutes, chapter 144. 
  1.9   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.10     Section 1.  [144.480] [AUTHORITY.] 
  1.11     Subdivision 1.  [AUTHORITY TO COMMIT.] Under the powers and 
  1.12  duties assigned to the commissioner in chapters 144 and 145, the 
  1.13  commissioner may proceed according to sections 144.480 to 
  1.14  144.4811 whenever the commissioner has reasonable cause to 
  1.15  believe that the public health or the health of any other person 
  1.16  is endangered by a person who has active tuberculosis or is 
  1.17  clinically suspected of having active tuberculosis. 
  1.18     Subd. 2.  [PREEMPTION.] Sections 144.480 to 144.4811 
  1.19  preempt and supersede sections 144.4171 to 144.4186 with regard 
  1.20  to a tuberculosis health threat.  Nothing in this provision 
  1.21  shall be construed to restrict the commissioner's authority to 
  1.22  seek injunctive relief pursuant to section 145.075. 
  1.23     Sec. 2.  [144.4801] [DEFINITIONS.] 
  1.24     Subdivision 1.  [ACTIVE TUBERCULOSIS.] "Active tuberculosis"
  1.25  includes infectious and noninfectious tuberculosis and means: 
  1.26     (1) a condition evidenced by a positive culture for 
  1.27  mycobacterium tuberculosis taken from a pulmonary or laryngeal 
  2.1   source when the patient has not initiated or completed a course 
  2.2   of treatment for tuberculosis that is prescribed by a physician 
  2.3   and reasonable according to currently accepted standards of 
  2.4   medical practice; 
  2.5      (2) a condition evidenced by a positive culture for 
  2.6   mycobacterium tuberculosis taken from an extrapulmonary source 
  2.7   when there is clinical evidence such as a positive skin test for 
  2.8   tuberculosis infection, coughing, sputum production, fever, and 
  2.9   other symptoms compatible with pulmonary tuberculosis, and the 
  2.10  person has not initiated or completed a course of treatment for 
  2.11  tuberculosis that is prescribed by a physician and is reasonable 
  2.12  according to currently accepted standards of medical practice; 
  2.13  or 
  2.14     (3) a condition in which clinical specimens are not 
  2.15  available for culture, but there is radiographic evidence of 
  2.16  tuberculosis such as an abnormal chest x-ray, and clinical 
  2.17  evidence such as a positive skin test for tuberculosis 
  2.18  infection, coughing, sputum production, fever, and other 
  2.19  symptoms compatible with pulmonary tuberculosis, that lead the 
  2.20  patient's physician to reasonably diagnose active tuberculosis 
  2.21  according to currently accepted standards of medical practice 
  2.22  and to initiate treatment for tuberculosis. 
  2.23     Subd. 2.  [CARRIER.] "Carrier" means a person who has 
  2.24  active tuberculosis or is clinically suspected of having active 
  2.25  tuberculosis. 
  2.26     Subd. 3.  [CLINICALLY SUSPECTED OF HAVING ACTIVE 
  2.27  TUBERCULOSIS.] "Clinically suspected of having active 
  2.28  tuberculosis" means presenting a substantial likelihood of 
  2.29  having active tuberculosis based upon epidemiologic, clinical or 
  2.30  radiographic evidence, laboratory test results, or other 
  2.31  reliable evidence as determined by a physician using currently 
  2.32  accepted standards of medical practice. 
  2.33     Subd. 4.  [COMMISSIONER.] "Commissioner" means the 
  2.34  commissioner of health. 
  2.35     Subd. 5.  [CONTAGION PRECAUTIONS FOR TUBERCULOSIS.] 
  2.36  "Contagion precautions for tuberculosis" means those measures 
  3.1   specified by the commissioner which have been generally 
  3.2   recognized in the medical community to prevent a carrier from 
  3.3   exposing others to tuberculosis. 
  3.4      Subd. 6.  [DEPARTMENT.] "Department" means the department 
  3.5   of health. 
  3.6      Subd. 7.  [DIRECTLY OBSERVED THERAPY.] "Directly observed 
  3.7   therapy" means a methodology for ensuring compliance with 
  3.8   medication directions in which a licensed health professional or 
  3.9   designee observes the person ingesting prescribed medications or 
  3.10  administers the prescribed medication to the person. 
