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             proposing coding for new law in Minnesota Statutes, 
  1.8             chapter 144. 
  1.9   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.10     Section 1.  [144.4801] [TITLE.] 
  1.11     Sections 144.4801 to 144.4815 may be cited as the 
  1.12  "tuberculosis health threat act." 
  1.13     Sec. 2.  [144.4802] [INTERPRETATION OF STATUTE.] 
  1.14     Sections 144.4801 to 144.4815 shall be interpreted 
  1.15  liberally to effectuate the purpose of the tuberculosis health 
  1.16  threat act, which is to: 
  1.17     (1) enable the commissioner to take all necessary measures 
  1.18  to prevent and control the spread of tuberculosis, a potentially 
  1.19  fatal, costly, and largely preventable disease; and 
  1.20     (2) reduce the time and public resources expended in a full 
  1.21  trial by requiring prompt communication between the parties in 
  1.22  order to facilitate settlement. 
  1.23     Sec. 3.  [144.4803] [AUTHORITY.] 
  1.24     Subdivision 1.  [AUTHORITY TO COMMIT.] Under the powers and 
  1.25  duties assigned to the commissioner in this chapter and chapter 
  1.26  145, the commissioner may proceed under sections 144.4801 to 
  1.27  144.4815 whenever the commissioner has probable cause to believe 
  2.1   that a person who has active tuberculosis or is clinically 
  2.2   suspected of having active tuberculosis is an endangerment to 
  2.3   the public health.  
  2.4      Subd. 2.  [PREEMPTION.] Sections 144.4801 to 144.4813 
  2.5   preempt and supersede sections 144.4171 to 144.4186, 144.443, 
  2.6   and 144.444 with regard to a tuberculosis health threat.  
  2.7   Nothing in sections 144.4801 to 144.4815 shall be construed to 
  2.8   restrict the commissioner's authority to seek injunctive relief 
  2.9   pursuant to section 145.075, or any other relief under other 
  2.10  statutes or at common law. 
  2.11     Sec. 4.  [144.4804] [DEFINITIONS.] 
  2.12     Subdivision 1.  [ACTIVE TUBERCULOSIS.] "Active tuberculosis"
  2.13  includes infectious and noninfectious tuberculosis and means: 
  2.14     (1) a condition evidenced by a positive culture for 
  2.15  mycobacterium tuberculosis taken from a pulmonary or laryngeal 
  2.16  source; 
  2.17     (2) a condition evidenced by a positive culture for 
  2.18  mycobacterium tuberculosis taken from an extrapulmonary source 
  2.19  when there is clinical evidence such as a positive skin test for 
  2.20  tuberculosis infection, coughing, sputum production, fever, or 
  2.21  other symptoms compatible with pulmonary tuberculosis; or 
  2.22     (3) a condition in which clinical specimens are not 
  2.23  available for culture, but there is radiographic evidence of 
  2.24  tuberculosis such as an abnormal chest x-ray, and clinical 
  2.25  evidence such as a positive skin test for tuberculosis 
  2.26  infection, coughing, sputum production, fever, or other symptoms 
  2.27  compatible with pulmonary tuberculosis, that lead a physician to 
  2.28  reasonably diagnose active tuberculosis according to currently 
  2.29  accepted standards of medical practice and to initiate treatment 
  2.30  for tuberculosis. 
  2.31     Subd. 2.  [BOARD OF HEALTH.] "Board of health" means an 
  2.32  administrative authority established under section 145A.03. 
  2.33     Subd. 3.  [CARRIER.] "Carrier" means a person who has 
  2.34  active tuberculosis or is clinically suspected of having active 
  2.35  tuberculosis. 
  2.36     Subd. 4.  [CLINICALLY SUSPECTED OF HAVING ACTIVE 
  3.1   TUBERCULOSIS.] "Clinically suspected of having active 
  3.2   tuberculosis" means presenting a reasonable possibility of 
  3.3   having active tuberculosis based upon epidemiologic, clinical, 
  3.4   or radiographic evidence, laboratory test results, or other 
  3.5   reliable evidence as determined by a physician using currently 
  3.6   accepted standards of medical practice. 
  3.7      Subd. 5.  [COMMISSIONER.] "Commissioner" means the 
  3.8   commissioner of health. 
  3.9      Subd. 6.  [CONTAGION PRECAUTIONS FOR TUBERCULOSIS.] 
  3.10  "Contagion precautions for tuberculosis" means those measures 
  3.11  under currently accepted standards of medical practice that 
  3.12  prevent a carrier from exposing others to tuberculosis. 
  3.13     Subd. 7.  [CURRENTLY ACCEPTED STANDARDS OF MEDICAL 
  3.14  PRACTICE.] "Currently accepted standards of medical practice" 
  3.15  means: 
  3.16     (1) for diagnosis of tuberculosis, those standards 
  3.17  contained in "Diagnostic Standards and Classification of 
  3.18  Tuberculosis 1990," American Review of Respiratory Disease, 
  3.19  volume 142, number 3, pages 725 to 735 (September 1990), 
  3.20  published by the American Lung Association.  The standards are 
  3.21  incorporated by reference; 
  3.22     (2) for treatment of tuberculosis, those standards 
  3.23  contained in "Treatment of Tuberculosis and Tuberculosis 
  3.24  Infection in Adults and Children," American Journal of 
  3.25  Respiratory and Critical Care Medicine, volume 149, pages 1359 
  3.26  to 1374 (1994), published by the American Thoracic Society.  The 
  3.27  standards are incorporated by reference; or 
  3.28     (3) for contagion precautions for tuberculosis, those 
  3.29  standards contained in "Guidelines for Preventing Transmission 
  3.30  of Mycobacterium Tuberculosis in Health Care Facilities," 
  3.31  Morbidity and Mortality Weekly Report, number RR-13 (October 28, 
  3.32  1994), published by the United States Centers for Disease 
  3.33  Control and Prevention.  The standards are incorporated by 
  3.34  reference. 
