HF 2108

1st Engrossment - 79th Legislature (1995 - 1996) Posted on 12/15/2009 12:00am

  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.  [144.419] [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 144.419 to 
  1.14  144.4199 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 144.419 to 144.4199 
  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.  [144.4191] [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.  [PHYSICIAN.] "Physician" means any person who is 
  4.27  licensed by the Minnesota board of medical practice to practice 
  4.28  medicine. 
  4.29     Subd. 14.  [RESPONDENT.] "Respondent" means any person or 
  4.30  group of persons to whom the commissioner has issued a health 
  4.31  order. 
  4.32     Sec. 3.  [144.4192] [REPORTING RELATING TO TUBERCULOSIS.] 
  4.33     Subdivision 1.  [MANDATORY REPORTING.] A licensed health 
  4.34  professional must report to the commissioner within 24 hours of 
  4.35  obtaining knowledge of a reportable person as specified in 
  4.36  subdivision 3. 
  5.1      Subd. 2.  [VOLUNTARY REPORTING.] Any person other than a 
  5.2   licensed health professional may report to the commissioner if 
  5.3   that person has knowledge of a reportable person as specified in 
  5.4   subdivision 3, or has reasonable cause to believe that a person 
  5.5   should be reported under subdivision 3. 
  5.6      Subd. 3.  [REPORTABLE PERSONS.] A licensed health 
  5.7   professional must report to the commissioner after obtaining 
  5.8   knowledge of: 
  5.9      (1) a person who has been diagnosed with active 
  5.10  tuberculosis; 
  5.11     (2) a person who is clinically suspected of having active 
  5.12  tuberculosis; 
  5.13     (3) a person who refuses or fails to submit to a diagnostic 
  5.14  tuberculosis examination when the person is clinically suspected 
  5.15  of having tuberculosis; 
  5.16     (4) a carrier who has refused or failed to initiate or 
  5.17  complete treatment for tuberculosis, including refusal or 
  5.18  failure to take medication for tuberculosis or keep appointments 
  5.19  for directly observed therapy or other treatment of 
  5.20  tuberculosis; or 
  5.21     (5) a person who refuses or fails to follow contagion 
  5.22  precautions for tuberculosis after being instructed on such 
  5.23  precautions. 
  5.24     Subd. 4.  [REPORTING INFORMATION.] The report by a licensed 
  5.25  health professional under subdivision 1 or by a health or human 
  5.26  services person under subdivision 2 shall contain the following 
  5.27  information, to the extent known:  
  5.28     (1) the reported person's name, address or last known 
  5.29  location, and telephone number; 
  5.30     (2) the date and specific circumstances of the reported 
  5.31  event; 
  5.32     (3) the reporting person's name, title, address, and 
  5.33  telephone number; and 
  5.34     (4) any other information relevant to the person's case of 
  5.35  tuberculosis, including why the carrier is an endangerment to 
  5.36  the public health or to the health of any other person. 
  6.1      Subd. 5.  [IMMUNITY FOR REPORTING.] A licensed health 
  6.2   professional who is required to report under subdivision 1 or 
  6.3   any other person who voluntarily reports in good faith under 
  6.4   subdivision 2 shall be immune from liability in any civil, 
  6.5   administrative, disciplinary, or criminal action for reporting 
  6.6   under this section. 
  6.7      Subd. 6.  [FALSIFIED REPORTS.] A person who knowingly or 
  6.8   recklessly makes a false report under this section shall be 
  6.9   liable in a civil suit for any actual damages suffered by the 
  6.10  person or persons so reported and for any punitive damages 
  6.11  awarded by a court or jury. 
  6.12     Subd. 7.  [WAIVER OF PRIVILEGE.] A person who is the 
  6.13  subject of a report under subdivision 1 shall be deemed to have 
  6.14  waived any privilege created in section 595.02, subdivision 1, 
  6.15  paragraphs (d), (e), (g), and (i), with respect to any 
  6.16  information provided under this section. 