  3.11     Subd. 8.  [ENDANGERMENT TO THE PUBLIC HEALTH OR TO THE 
  3.12  HEALTH OF ANY OTHER PERSON.] "Endangerment to the public health 
  3.13  or to the health of any other person" means a carrier who 
  3.14  engages in any of the following conduct: 
  3.15     (1) refuses or fails to submit to a diagnostic tuberculosis 
  3.16  examination ordered by a physician that is reasonable according 
  3.17  to currently accepted standards of medical practice; 
  3.18     (2) refuses or fails to initiate or complete treatment for 
  3.19  tuberculosis prescribed by a physician that is reasonable 
  3.20  according to currently accepted standards of medical practice; 
  3.21     (3) refuses or fails to keep appointments for treatment of 
  3.22  tuberculosis; 
  3.23     (4) refuses or fails to provide the commissioner, upon 
  3.24  request, with evidence showing the completion of a course of 
  3.25  treatment for tuberculosis prescribed by a physician that is 
  3.26  reasonable according to currently accepted standards of medical 
  3.27  practice; 
  3.28     (5) refuses or fails to initiate or complete a course of 
  3.29  directly observed therapy prescribed by a physician that is 
  3.30  reasonable according to currently accepted standards of medical 
  3.31  practice; 
  3.32     (6) refuses or fails to keep at least 80 percent of 
  3.33  directly observed therapy appointments; 
  3.34     (7) refuses or fails to follow contagion precautions for 
  3.35  tuberculosis after being instructed on such precautions; 
  3.36     (8) is unlikely, based on evidence of the carrier's past or 
  4.1   present behavior, to complete a course of treatment for 
  4.2   tuberculosis that is reasonable according to currently accepted 
  4.3   standards of medical practice; or 
  4.4      (9) may expose or may have exposed other persons to 
  4.5   tuberculosis who are at risk of converting from a negative to a 
  4.6   positive skin test for tuberculosis infection, based on 
  4.7   epidemiological, medical, or other reliable evidence. 
  4.8      Subd. 9.  [EPIDEMIOLOGICAL DATA OR EPIDEMIOLOGICAL 
  4.9   EVIDENCE.] "Epidemiological data" or "epidemiological evidence" 
  4.10  means data or evidence relating to the occurrence, distribution, 
  4.11  clinical characteristics, and control of disease within a group 
  4.12  of people or within a specified population. 
  4.13     Subd. 10.  [INFECTIOUS TUBERCULOSIS.] "Infectious 
  4.14  tuberculosis" means the stage of tuberculosis where 
  4.15  mycobacterial organisms are capable of being expelled into the 
  4.16  air by a person, as determined by laboratory, epidemiological, 
  4.17  or clinical findings. 
  4.18     Subd. 11.  [ISOLATION.] "Isolation" means the placement of 
  4.19  a person who has infectious tuberculosis in a hospital or other 
  4.20  treatment facility so as to prevent or limit the transmission of 
  4.21  the infectious tuberculosis agent to others during the period of 
  4.22  infectiousness.  
  4.23     Subd. 12.  [LICENSED HEALTH PROFESSIONAL.] "Licensed health 
  4.24  professional" means a person licensed in Minnesota to practice 
  4.25  those professions described in section 214.01, subdivision 2. 
  4.26     Subd. 13.  [PEACE OFFICER.] "Peace officer" means an 
  4.27  employee or an elected or appointed official of a political 
  4.28  subdivision or law enforcement agency who is licensed by the 
  4.29  board of peace officer standards and training, charged with the 
  4.30  prevention and detection of crime and the enforcement of the 
  4.31  general criminal laws of the state and who has the full power of 
  4.32  arrest.  "Peace officer" includes the Minnesota state patrol. 
  4.33     Subd. 14.  [PHYSICIAN.] "Physician" means any person who is 
  4.34  licensed by the Minnesota board of medical practice to practice 
  4.35  medicine. 
  4.36     Subd. 15.  [RESPONDENT.] "Respondent" means any person or 
  5.1   group of persons to whom the commissioner has issued a health 
  5.2   order. 