  3.35     Subd. 8.  [DEPARTMENT.] "Department" means the department 
  3.36  of health. 
  4.1      Subd. 9.  [DIRECTLY OBSERVED THERAPY.] "Directly observed 
  4.2   therapy" means a method for ensuring compliance with medication 
  4.3   directions in which a licensed health professional or designee 
  4.4   observes a person ingesting prescribed medications or 
  4.5   administers the prescribed medication to the person. 
  4.6      Subd. 10.  [DISEASE PREVENTION OFFICER.] "Disease 
  4.7   prevention officer" means a designated agent of the 
  4.8   commissioner, or a designated agent of a board of health that 
  4.9   has express delegated authority from the commissioner to proceed 
  4.10  under sections 144.4801 to 144.4815. 
  4.11     Subd. 11.  [ENDANGERMENT TO THE PUBLIC HEALTH.] 
  4.12  "Endangerment to the public health" means a carrier who may 
  4.13  transmit tuberculosis to another person or persons because the 
  4.14  carrier has engaged or is engaging in any of the following 
  4.15  conduct: 
  4.16     (1) refuses or fails to submit to a diagnostic tuberculosis 
  4.17  examination that is ordered by a physician and is reasonable 
  4.18  according to currently accepted standards of medical practice; 
  4.19     (2) refuses or fails to initiate or complete treatment for 
  4.20  tuberculosis that is prescribed by a physician and is reasonable 
  4.21  according to currently accepted standards of medical practice; 
  4.22     (3) refuses or fails to keep appointments for treatment of 
  4.23  tuberculosis; 
  4.24     (4) refuses or fails to provide the commissioner, upon 
  4.25  request, with evidence showing the completion of a course of 
  4.26  treatment for tuberculosis that is prescribed by a physician and 
  4.27  is reasonable according to currently accepted standards of 
  4.28  medical practice; 
  4.29     (5) refuses or fails to initiate or complete a course of 
  4.30  directly observed therapy that is prescribed by a physician and 
  4.31  is reasonable according to currently accepted standards of 
  4.32  medical practice; 
  4.33     (6) misses at least 20 percent of scheduled appointments 
  4.34  for directly observed therapy, or misses at least two 
  4.35  consecutive appointments for directly observed therapy; 
  4.36     (7) refuses or fails to follow contagion precautions for 
  5.1   tuberculosis after being instructed on the precautions; 
  5.2      (8) based on evidence of the carrier's past or present 
  5.3   behavior, may not complete a course of treatment for 
  5.4   tuberculosis that is reasonable according to currently accepted 
  5.5   standards of medical practice; or 
  5.6      (9) may expose other persons to tuberculosis who are at 
  5.7   risk of converting from a negative to a positive skin test for 
  5.8   tuberculosis infection, based on epidemiological, medical, or 
  5.9   other reliable evidence. 
  5.10     Subd. 12.  [EPIDEMIOLOGICAL DATA OR EPIDEMIOLOGICAL 
  5.11  EVIDENCE.] "Epidemiological data" or "epidemiological evidence" 
  5.12  means data or evidence relating to the occurrence, distribution, 
  5.13  clinical characteristics, and control of disease within a group 
  5.14  of people or within a specified population. 
  5.15     Subd. 13.  [HEALTH ORDER.] "Health order" means an order 
  5.16  issued by the commissioner or a board of health with express 
  5.17  delegated authority from the commissioner. 
  5.18     Subd. 14.  [INFECTIOUS TUBERCULOSIS.] "Infectious 
  5.19  tuberculosis" means the stage of tuberculosis where 
  5.20  mycobacterial organisms are capable of being expelled into the 
  5.21  air by a person, as determined by laboratory, epidemiological, 
  5.22  or clinical findings. 
  5.23     Subd. 15.  [ISOLATION.] "Isolation" means placing a carrier 
  5.24  who has infectious tuberculosis in:  (1) a hospital or other 
  5.25  treatment facility; (2) the carrier's residence or current 
  5.26  location; or (3) any other place approved by the commissioner, 
  5.27  provided that the place of isolation prevents or limits the 
  5.28  transmission of the infectious tuberculosis agent to others 
  5.29  during the period of infectiousness. 
  5.30     Subd. 16.  [LICENSED HEALTH PROFESSIONAL.] "Licensed health 
  5.31  professional" means a person licensed by one of the 
  5.32  health-related licensing boards listed in section 214.01, 
  5.33  subdivision 2. 
  5.34     Subd. 17.  [PEACE OFFICER.] "Peace officer" means an 
  5.35  employee or an elected or appointed official of a political 
  5.36  subdivision or law enforcement agency who is licensed by the 
  6.1   board of peace officer standards and training, is charged with 
  6.2   the prevention and detection of crime and the enforcement of the 
  6.3   general criminal laws of the state, and has the full power of 
  6.4   arrest.  "Peace officer" includes an officer of the Minnesota 
  6.5   state patrol. 