  6.17     Sec. 4.  [144.4193] [NOTICE OF OBLIGATION TO ISOLATE.] 
  6.18     Subdivision 1.  [ISSUANCE OF NOTICE.] The commissioner, or 
  6.19  a carrier's attending physician after obtaining approval from 
  6.20  the commissioner, may issue a notice of obligation to isolate to 
  6.21  a hospital or other treatment facility if the commissioner or 
  6.22  attending physician has reasonable cause to believe that a 
  6.23  carrier is a potential endangerment to the public health or to 
  6.24  the health of any other person.  Upon receiving the notice, the 
  6.25  hospital or other treatment facility shall immediately take all 
  6.26  reasonable precautions to prevent the carrier from leaving the 
  6.27  carrier's room or the facility, including use of guards or 
  6.28  locks, if appropriate. 
  6.29     Subd. 2.  [DURATION OF DETENTION.] No carrier may be 
  6.30  detained under this section longer than 72 hours, exclusive of 
  6.31  Saturdays, Sundays, and legal holidays, unless the carrier is 
  6.32  served with a health order issued by the commissioner under 
  6.33  section 144.4194.  No carrier may be released prior to the 
  6.34  expiration of 72 hours unless the court has received a written 
  6.35  petition for release and held a summary hearing regarding the 
  6.36  release.  The petition for release must include the name of the 
  7.1   carrier being held, the name and location of the hospital or 
  7.2   treatment facility holding the carrier, the basis for the 
  7.3   detention and any written documentation in support of the 
  7.4   detention, and a statement as to why the detention is improper.  
  7.5   The summary hearing on the release must be held as soon as 
  7.6   practicable and may be conducted by means of a telephone 
  7.7   conference call or other similar method by which the 
  7.8   participants are able to simultaneously hear each other.  The 
  7.9   court may release the carrier, if the court determines at the 
  7.10  summary hearing that the carrier is not an endangerment to the 
  7.11  public health or to the health of any other person.  The court 
  7.12  shall issue written findings in support of the release. 
  7.13     Subd. 3.  [IMMUNITY.] Any physician, hospital, or other 
  7.14  treatment facility which acts in good faith under this section 
  7.15  shall be immune from liability in any civil, administrative, 
  7.16  disciplinary, or criminal action for acting under this section.  
  7.17     Subd 4.  [COSTS OF ISOLATION.] The cost incurred by the 
  7.18  hospital to isolate the carrier under this section shall be 
  7.19  deemed a cost of care and shall be borne by the carrier and the 
  7.20  county in which the carrier resides as provided in section 
  7.21  144.4198. 
  7.22     Sec. 5.  [144.4194] [ISSUANCE OF HEALTH ORDER; REQUEST FOR 
  7.23  HEARING; RESPONDENT'S RIGHTS.] 
  7.24     Subdivision 1.  [STANDING.] Only the commissioner, or a 
  7.25  board of health with express delegated authority from the 
  7.26  commissioner, may issue a health order under this section. 
  7.27     Subd. 2.  [GROUNDS FOR HEALTH ORDER.] Whenever the 
  7.28  commissioner has reasonable cause to believe that a carrier is 
  7.29  an endangerment to the public health or to the health of any 
  7.30  other person, the commissioner may issue any order the 
  7.31  commissioner deems necessary to protect the public health or the 
  7.32  health of any other person.  The commissioner may petition the 
  7.33  court for enforcement of the order.  In any court proceeding for 
  7.34  enforcement, the commissioner shall demonstrate the 
  7.35  particularized circumstances constituting the necessity for an 
  7.36  order.  The order may be issued to a group of persons if 
  8.1   necessary.  The order may also be issued to a physician, other 
  8.2   licensed health professional, hospital, or other treatment 
  8.3   facility to detain the carrier and to provide certified copies 
  8.4   to the commissioner of all medical data relating to the 
  8.5   carrier's tuberculosis and to why the carrier is an endangerment 
  8.6   to the public or to the health of any other person. 