  5.3      Subd. 16.  [TREATMENT FACILITY.] "Treatment facility" means 
  5.4   a hospital or other treatment provider qualified to provide 
  5.5   care, treatment, and appropriate contagion precautions for 
  5.6   tuberculosis. 
  5.7      Sec. 3.  [144.4802] [REPORTING RELATING TO TUBERCULOSIS.] 
  5.8      Subdivision 1.  [MANDATORY REPORTING.] A licensed health 
  5.9   professional must report to the commissioner within 24 hours of 
  5.10  obtaining knowledge of a reportable person as specified in 
  5.11  subdivision 3, unless the current status has previously been 
  5.12  reported.  A reporting facility may designate an infection 
  5.13  control practitioner to report as provided in subdivision 3. 
  5.14     Subd. 2.  [VOLUNTARY REPORTING.] Any person other than a 
  5.15  licensed health professional may report to the commissioner if 
  5.16  that person has knowledge of a reportable person as specified in 
  5.17  subdivision 3, or has reasonable cause to believe that a person 
  5.18  should be reported under subdivision 3. 
  5.19     Subd. 3.  [REPORTABLE PERSONS.] A licensed health 
  5.20  professional must report to the commissioner after obtaining 
  5.21  knowledge of: 
  5.22     (1) a person who has been diagnosed with active 
  5.23  tuberculosis; 
  5.24     (2) a person who is clinically suspected of having active 
  5.25  tuberculosis; 
  5.26     (3) a person who refuses or fails to submit to a diagnostic 
  5.27  tuberculosis examination when the person is clinically suspected 
  5.28  of having tuberculosis; 
  5.29     (4) a carrier who has refused or failed to initiate or 
  5.30  complete treatment for tuberculosis, including refusal or 
  5.31  failure to take medication for tuberculosis or keep appointments 
  5.32  for directly observed therapy or other treatment of 
  5.33  tuberculosis; or 
  5.34     (5) a person who refuses or fails to follow contagion 
  5.35  precautions for tuberculosis after being instructed on such 
  5.36  precautions. 
  6.1      Subd. 4.  [REPORTING INFORMATION.] The report by a licensed 
  6.2   health professional under subdivision 1 or by any other person 
  6.3   under subdivision 2 shall contain the following information, to 
  6.4   the extent known:  
  6.5      (1) the reported person's name, address or last known 
  6.6   location, and telephone number; 
  6.7      (2) the date and specific circumstances of the reported 
  6.8   event; 
  6.9      (3) the reporting person's name, title, address, and 
  6.10  telephone number; and 
  6.11     (4) any other information relevant to the person's case of 
  6.12  tuberculosis, including why the carrier is an endangerment to 
  6.13  the public health or to the health of any other person. 
  6.14     Subd. 5.  [IMMUNITY FOR REPORTING.] A licensed health 
  6.15  professional who is required to report under subdivision 1 or 
  6.16  any other person who voluntarily reports in good faith under 
  6.17  subdivision 2 shall be immune from liability in any civil, 
  6.18  administrative, disciplinary, or criminal action for reporting 
  6.19  under this section. 
  6.20     Subd. 6.  [FALSIFIED REPORTS.] A person who knowingly or 
  6.21  recklessly makes a false report under this section shall be 
  6.22  liable in a civil suit for any actual damages suffered by the 
  6.23  person or persons so reported and for any punitive damages 
  6.24  awarded by a court or jury. 
  6.25     Subd. 7.  [WAIVER OF PRIVILEGE.] A person who is the 
  6.26  subject of a report under subdivision 1 shall be deemed to have 
  6.27  waived any privilege created in section 595.02, subdivision 1, 
  6.28  paragraphs (d), (e), (g), and (i), with respect to any 
  6.29  information provided under this section. 
  6.30     Sec. 4.  [144.4803] [ISSUANCE OF HEALTH DIRECTIVE.] 
  6.31     Subdivision 1.  [STANDING.] Only the commissioner, or a 
  6.32  board of health with express delegated authority from the 
  6.33  commissioner, may issue a health directive under this section. 