  6.6      Subd. 18.  [PHYSICIAN.] "Physician" means a person who is 
  6.7   licensed by the board of medical practice under chapter 147 to 
  6.8   practice medicine. 
  6.9      Subd. 19.  [RESPONDENT.] "Respondent" means a person or 
  6.10  group of persons to whom the commissioner has issued a health 
  6.11  order, excluding the carrier. 
  6.12     Subd. 20.  [TREATMENT FACILITY.] "Treatment facility" means 
  6.13  a hospital or other treatment provider that is qualified to 
  6.14  provide care, treatment, and appropriate contagion precautions 
  6.15  for tuberculosis. 
  6.16     Sec. 5.  [144.4805] [REPORTING RELATING TO TUBERCULOSIS.] 
  6.17     Subdivision 1.  [MANDATORY REPORTING.] A licensed health 
  6.18  professional must report to the commissioner or a disease 
  6.19  prevention officer within 24 hours of obtaining knowledge of a 
  6.20  reportable person as specified in subdivision 3, unless the 
  6.21  licensed health professional is aware that the facts causing the 
  6.22  person to be a reportable person have previously been reported.  
  6.23  Within 72 hours of making a report, excluding Saturdays, 
  6.24  Sundays, and legal holidays, the licensed health professional 
  6.25  shall submit to the commissioner or to the disease prevention 
  6.26  officer a certified copy of the reportable person's medical 
  6.27  records.  A reporting facility may designate an infection 
  6.28  control practitioner to make reports and to send certified 
  6.29  medical records under this subdivision. 
  6.30     Subd. 2.  [VOLUNTARY REPORTING.] A person other than a 
  6.31  licensed health professional may report to the commissioner or a 
  6.32  disease prevention officer if the person has knowledge of a 
  6.33  reportable person as specified in subdivision 3, or has probable 
  6.34  cause to believe that a person should be reported under 
  6.35  subdivision 3. 
  6.36     Subd. 3.  [REPORTABLE PERSONS.] A licensed health 
  7.1   professional must report to the commissioner or a disease 
  7.2   prevention officer if the licensed health professional has 
  7.3   knowledge of: 
  7.4      (1) a person who has been diagnosed with active 
  7.5   tuberculosis; 
  7.6      (2) a person who is clinically suspected of having active 
  7.7   tuberculosis; 
  7.8      (3) a person who refuses or fails to submit to a diagnostic 
  7.9   tuberculosis examination when the person is clinically suspected 
  7.10  of having tuberculosis; 
  7.11     (4) a carrier who has refused or failed to initiate or 
  7.12  complete treatment for tuberculosis, including refusal or 
  7.13  failure to take medication for tuberculosis or keep appointments 
  7.14  for directly observed therapy or other treatment of 
  7.15  tuberculosis; or 
  7.16     (5) a person who refuses or fails to follow contagion 
  7.17  precautions for tuberculosis after being instructed on the 
  7.18  precautions. 
  7.19     Subd. 4.  [REPORTING INFORMATION.] The report by a licensed 
  7.20  health professional under subdivision 1 or by a person under 
  7.21  subdivision 2 shall contain the following information, to the 
  7.22  extent known: 
  7.23     (1) the reportable person's name, birth date, address or 
  7.24  last known location, and telephone number; 
  7.25     (2) the date and specific circumstances that cause the 
  7.26  person to be a reportable person; 
  7.27     (3) the reporting person's name, title, address, and 
  7.28  telephone number; and 
  7.29     (4) any other information relevant to the reportable 
  7.30  person's case of tuberculosis. 
  7.31     Subd. 5.  [IMMUNITY FOR REPORTING.] A licensed health 
  7.32  professional who is required to report under subdivision 1 or a 
  7.33  person who voluntarily reports in good faith under subdivision 2 
  7.34  shall be immune from liability in a civil, administrative, 
  7.35  disciplinary, or criminal action for reporting under this 
  7.36  section. 
  8.1      Subd. 6.  [FALSIFIED REPORTS.] A person who knowingly or 
  8.2   recklessly makes a false report under this section shall be 
  8.3   liable in a civil suit for actual damages suffered by the person 
  8.4   or persons reported and for punitive damages awarded by a court 
  8.5   or jury. 
  8.6      Subd. 7.  [WAIVER OF PRIVILEGE.] A person who is the 
  8.7   subject of a report under subdivision 1 shall be deemed to have 
  8.8   waived any privilege created in section 595.02, subdivision 1, 
  8.9   paragraphs (d), (e), (g), (i), (j), and (k), with respect to any 
  8.10  information provided under this section. 
  8.11     Sec. 6.  [144.4806] [ISSUANCE OF HEALTH ORDER; RIGHTS OF 
  8.12  CARRIER AND RESPONDENT.] 
  8.13     Subdivision 1.  [AUTHORITY.] Only the commissioner, or a 
  8.14  board of health with express delegated authority from the 
  8.15  commissioner, may issue a health order under this section. 