  8.7      Subd. 3.  [CONTENTS OF HEALTH ORDER.] The order issued by 
  8.8   the commissioner shall include: 
  8.9      (1) a citation to this section as the legal authority under 
  8.10  which the order is issued; 
  8.11     (2) if the respondent is a carrier, a summary of medical 
  8.12  evidence or facts upon which the respondent is alleged to be a 
  8.13  carrier; 
  8.14     (3) if the respondent is a carrier, a description of the 
  8.15  alleged conduct of the carrier which constitutes an endangerment 
  8.16  to the public health or to the health of any other person; 
  8.17     (4) if the respondent is a carrier, a description of less 
  8.18  restrictive alternatives that the commissioner considered and 
  8.19  rejected, together with the reasons for the rejection, or a 
  8.20  description of less restrictive alternatives that the 
  8.21  commissioner used and that were unsuccessful; 
  8.22     (5) the remedy or relief sought; and 
  8.23     (6) a notice advising the respondent that: 
  8.24     (i) the respondent has the right to request a hearing; 
  8.25     (ii) the respondent has the right to appear at the hearing; 
  8.26     (iii) the respondent has the right to present and 
  8.27  cross-examine witnesses at the hearing; 
  8.28     (iv) the respondent has the right to be represented by 
  8.29  counsel, and if the respondent is a carrier and is unable to pay 
  8.30  for counsel, the right to court-appointed counsel; 
  8.31     (v) the respondent has the right to the assistance of an 
  8.32  interpreter; 
  8.33     (vi) within 72 hours of the respondent's request for a 
  8.34  hearing, exclusive of Saturdays, Sundays, and legal holidays, 
  8.35  the commissioner must petition the court for a hearing, which 
  8.36  hearing must be held within five days of the commissioner's 
  9.1   petition for a hearing is filed, exclusive of Saturdays, 
  9.2   Sundays, and legal holidays; 
  9.3      (vii) if the respondent is a carrier, the carrier must 
  9.4   contact the person designated on the health order at the 
  9.5   telephone number stated on the health order in order to request 
  9.6   release from detention or to request the services of an 
  9.7   attorney; 
  9.8      (viii) if the respondent is a carrier, in no event shall 
  9.9   the carrier be detained more than 60 days without a court order; 
  9.10  and 
  9.11     (ix) if the respondent is a carrier, the court may order 
  9.12  the carrier to be committed to a hospital or treatment facility 
  9.13  for as long as is necessary to render the carrier cured. 
  9.14     Subd. 4.  [RESPONDENT'S REQUEST FOR HEARING.] If the 
  9.15  respondent makes a request to the commissioner for a hearing, 
  9.16  the commissioner shall petition the court for a hearing and for 
  9.17  a court order authorizing the relief in the health order.  The 
  9.18  commissioner shall make the petition to the court under section 
  9.19  144.4196 within 72 hours of receipt of the respondent's request 
  9.20  for a hearing, exclusive of Saturdays, Sundays, and legal 
  9.21  holidays.  
  9.22     Subd. 5.  [DETENTION OF CARRIER.] A carrier shall not be 
  9.23  detained for more than 60 days without a court order authorizing 
  9.24  the detention.  If the carrier requests a hearing, the carrier 
  9.25  may not be detained for more than five business days from the 
  9.26  day the commissioner files a petition for a hearing. 
  9.27     Subd. 6.  [RIGHT TO COUNSEL.] The respondent has the right 
  9.28  to be represented by counsel in any proceeding under sections 
  9.29  144.419 to 144.4199 after the health order is issued under this 
  9.30  section.  If the respondent is a carrier and is unable to pay 
  9.31  for counsel, the carrier has the right to counsel appointed by 
  9.32  the court and paid for by the county in which the carrier 
  9.33  resides, except to the extent that the court finds that the 
  9.34  carrier is financially able to pay for counsel's services. 
  9.35     Subd. 7.  [RIGHT TO INTERPRETER.] The respondent has the 
  9.36  right to the assistance of an interpreter in any proceeding 
 10.1   under sections 144.419 to 144.4199 after a health order is 
 10.2   issued under this section. 