  6.34     Subd. 2.  [GROUNDS FOR HEALTH DIRECTIVE.] If the 
  6.35  commissioner has reasonable cause to believe that a carrier is 
  6.36  an endangerment to the public health or to the health of any 
  7.1   other person, and the commissioner seeks to remove a carrier to 
  7.2   a hospital or other treatment facility, the commissioner shall, 
  7.3   prior to obtaining an apprehend and hold order under section 
  7.4   144.4804, subdivision 2, first issue a health directive to the 
  7.5   carrier. 
  7.6      Subd. 3.  [CONTENTS OF HEALTH DIRECTIVE.] The health 
  7.7   directive must be in writing and must clearly state the relief 
  7.8   sought and notify the carrier that failure to timely comply with 
  7.9   the directive is grounds for the commissioner to seek an order 
  7.10  for a peace officer to apprehend and hold the carrier, transport 
  7.11  the carrier to a designated treatment facility, and detain the 
  7.12  carrier up to 72 hours, exclusive of Saturdays, Sundays, and 
  7.13  legal holidays.  In urgent circumstances, the health directive 
  7.14  may be an oral statement. 
  7.15     Subd. 4.  [SERVICE OF HEALTH DIRECTIVE.] The health 
  7.16  directive must be served in the same manner as a summons and 
  7.17  complaint under the Minnesota Rules of Civil Procedure 4.03(a) 
  7.18  and 4.05, except if urgent circumstances require the health 
  7.19  directive to be issued orally. 
  7.20     Sec. 5.  [144.4804] [EMERGENCY HOLD.] 
  7.21     Subdivision 1.  [NOTICE OF OBLIGATION TO ISOLATE.] If the 
  7.22  carrier is in a hospital or other treatment facility, the 
  7.23  commissioner, or a carrier's attending physician after obtaining 
  7.24  approval from the commissioner, may issue a notice of obligation 
  7.25  to isolate to a hospital or other treatment facility if the 
  7.26  commissioner or attending physician has reasonable cause to 
  7.27  believe that a carrier is a potential endangerment to the public 
  7.28  health or to the health of any other person.  Upon receiving the 
  7.29  notice, the hospital or other treatment facility shall 
  7.30  immediately take all reasonable precautions to prevent the 
  7.31  carrier from leaving the carrier's room or the facility, 
  7.32  including the use of guards or locks, if appropriate. 
  7.33     Subd. 2.  [COMMISSIONER'S APPREHEND AND HOLD ORDER.] (a) If 
  7.34  the carrier is not in a hospital or other treatment facility, 
  7.35  and the carrier has failed to comply in a timely manner with a 
  7.36  health directive, the commissioner may apply for an ex parte 
  8.1   court order that directs a peace officer in the jurisdiction of 
  8.2   the location of the carrier to apprehend and hold the carrier, 
  8.3   transport the carrier to a designated treatment facility, and 
  8.4   detain the carrier until the carrier is admitted to the 
  8.5   treatment facility. 
  8.6      (b) If the carrier flees or forcibly resists the officer or 
  8.7   refuses admittance, the officer may use all necessary and lawful 
  8.8   means to apprehend and hold the carrier. 
  8.9      (c) This subdivision is sufficient authority for the peace 
  8.10  officer to carry out the duties specified in this subdivision. 
  8.11     (d) The commissioner shall provide any information and 
  8.12  equipment necessary to protect the peace officer and the peace 
  8.13  officer's agents from becoming exposed to tuberculosis by the 
  8.14  carrier. 
  8.15     Subd. 3.  [DURATION OF DETENTION.] No carrier may be 
  8.16  detained under subdivision 1 or 2 longer than 72 hours, 
  8.17  exclusive of Saturdays, Sundays, and legal holidays, unless the 
  8.18  carrier is served with a health order issued by the court under 
  8.19  section 144.4805 and the court has extended the detention under 
  8.20  subdivision 4. 
  8.21     Subd. 4.  [COURT EXTENSION OF EMERGENCY HOLD.] The 
  8.22  commissioner may apply for a court order on an ex parte basis to 
  8.23  extend the detention of a carrier for an additional 72 hours, 
  8.24  upon an affidavit of the commissioner and service of a health 
  8.25  order upon the carrier.  The court shall order the continued 
  8.26  detention of the carrier for up to 72 hours, exclusive of 
  8.27  Saturdays, Sundays, and legal holidays, if it finds that there 
  8.28  is reasonable cause to believe that the carrier is an 
  8.29  endangerment to the public health or to the health of any other 
  8.30  person. 