  8.16     Subd. 2.  [GROUNDS FOR HEALTH ORDER.] Whenever the 
  8.17  commissioner has probable cause to believe that a carrier is an 
  8.18  endangerment to the public health, the commissioner may issue a 
  8.19  health order that the commissioner deems necessary to protect 
  8.20  the public health.  The health order shall provide for the least 
  8.21  restrictive alternative to achieve the desired purpose of 
  8.22  preventing and controlling the spread of tuberculosis.  The 
  8.23  commissioner may petition the court for enforcement of the 
  8.24  health order.  In a court proceeding for enforcement of the 
  8.25  health order, the commissioner shall demonstrate the 
  8.26  particularized circumstances constituting the necessity for the 
  8.27  health order.  The health order may be issued to any person, 
  8.28  including a carrier, physician, licensed health professional, 
  8.29  treatment facility, disease prevention officer, or peace 
  8.30  officer.  The health order may be in the form of a subpoena by 
  8.31  the commissioner for certified medical records relating to the 
  8.32  carrier's tuberculosis and status as an endangerment to the 
  8.33  public health. 
  8.34     Subd. 3.  [CONTENTS OF HEALTH ORDER.] A health order shall 
  8.35  include: 
  8.36     (1) a citation to this section as the legal authority under 
  9.1   which the order is issued; 
  9.2      (2) a summary of evidence upon which the person is alleged 
  9.3   to be a carrier; 
  9.4      (3) a description of the alleged conduct of the carrier 
  9.5   that makes the carrier an endangerment to the public health; 
  9.6      (4) a description of less restrictive alternatives that the 
  9.7   commissioner considered and rejected, together with the reasons 
  9.8   for the rejection, or a description of less restrictive 
  9.9   alternatives that the commissioner used and that were 
  9.10  unsuccessful; 
  9.11     (5) the preventive measure ordered; and 
  9.12     (6) a notice advising the carrier or respondent that: 
  9.13     (i) a hearing will be held if the carrier or respondent 
  9.14  petitions the court for a hearing, or if the commissioner 
  9.15  determines that the carrier has not complied with the health 
  9.16  order; 
  9.17     (ii) the carrier or respondent has the right to appear at 
  9.18  the hearing; 
  9.19     (iii) the carrier or respondent has the right to present 
  9.20  and cross-examine witnesses at the hearing; 
  9.21     (iv) the carrier or respondent has the right to assistance 
  9.22  of counsel in a proceeding under sections 144.4801 to 144.4815, 
  9.23  and if the carrier is indigent, the carrier has the right to 
  9.24  court-appointed counsel; and 
  9.25     (v) the carrier or respondent has the right to the 
  9.26  assistance of an interpreter in a proceeding under sections 
  9.27  144.4801 to 144.4815. 
  9.28     Subd. 4.  [RIGHT TO COUNSEL.] (a) The carrier or respondent 
  9.29  has the right to counsel in any proceeding under sections 
  9.30  144.4801 to 144.4815.  If the carrier does not have counsel and 
  9.31  the court determines that the carrier is indigent, the court 
  9.32  shall appoint counsel for the carrier.  If the health order is 
  9.33  an emergency hold health order under section 144.4808, counsel 
  9.34  must be appointed at the time the commissioner seeks a judicial 
  9.35  extension of the 72-hour hold under section 144.4808, 
  9.36  subdivision 4.  For all other health orders, the court shall 
 10.1   appoint counsel for the carrier at least 72 hours, excluding 
 10.2   Saturdays, Sundays, and legal holidays, prior to the time of the 
 10.3   preliminary hearing under section 144.4810.  The cost of counsel 
 10.4   must be paid for by the county in which the carrier resides, 
 10.5   except to the extent that the court finds that the carrier is 
 10.6   financially able to pay for counsel's services. 
 10.7      (b) Immediately upon being notified of the name and address 
 10.8   of counsel for the carrier, the commissioner shall forward to 
 10.9   the carrier and the carrier's counsel the following: 
 10.10     (i) a copy of the health order; 
 10.11     (ii) a certified copy of relevant portions of the carrier's 
 10.12  medical records; and 
 10.13     (iii) the name and address of the licensed health 
 10.14  professional, including the carrier's attending physician or 
 10.15  nurse, or the public health physician or nurse whom the 
 10.16  commissioner intends to have testify at the preliminary hearing, 
 10.17  and a summary of the witness' testimony, including a copy of the 
 10.18  witness' affidavit, if any. 
 10.19     Subd. 5.  [DUTY TO COMMUNICATE.] The commissioner's counsel 
 10.20  and the carrier's counsel shall make every effort to communicate 
 10.21  prior to any hearing and to stipulate as to undisputed facts, 
 10.22  witnesses, and exhibits. 
 10.23     Subd. 6.  [RIGHT TO INTERPRETER.] The carrier or respondent 
 10.24  has the right to the assistance of an interpreter in a 
 10.25  proceeding under sections 144.4801 to 144.4815. 
 10.26     Subd. 7.  [SERVICE OF ORDER.] A health order may be served 
 10.27  by a disease prevention officer or peace officer. 
 10.28     Sec. 7.  [144.4807] [PREVENTIVE MEASURES UNDER HEALTH 
 10.29  ORDER.] 
 10.30     A health order may include, but need not be limited to, an 
 10.31  order: 
 10.32     (1) requiring the carrier's attending physician or 
 10.33  treatment facility to isolate and detain the carrier for 
 10.34  treatment or for a diagnostic examination for tuberculosis, 
 10.35  pursuant to section 144.4808, subdivision 1, if the carrier is 
 10.36  an endangerment to the public health and is in a treatment 
 11.1   facility; 
 11.2      (2) requiring a disease prevention officer or a peace 
 11.3   officer to apprehend and transport the carrier to a treatment 
 11.4   facility for treatment or for a diagnostic examination for 
 11.5   tuberculosis, or to apprehend and isolate the carrier, pursuant 
 11.6   to section 144.4808, subdivision 2, if the carrier is an 
 11.7   endangerment to the public health; 
 11.8      (3) requiring a carrier who is an endangerment to the 
 11.9   public health to submit to diagnostic examination for 
 11.10  tuberculosis and to remain in the treatment facility until the 
 11.11  commissioner receives the results of the examination; 
 11.12     (4) requiring a carrier who is an endangerment to the 
 11.13  public health to remain in or present at a treatment facility 
 11.14  until the carrier has completed a course of treatment for 
 11.15  tuberculosis that is prescribed by a physician and is reasonable 
 11.16  according to currently accepted standards of medical practice; 
 11.17     (5) requiring a carrier who is an endangerment to the 
 11.18  public health to complete a course of treatment for tuberculosis 
 11.19  that is prescribed by a physician and is reasonable according to 
 11.20  currently accepted standards of medical practice and, if 
 11.21  necessary, to follow contagion precautions for tuberculosis; 
 11.22     (6) requiring a carrier who is an endangerment to the 
 11.23  public health to follow a course of directly observed therapy 
 11.24  that is prescribed by a physician and is reasonable according to 
 11.25  currently accepted standards of medical practice; 
 11.26     (7) excluding a carrier who is an endangerment to the 
 11.27  public health from the carrier's place of work or school, or 
 11.28  from other premises if the commissioner determines that 
 11.29  exclusion is necessary because contagion precautions for 
 11.30  tuberculosis cannot be maintained in a manner adequate to 
 11.31  protect others from being exposed to tuberculosis; 
 11.32     (8) requiring a licensed health professional or treatment 
 11.33  facility to provide to the commissioner certified copies of all 
 11.34  medical and epidemiological data relevant to the carrier's 
 11.35  tuberculosis and status as an endangerment to the public health; 
 11.36     (9) requiring the diagnostic examination for tuberculosis 
 12.1   of other persons in the carrier's household, workplace, or 
 12.2   school, or other persons in close contact with the carrier if 
 12.3   the commissioner has probable cause to believe that the persons 
 12.4   may have active tuberculosis or may have been exposed to 
 12.5   tuberculosis and are at risk of converting from a negative to a 
 12.6   positive skin test for tuberculosis infection based on 
 12.7   epidemiological, medical, or other reliable evidence; or 
 12.8      (10) requiring a carrier or other persons to follow 
 12.9   contagion precautions for tuberculosis. 
 12.10     Sec. 8.  [144.4808] [EMERGENCY HOLD HEALTH ORDER.] 
 12.11     Subdivision 1.  [NOTICE OF OBLIGATION TO ISOLATE OR 
 12.12  EXAMINE.] (a) If the carrier is in a treatment facility, the 
 12.13  commissioner or a carrier's attending physician, after obtaining 
 12.14  approval from the commissioner, may issue a notice of obligation 
 12.15  to isolate to a treatment facility if the commissioner or 
 12.16  attending physician has probable cause to believe that a carrier 
 12.17  is an endangerment to the public health.  
 12.18     (b) If the carrier is clinically suspected of having active 
 12.19  tuberculosis, the commissioner may issue a notice of obligation 
 12.20  to examine to the carrier's attending physician to conduct a 
 12.21  diagnostic examination for tuberculosis on the carrier. 
 12.22     (c) Upon receiving a notice of obligation to isolate or 
 12.23  notice of obligation to examine, a treatment facility shall 
 12.24  immediately take all reasonable precautions to prevent the 
 12.25  carrier from exposing other persons to tuberculosis, including 
 12.26  the use of guards or locks, if appropriate. 
 12.27     (d) When issuing a notice of obligation to isolate or 
 12.28  examine to the carrier's physician or a treatment facility, the 
 12.29  commissioner shall simultaneously serve a health order on the 
 12.30  carrier ordering the carrier to remain in the treatment facility 
 12.31  for treatment or examination. 
 12.32     Subd. 2.  [COMMISSIONER'S APPREHEND AND HOLD ORDER.] (a) If 
 12.33  the carrier is not in a treatment facility, the commissioner 
 12.34  may, without a court order, issue an apprehend and hold order to 
 12.35  a disease prevention officer, a peace officer, or both if the 
 12.36  commissioner has probable cause to believe that:  
 13.1      (1) the carrier is an endangerment to the public health and 
 13.2   is in imminent danger of exposing another person or persons to 
 13.3   tuberculosis; or 
 13.4      (2) the carrier is an endangerment to the public health and 
 13.5   may flee or become unlocatable.  
 13.6      (b) An apprehend and hold order may require a disease 
 13.7   prevention officer, a peace officer, or both to:  
 13.8      (1) apprehend and transport the carrier to a designated 
 13.9   treatment facility, and detain the carrier until the carrier is 
 13.10  admitted to the treatment facility; or 
 13.11     (2) apprehend and isolate the carrier. 
 13.12     (c) If the carrier flees or forcibly resists the disease 
 13.13  prevention officer or peace officer, the officer may use all 
 13.14  necessary and lawful means to apprehend, hold, transport, or 
 13.15  isolate the carrier. 
 13.16     (d) This subdivision is authority for the disease 
 13.17  prevention officer or peace officer to carry out the duties 
 13.18  specified in this subdivision. 