  8.31     Subd. 5.  [NOTICE.] A carrier held pursuant to this section 
  8.32  must be notified in writing at the time of detention or 
  8.33  admission to the hospital or other treatment facility that the 
  8.34  carrier cannot be detained longer than 72 hours, exclusive of 
  8.35  Saturdays, Sundays, and legal holidays, unless the carrier is 
  8.36  served with a health order and a court order extending the 
  9.1   detention. 
  9.2      Subd. 6.  [IMMUNITY.] Any peace officer, physician, 
  9.3   hospital, or other treatment facility that acts in good faith 
  9.4   under this section is immune from liability in any civil, 
  9.5   administrative, disciplinary, or criminal action for acting 
  9.6   under this section. 
  9.7      Sec. 6.  [144.4805] [ISSUANCE OF HEALTH ORDER; REQUEST FOR 
  9.8   HEARING; RESPONDENT'S RIGHTS.] 
  9.9      Subdivision 1.  [STANDING.] Only the commissioner, or a 
  9.10  board of health with express delegated authority from the 
  9.11  commissioner, may issue a health order under this section. 
  9.12     Subd. 2.  [GROUNDS FOR HEALTH ORDER.] Whenever the 
  9.13  commissioner has reasonable cause to believe that a carrier is 
  9.14  an endangerment to the public health or to the health of any 
  9.15  other person, the commissioner may issue any order the 
  9.16  commissioner deems necessary to protect the public health or the 
  9.17  health of any other person.  The commissioner may petition the 
  9.18  court for enforcement of the order.  In any court proceeding for 
  9.19  enforcement, the commissioner shall demonstrate the 
  9.20  particularized circumstances constituting the necessity for an 
  9.21  order.  The order may also be issued to a physician, other 
  9.22  licensed health professional, hospital, or other treatment 
  9.23  facility to detain the carrier and to provide certified copies 
  9.24  to the commissioner of all medical data relating to the 
  9.25  carrier's tuberculosis and to why the carrier is an endangerment 
  9.26  to the public or to the health of any other person. 
  9.27     Subd. 3.  [CONTENTS OF HEALTH ORDER.] The order issued by 
  9.28  the commissioner shall include: 
  9.29     (1) a citation to this section as the legal authority under 
  9.30  which the order is issued; 
  9.31     (2) a summary of medical evidence or facts upon which the 
  9.32  respondent is alleged to be a carrier; 
  9.33     (3) a description of the alleged conduct of the carrier 
  9.34  which constitutes an endangerment to the public health or to the 
  9.35  health of any other person; 
  9.36     (4) a description of less restrictive alternatives that the 
 10.1   commissioner considered and rejected, together with the reasons 
 10.2   for the rejection, or a description of less restrictive 
 10.3   alternatives that the commissioner used and that were 
 10.4   unsuccessful; 
 10.5      (5) the remedy or relief sought; and 
 10.6      (6) a notice advising the respondent that: 
 10.7      (i) the respondent has the right to request a hearing; 
 10.8      (ii) the respondent has the right to appear at the hearing; 
 10.9      (iii) the respondent has the right to present and 
 10.10  cross-examine witnesses at the hearing; 
 10.11     (iv) the carrier has the right to court-appointed counsel; 
 10.12     (v) the carrier has the right to the assistance of an 
 10.13  interpreter; and 
 10.14     (vi) the court may authorize the detention of the carrier 
 10.15  for up to 60 days, or until a final hearing is held, whichever 
 10.16  is sooner. 
 10.17     Subd. 4.  [RIGHT TO COUNSEL.] The carrier has the right to 
 10.18  court-appointed counsel in any proceeding under sections 144.480 
 10.19  to 144.4811 after the health order is issued under this section. 
 10.20  The counsel must be paid for by the county in which the carrier 
 10.21  resides, except to the extent that the court finds that the 
 10.22  carrier is financially able to pay for counsel's services. 
 10.23     Subd. 5.  [RIGHT TO INTERPRETER.] The respondent has the 
 10.24  right to the assistance of an interpreter in any proceeding 
 10.25  under sections 144.480 to 144.4811 after a health order is 
 10.26  issued under this section. 