 13.19     (e) The commissioner shall provide any information and 
 13.20  equipment necessary to protect the disease prevention officer or 
 13.21  peace officer or the agents thereof from becoming exposed to 
 13.22  tuberculosis by the carrier. 
 13.23     Subd. 3.  [DURATION OF DETENTION.] No carrier may be 
 13.24  detained under subdivision 1 or 2 longer than 72 hours, 
 13.25  excluding Saturdays, Sundays, and legal holidays, unless the 
 13.26  court issues an order authorizing continued detention of the 
 13.27  carrier pursuant to subdivision 4.  A carrier may not be 
 13.28  released prior to the expiration of 72 hours, excluding 
 13.29  Saturdays, Sundays, and legal holidays, without the express 
 13.30  consent of the commissioner. 
 13.31     Subd. 4.  [EXTENSION OF 72-HOUR HOLD.] Upon an ex parte 
 13.32  application of the commissioner, the court may extend the 
 13.33  initial 72-hour hold under subdivision 3 by up to 72 hours, 
 13.34  excluding Saturdays, Sundays, and legal holidays, if the court 
 13.35  finds that there is probable cause to believe that the carrier 
 13.36  is an endangerment to the public health.  The court may find 
 14.1   probable cause based solely upon an affidavit or sworn testimony 
 14.2   by telephone from a licensed health professional, including the 
 14.3   carrier's attending physician or nurse, or a public health 
 14.4   physician or nurse, attesting to the reason the carrier 
 14.5   constitutes an endangerment to the public health. 
 14.6      Subd. 5.  [IMMUNITY.] A disease prevention officer, peace 
 14.7   officer, physician, or treatment facility that acts in good 
 14.8   faith under this section is immune from liability in a civil, 
 14.9   administrative, disciplinary, or criminal action for acting 
 14.10  under this section. 
 14.11     Sec. 9.  [144.4810] [PRELIMINARY HEARING.] 
 14.12     Subdivision 1.  [GROUNDS FOR HEARING.] A party may petition 
 14.13  the court for an order for enforcement of or relief from a 
 14.14  health order or judicial order.  If the carrier seeks release 
 14.15  from detention ordered under section 144.4808, subdivision 4, 
 14.16  the preliminary hearing shall be held at the expiration of the 
 14.17  court-extended hold issued under section 144.4808, subdivision 4.
 14.18     Subd. 2.  [PETITION FOR PRELIMINARY HEARING.] The 
 14.19  petitioning party shall serve on the commissioner and file in 
 14.20  the probate division of the district court of the county in 
 14.21  which the carrier or respondent resides a petition and notice of 
 14.22  preliminary hearing.  The court shall hold a preliminary hearing 
 14.23  no later than 15 days from the date of the filing and service of 
 14.24  the petition for a preliminary hearing, except as provided under 
 14.25  subdivision 1. 
 14.26     Subd. 3.  [COMMISSIONER'S NOTICE OF HEARING.] If the 
 14.27  commissioner petitions the court to enforce the health order, 
 14.28  the notice of the preliminary hearing shall contain the 
 14.29  following information: 
 14.30     (1) the date, time, and place of the hearing; 
 14.31     (2) the right of the carrier to be represented by counsel 
 14.32  during any proceeding under sections 144.4801 to 144.4815, and 
 14.33  the right to court-appointed counsel if the carrier is indigent; 
 14.34     (3) the right of the carrier or respondent to the 
 14.35  assistance of an interpreter in any proceeding under sections 
 14.36  144.4801 to 144.4815; 
 15.1      (4) the right of the carrier or respondent to appear at the 
 15.2   hearing; 
 15.3      (5) the right of the carrier or respondent to present and 
 15.4   cross-examine witnesses; 
 15.5      (6) a statement of any disputed facts, or a statement of 
 15.6   the nature of any other disputed matter; and 
 15.7      (7) the name and address of any witness that the 
 15.8   petitioning party intends to call to testify at the hearing, and 
 15.9   a brief summary of the witness' testimony. 
 15.10     Subd. 4.  [CARRIER'S OR RESPONDENT'S NOTICE OF HEARING.] If 
 15.11  the carrier or respondent petitions the court for relief from 
 15.12  the health order or court order, the notice of preliminary 
 15.13  hearing shall contain the information in subdivision 3, clauses 
 15.14  (1), (6), and (7). 
 15.15     Subd. 5.  [DUTY TO COMMUNICATE.] (a) At least five days 
 15.16  before the date of the preliminary hearing, the nonpetitioning 
 15.17  party shall respond to the petition for hearing by filing and 
 15.18  serving on the petitioning party:  
 15.19     (1) a statement of any disputed facts, or a statement of 
 15.20  the nature of any other disputed matter; and 
 15.21     (2) the name and address of any witness that the 
 15.22  nonpetitioning party intends to call to testify at the hearing, 
 15.23  and a brief summary of the witness' testimony.  
 15.24     If the carrier seeks release from detention ordered under 
 15.25  section 144.4808, subdivision 4, the commissioner shall file and 
 15.26  serve on the carrier's counsel the items in clauses (1) and (2) 
 15.27  at least 24 hours prior to the preliminary hearing. 
 15.28     (b) At the hearing, the parties shall identify the efforts 
 15.29  they made to resolve the matter prior to the preliminary hearing.
 15.30     Subd. 6.  [HEARING ROOM IN TREATMENT FACILITY.] If the 
 15.31  carrier is infectious, the treatment facility in which the 
 15.32  carrier is sought to be detained or to which the carrier is 
 15.33  sought to be removed shall make reasonable accommodations to 
 15.34  provide a room where the hearing may be held that minimizes the 
 15.35  risk of exposing persons attending the hearing to tuberculosis.  
 15.36  If a room is not available at the treatment facility, the court 
 16.1   may designate another location for the hearing. 
 16.2      Subd. 7.  [STANDARD OF PROOF.] The commissioner must prove 
 16.3   by a preponderance of the evidence that the carrier is an 
 16.4   endangerment to the public health and that the preventive 
 16.5   measure requested is the least restrictive alternative to 
 16.6   prevent and control the spread of tuberculosis by the carrier. 
 16.7      Subd. 8.  [RULES OF EVIDENCE.] The court shall admit all 
 16.8   reliable relevant evidence.  Medical and epidemiological data 
 16.9   must be admitted if it conforms with section 145.31, chapter 
 16.10  600, Minnesota Rules of Evidence, rule 803(6), or other statutes 
 16.11  or rules that permit reliable evidence to be admitted in civil 
 16.12  cases.  The court may rely on medical and epidemiological data, 
 16.13  including hearsay, if it finds that physicians and other 
 16.14  licensed health professionals rely on the data in the regular 
 16.15  course of providing health care and treatment. 
 16.16     Subd. 9.  [SUFFICIENCY OF EVIDENCE.] It shall be a 
 16.17  sufficient basis for the court to order continued confinement of 
 16.18  the carrier or other preventive measures requested by the 
 16.19  commissioner if reliable testimony is provided solely by the 
 16.20  carrier's attending physician or nurse, or a public health 
 16.21  physician or nurse knowledgeable about tuberculosis, or any 
 16.22  other person who alleges that the carrier is an endangerment to 
 16.23  the public health. 
 16.24     Subd. 10.  [FAILURE TO APPEAR AT HEARING.] If the carrier 
 16.25  or respondent fails to appear at the hearing without prior court 
 16.26  approval, the hearing may proceed without the carrier or 
 16.27  respondent and the court may make its determination on the basis 
 16.28  of all reliable evidence submitted at the hearing. 
 16.29     Sec. 10.  [144.4811] [FINAL HEARING.] 
 16.30     Subdivision 1.  [GROUNDS FOR HEARING.] After the 
 16.31  preliminary hearing, the commissioner, carrier, or respondent 
 16.32  may petition the court for relief from or enforcement of the 
 16.33  court order issued pursuant to the preliminary hearing.  The 
 16.34  commissioner may petition the court for additional preventive 
 16.35  measures if the carrier or respondent has not complied with the 
 16.36  court order issued pursuant to the preliminary hearing.  The 
 17.1   petitioning party shall serve and file a petition and notice of 
 17.2   hearing with the probate division of the district court.  The 
 17.3   court shall hold the final hearing no later than 15 days from 
 17.4   the date of the filing and service of the petition for a final 
 17.5   hearing. 
 17.6      Subd. 2.  [NOTICE OF HEARING.] The notice of the final 
 17.7   hearing shall contain the same information as for the 
 17.8   preliminary hearing in section 144.4810, subdivision 3 or 4. 
 17.9      Subd. 3.  [DUTY TO COMMUNICATE.] The parties have a duty to 
 17.10  communicate and exchange information as provided in section 
 17.11  144.4810, subdivision 5. 
 17.12     Subd. 4.  [HEARING ROOM IN HOSPITAL.] The hearing room for 
 17.13  the final hearing shall be governed by section 144.4810, 
 17.14  subdivision 6. 
 17.15     Subd. 5.  [STANDARD OF PROOF.] The commissioner must prove 
 17.16  by clear and convincing evidence that the carrier is an 
 17.17  endangerment to the public health and that the preventive 
 17.18  measure requested is the least restrictive alternative to 
 17.19  prevent and control the spread of tuberculosis by the carrier. 
 17.20     Subd. 6.  [RULES OF EVIDENCE.] The rules of evidence shall 
 17.21  be governed by section 144.4810, subdivision 8. 
 17.22     Subd. 7.  [SUFFICIENCY OF EVIDENCE.] The sufficiency of 
 17.23  evidence shall be governed by section 144.4810, subdivision 9. 
 17.24     Subd. 8.  [FAILURE TO APPEAR AT HEARING.] The failure of 
 17.25  the carrier or respondent to appear at the hearing shall be 
 17.26  governed by section 144.4810, subdivision 10. 
 17.27     Subd. 9.  [RIGHT OF APPEAL.] The commissioner, carrier, or 
 17.28  respondent may appeal the decision of the district court.  The 
 17.29  court of appeals shall hear the appeal within 60 days after 
 17.30  filing and service of the notice of appeal. 
 17.31     Subd. 10.  [RIGHT OF COMMISSIONER TO ISSUE SUBSEQUENT 
 17.32  ORDER.] Notwithstanding any ruling by the district court, the 
 17.33  commissioner may issue a subsequent health order if the 
 17.34  commissioner has probable cause to believe that a health order 
 17.35  is necessary based on additional facts not known or present at 
 17.36  the time of the district court hearing. 