 10.27     Subd. 6.  [SERVICE OF ORDER.] A health order shall be 
 10.28  served in the same manner as a summons and complaint under the 
 10.29  Minnesota Rules of Civil Procedure 4.03(a) and 4.05 and shall 
 10.30  contain the items listed in subdivision 3. 
 10.31     Sec. 7.  [144.4806] [REMEDIES AND RELIEF UNDER HEALTH 
 10.32  ORDER.] 
 10.33     A health order by the commissioner may include, but need 
 10.34  not be limited to: 
 10.35     (1) requiring a carrier who is an endangerment to the 
 10.36  public health or to the health of any other person to be 
 11.1   detained in or removed to a hospital or other treatment facility 
 11.2   until the carrier has submitted to a diagnostic examination for 
 11.3   tuberculosis and has obtained the results of the examination; 
 11.4      (2) requiring a carrier who is an endangerment to the 
 11.5   public health or to the health of any other person to be 
 11.6   detained in or removed to a hospital or other treatment facility 
 11.7   until the carrier has completed a course of treatment for 
 11.8   tuberculosis prescribed by a physician that is reasonable 
 11.9   according to currently accepted standards of medical practice; 
 11.10     (3) requiring a carrier who is an endangerment to the 
 11.11  public health or to the health of any other person to complete a 
 11.12  course of treatment for tuberculosis prescribed by a physician 
 11.13  that is reasonable according to currently accepted standards of 
 11.14  medical practice and, if necessary, to follow contagion 
 11.15  precautions for tuberculosis; 
 11.16     (4) requiring a carrier who is an endangerment to the 
 11.17  public health or to the health of any other person to follow a 
 11.18  course of directly observed therapy prescribed by a physician 
 11.19  that is reasonable according to currently accepted standards of 
 11.20  medical practice; 
 11.21     (5) excluding a carrier who is an endangerment to the 
 11.22  public health or to the health of any other person from the 
 11.23  carrier's place of work or school, or from other premises if the 
 11.24  commissioner determines that exclusion is necessary because 
 11.25  contagion precautions for tuberculosis cannot be maintained in a 
 11.26  manner adequate to protect others from being exposed to 
 11.27  tuberculosis; 
 11.28     (6) requiring a licensed health professional, hospital, or 
 11.29  other treatment facility to provide to the commissioner 
 11.30  certified copies of all medical and epidemiological data 
 11.31  relevant to the carrier's tuberculosis and relating to why the 
 11.32  carrier is an endangerment to the public health or to the health 
 11.33  of any other person; and 
 11.34     (7) requiring the diagnostic examination for tuberculosis 
 11.35  of other persons in the carrier's household, workplace, and 
 11.36  school, or other persons in close contact with the carrier if 
 12.1   the commissioner has reasonable cause to believe that the other 
 12.2   persons may have active tuberculosis or may have been exposed to 
 12.3   tuberculosis.  
 12.4      Sec. 8.  [144.4807] [PRELIMINARY HEARING.] 
 12.5      Subdivision 1.  [GROUNDS FOR HEARING.] The commissioner, or 
 12.6   a board of health with express delegated authority from the 
 12.7   commissioner, may petition the court for a preliminary hearing 
 12.8   to enforce a health order.  A respondent may petition the court 
 12.9   for relief from the health order.  The petition must be filed in 
 12.10  the district court for relief from the health order.  The 
 12.11  petition must be filed in the district court in the county in 
 12.12  which the respondent resides. 
 12.13     Subd. 2.  [NOTICE OF HEARING.] The notice of the 
 12.14  preliminary hearing shall contain the following information: 
 12.15     (1) the time, date, and place of the hearing; 
 12.16     (2) the respondent's right to appear at the hearing; 
 12.17     (3) the respondent's right to present and cross-examine 
 12.18  witnesses; 
 12.19     (4) the carrier's right to court-appointed counsel; 
 12.20     (5) the carrier's right to the assistance of an 
 12.21  interpreter; and 
 12.22     (6) the court may authorize the detention of the carrier 
 12.23  for up to 60 days, or until a final hearing is held, whichever 
 12.24  is sooner. 