 18.1      Sec. 11.  [144.4812] [PERIODIC REVIEW AND RELEASE FROM 
 18.2   DETENTION.] 
 18.3      Subdivision 1.  [PERIODIC REVIEW.] If the carrier has been 
 18.4   detained in a treatment facility or has been isolated pursuant 
 18.5   to a court order, the commissioner shall submit a report to the 
 18.6   court, the carrier, and the carrier's counsel within 90 days of 
 18.7   the date of the court-ordered detention and every 90 days 
 18.8   thereafter, until the carrier is released.  The report must 
 18.9   state the treatment the carrier receives, whether the carrier is 
 18.10  cured or noninfectious, and whether the carrier will continue to 
 18.11  be detained.  If the carrier contests the commissioner's 
 18.12  determination for continued detention, the carrier may request a 
 18.13  hearing.  The hearing on continued detention is governed by the 
 18.14  provisions for a final hearing under section 144.4811.  This 
 18.15  subdivision does not apply to consent orders or other 
 18.16  confinement that has been voluntarily agreed upon by the parties.
 18.17     Subd. 2.  [CARRIER'S PETITION FOR RELEASE.] If the carrier 
 18.18  is detained in a treatment facility or isolated pursuant to a 
 18.19  court order, the carrier may make a good faith request for 
 18.20  release from confinement prior to the 90-day review under 
 18.21  subdivision 1 by filing a petition and notice of hearing with 
 18.22  the court that ordered the confinement and by serving the 
 18.23  petition and notice on the commissioner.  The hearing on 
 18.24  continued confinement shall be governed by the provisions for a 
 18.25  final hearing under section 144.4811. 
 18.26     Subd. 3.  [RELEASE FROM DETENTION BASED ON ORDER TO COMPEL 
 18.27  EXAMINATION.] A carrier who has been detained in a treatment 
 18.28  facility under a court order to compel the carrier to submit to 
 18.29  a diagnostic tuberculosis examination shall be released only 
 18.30  after: 
 18.31     (1) the commissioner determines that the carrier does not 
 18.32  have active tuberculosis; or 
 18.33     (2) the commissioner determines that the carrier is not an 
 18.34  endangerment to the public health. 
 18.35     Subd. 4.  [RELEASE FROM DETENTION BASED ON ENDANGERMENT.] A 
 18.36  carrier who is detained in a treatment facility or isolated 
 19.1   under a court order because the carrier is an endangerment to 
 19.2   the public health shall be released only after: 
 19.3      (1) the commissioner determines that the carrier is cured; 
 19.4   or 
 19.5      (2) the commissioner determines that the carrier is no 
 19.6   longer an endangerment to the public health. 
 19.7      Sec. 12.  [144.4813] [COSTS OF CARE.] 
 19.8      The costs incurred by the treatment facility and other 
 19.9   providers of services to diagnose or treat the carrier, 
 19.10  including the costs of isolation under sections 144.4807 to 
 19.11  144.4810, must be borne by the carrier, the carrier's health 
 19.12  plan, or public programs.  Those costs associated with the 
 19.13  specifications of the health order, including the cost of 
 19.14  isolation and detention, shall be considered medically necessary 
 19.15  for the purpose of insurance coverage.  A health plan may direct 
 19.16  the implementation of the care required by the health order and 
 19.17  shall pay at the contracted rate of payment, which shall be 
 19.18  considered payment in full.  Inpatient hospital services 
 19.19  required by the health order and covered by medical assistance 
 19.20  or general assistance medical care shall not be billable to any 
 19.21  other governmental entity.  If the carrier cannot pay for 
 19.22  treatment, and the carrier does not have public or private 
 19.23  health insurance coverage, the carrier shall apply for financial 
 19.24  assistance with the aid of the county.  For persons not 
 19.25  otherwise eligible for public assistance, the commissioner of 
 19.26  human services shall determine what, if any, costs the carrier 
 19.27  shall pay.  The commissioner of human services may waive 
 19.28  eligibility requirements for general assistance medical care 
 19.29  described in section 256D.03, subdivision 3, and shall make 
 19.30  payments at the general assistance medical care rate. 
 19.31     Sec. 13.  [144.4814] [DATA PRIVACY.] 
 19.32     Subdivision 1.  [NONPUBLIC DATA.] Data contained in the 
 19.33  health order are classified as health data under section 13.38 
 19.34  in the case of data on individuals, and as nonpublic data under 
 19.35  section 13.02, subdivision 9, in the case of data not on 
 19.36  individuals.  Other data collected by the commissioner as part 
 20.1   of an investigation of a carrier under sections 144.4801 to 
 20.2   144.4815 are classified as investigative data under section 
 20.3   13.39 in the case of data on individuals, and as protected 
 20.4   nonpublic data under section 13.02, subdivision 13, in the case 
 20.5   of data not on individuals. 
 20.6      Subd. 2.  [PROTECTIVE ORDER.] After a judicial action is 
 20.7   commenced, a party may seek a protective order to protect the 
 20.8   disclosure of portions of the court record identifying 
 20.9   individuals or entities. 
 20.10     Subd. 3.  [RECORDS RETENTION.] A records retention schedule 
 20.11  for records developed under sections 144.4801 to 144.4814 shall 
 20.12  be established pursuant to section 138.17, subdivision 7. 
 20.13     Sec. 14.  [144.4815] [RULEMAKING AUTHORITY.] 
 20.14     The commissioner may adopt rules that are necessary to 
 20.15  implement sections 144.4801 to 144.4815.