 12.25     Subd. 3.  [HEARING.] The preliminary hearing is governed by 
 12.26  section 144.4808, excluding subdivision 3. 
 12.27     Subd. 4.  [RELIEF.] If the court finds by clear and 
 12.28  convincing evidence that the carrier is an endangerment to the 
 12.29  public health or to the health of any other person, the court 
 12.30  shall order the relief sought in the health order.  No carrier 
 12.31  may be detained more than 60 days under this section without a 
 12.32  subsequent court order.  A carrier who has been ordered to be 
 12.33  detained may petition the court for a final hearing, which must 
 12.34  be held within 21 days of the date of the filing of the petition.
 12.35     Sec. 9.  [144.4808] [FINAL HEARING.] 
 12.36     Subdivision 1.  [GROUNDS FOR HEARING.] If the court at the 
 13.1   preliminary hearing has ordered a carrier to be detained, the 
 13.2   carrier may petition the court for a final hearing.  The hearing 
 13.3   must be held within 21 days of the date the petition is filed 
 13.4   with the court and notice of the hearing is served on the 
 13.5   commissioner. 
 13.6      Subd. 2.  [HEARING ROOM IN HOSPITAL.] The hospital or other 
 13.7   treatment facility in which the carrier is sought to be detained 
 13.8   or to which the carrier is sought to be removed shall make 
 13.9   reasonable accommodations to provide a room where the hearing 
 13.10  may be held which minimizes the risk of exposing those persons 
 13.11  attending the hearing to tuberculosis.  If a room is not 
 13.12  available at the hospital or treatment facility, the court may 
 13.13  designate another location for the hearing. 
 13.14     Subd. 3.  [STANDARD OF PROOF.] If the health order requires 
 13.15  the carrier to submit to a diagnostic examination for 
 13.16  tuberculosis, it is sufficient for the commissioner to prove 
 13.17  that there is reasonable cause to believe that the carrier is an 
 13.18  endangerment to the public health or the health of any other 
 13.19  person.  In all other instances, the commissioner must prove the 
 13.20  allegations in the health order by clear and convincing evidence.
 13.21     Subd. 4.  [RULES OF EVIDENCE.] The court shall admit all 
 13.22  reliable relevant evidence.  Medical and epidemiological data 
 13.23  must be admitted if it otherwise conforms with section 145.31, 
 13.24  chapter 600, Minnesota Rules of Evidence 803(6), or other 
 13.25  statutes or rules that permit reliable evidence to be admitted 
 13.26  in civil cases.  The court may rely on medical and 
 13.27  epidemiological data if it finds that physicians and other 
 13.28  licensed health professionals rely on the data in the regular 
 13.29  course of providing health care and treatment. 
 13.30     Subd. 5.  [DUTY TO COMMUNICATE PRIOR TO HEARING.] The 
 13.31  commissioner or the commissioner's agent and the respondent and 
 13.32  the respondent's counsel shall make every effort to communicate 
 13.33  prior to any hearing to stipulate as to undisputed facts, 
 13.34  witnesses, and exhibits. 
 13.35     Subd. 6.  [FAILURE TO APPEAR AT HEARING.] If the respondent 
 13.36  fails to appear at the hearing without prior court approval, the 
 14.1   hearing may proceed without the respondent and the court may 
 14.2   make its determination on the basis of all reliable evidence 
 14.3   submitted at the hearing. 
 14.4      Subd. 7.  [RIGHT TO APPEAL.] The commissioner or respondent 
 14.5   may appeal the decision of the district court.  The court of 
 14.6   appeals shall hear the appeal within 60 days after service of 
 14.7   the notice of appeal. 
 14.8      Subd. 8.  [RIGHT OF COMMISSIONER TO ISSUE SUBSEQUENT 
 14.9   ORDER.] Notwithstanding any ruling by the district court, the 
 14.10  commissioner may issue a subsequent order if the commissioner 
 14.11  has reasonable cause to believe that an order is necessary based 
 14.12  on additional facts not known or present at the time of the 
 14.13  district court hearing. 
 14.14     Sec. 10.  [144.4809] [PERIODIC REVIEW AND RELEASE FROM 
 14.15  DETENTION.] 
 14.16     Subdivision 1.  [PERIODIC REVIEW.] If the carrier has been 
 14.17  detained in a hospital or other treatment facility pursuant to a 
 14.18  court order, the commissioner shall submit a report to the 
 14.19  court, the carrier and the carrier's counsel within 90 days of 
 14.20  the date of the court-ordered detention and every 90 days after 
 14.21  that time, until the carrier is released.  The report must state 
 14.22  the treatment the carrier has been receiving, whether the 
 14.23  carrier has been cured or made noninfectious, and a 
 14.24  determination of whether the carrier will be released or 
 14.25  continue to be detained.  If the carrier contests the 
 14.26  commissioner's determination for continued detention, the 
 14.27  carrier may request a hearing.  The hearing on continued 
 14.28  detention is governed by section 144.4808. 
 14.29     Subd. 2.  [DETENTION BASED ON ORDER TO COMPEL EXAMINATION.] 
 14.30  A carrier who has been detained in a hospital or treatment 
 14.31  facility under a health order or a judicial order to compel the 
 14.32  carrier to submit to a diagnostic tuberculosis examination shall 
 14.33  be released only after: 
 14.34     (1) a medical determination has been made that the carrier 
 14.35  does not have active tuberculosis; or 
 14.36     (2) a medical determination has been made that the carrier 
 15.1   has active tuberculosis, but the commissioner determines that 
 15.2   the carrier is not an endangerment to the public health or to 
 15.3   the health of any other person. 
 15.4      Subd. 3.  [DETENTION BASED ON ENDANGERMENT.] A carrier who 
 15.5   has been detained in a hospital or treatment facility under a 
 15.6   health order or judicial order because the carrier was an 
 15.7   endangerment to the public health or to the health of any other 
 15.8   person shall be released only after:  
 15.9      (1) a medical determination has been made that the carrier 
 15.10  has been cured; or 
 15.11     (2) the commissioner determines that the carrier is no 
 15.12  longer an endangerment to the public health or to the health of 
 15.13  any other person. 
 15.14     Sec. 11.  [144.4810] [COSTS OF CARE.] 
 15.15     The costs incurred by the hospital and other providers of 
 15.16  services to treat the carrier must be borne by the carrier, the 
 15.17  carrier's health plan, or by the state through the public 
 15.18  assistance programs.  If the carrier cannot pay the full cost of 
 15.19  care, or the carrier does not have private health insurance 
 15.20  coverage, or the carrier is not eligible for any of the public 
 15.21  assistance programs, the carrier shall apply for financial 
 15.22  assistance with the aid of the county.  For persons not 
 15.23  otherwise eligible for public assistance, the commissioner of 
 15.24  human services shall determine what, if any, costs the carrier 
 15.25  is responsible for paying, and may waive eligibility 
 15.26  requirements for general assistance medical care described in 
 15.27  section 256D.03, subdivision 3.  If the commissioner waives 
 15.28  eligibility requirements, payments shall be made at the general 
 15.29  assistance medical care rate. 
 15.30     Sec. 12.  [144.4811] [DATA PRIVACY.] 
 15.31     Subdivision 1.  [NONPUBLIC DATA.] Data contained in a 
 15.32  health order are classified as protected nonpublic data under 
 15.33  section 13.02, subdivision 13, in the case of data not on 
 15.34  individuals, and private data under section 13.02, subdivision 
 15.35  12, in the case of data on individuals.  Investigative data 
 15.36  shall have the classification accorded it under section 13.39. 
 16.1      Subd. 2.  [PROTECTIVE ORDER.] Once a judicial action is 
 16.2   commenced, any party may seek a protective order to protect the 
 16.3   disclosure of portions of the court record identifying 
 16.4   individuals or entities. 
 16.5      Subd. 3.  [RECORDS RETENTION.] A records retention schedule 
 16.6   for records developed under sections 144.480 to 144.4811 shall 
 16.7   be established pursuant to section 138.17, subdivision 7. 
 16.8      Sec. 13.  [APPROPRIATION.] 
 16.9      $44,000 is appropriated from the general fund to the 
 16.10  commissioner of human services for the fiscal year ending June 
 16.11  30, 1997, for the purpose of covering the cost of care under 
 16.12  section 11.