 10.3      Subd. 8.  [SERVICE OF ORDER.] A health order shall be 
 10.4   served in the same manner as a summons and complaint under the 
 10.5   Minnesota Rules of Civil Procedure 4.03(a) and 4.05 and shall 
 10.6   contain the items listed in subdivision 3. 
 10.7      Subd. 9.  [SHERIFF'S ASSISTANCE.] The sheriff shall, upon 
 10.8   request by the commissioner, provide the assistance necessary to 
 10.9   enforce the commissioner's health order, including, but not 
 10.10  limited to, serving the order, apprehending and holding the 
 10.11  carrier, transporting the carrier to the facility designated in 
 10.12  the health order, and detaining the carrier until the carrier is 
 10.13  placed at the designated facility.  The department shall provide 
 10.14  any information and equipment necessary to protect the sheriff 
 10.15  and the sheriff's agents from becoming exposed to tuberculosis 
 10.16  by the carrier.  This subdivision shall be sufficient authority 
 10.17  for a peace or health officer to carry out the duties specified 
 10.18  herein. 
 10.19     Sec. 6.  [144.4195] [REMEDIES AND RELIEF UNDER HEALTH 
 10.20  ORDER.] 
 10.21     A health order by the commissioner may include, but need 
 10.22  not be limited to: 
 10.23     (1) requiring a carrier who is an endangerment to the 
 10.24  public health or to the health of any other person to be 
 10.25  detained in or removed to a hospital or other treatment facility 
 10.26  until the carrier has submitted to a diagnostic examination for 
 10.27  tuberculosis and has obtained the results of the examination; 
 10.28     (2) requiring a carrier who is an endangerment to the 
 10.29  public health or to the health of any other person to be 
 10.30  detained in or removed to a hospital or other treatment facility 
 10.31  until the carrier has completed a course of treatment for 
 10.32  tuberculosis prescribed by a physician that is reasonable 
 10.33  according to currently accepted standards of medical practice; 
 10.34     (3) requiring a carrier who is an endangerment to the 
 10.35  public health or to the health of any other person to complete a 
 10.36  course of treatment for tuberculosis prescribed by a physician 
 11.1   that is reasonable according to currently accepted standards of 
 11.2   medical practice and, if necessary, to follow contagion 
 11.3   precautions for tuberculosis; 
 11.4      (4) requiring a carrier who is an endangerment to the 
 11.5   public health or to the health of any other person to follow a 
 11.6   course of directly observed therapy prescribed by a physician 
 11.7   that is reasonable according to currently accepted standards of 
 11.8   medical practice; 
 11.9      (5) excluding a carrier who is an endangerment to the 
 11.10  public health or to the health of any other person from the 
 11.11  carrier's place of work or school, or from other premises if the 
 11.12  commissioner determines that exclusion is necessary because 
 11.13  contagion precautions for tuberculosis cannot be maintained in a 
 11.14  manner adequate to protect others from being exposed to 
 11.15  tuberculosis; 
 11.16     (6) requiring a licensed health professional, hospital, or 
 11.17  other treatment facility to provide to the commissioner 
 11.18  certified copies of all medical and epidemiological data 
 11.19  relevant to the carrier's tuberculosis and relating to why the 
 11.20  carrier is an endangerment to the public health or to the health 
 11.21  of any other person; and 
 11.22     (7) requiring the diagnostic examination for tuberculosis 
 11.23  of other persons in the carrier's household, workplace, and 
 11.24  school, or other persons in close contact with the carrier if 
 11.25  the commissioner has reasonable cause to believe that the other 
 11.26  persons may have active tuberculosis or may have been exposed to 
 11.27  tuberculosis.  
 11.28     Sec. 7.  [144.4196] [JUDICIAL ACTION.] 
 11.29     Subdivision 1.  [COMMENCEMENT OF LEGAL ACTION; NOTICE OF 
 11.30  HEARING.] The commissioner or a board of health with express 
 11.31  delegated authority from the commissioner shall, upon request by 
 11.32  the respondent under section 144.4194, or may, if the respondent 
 11.33  does not request a hearing, commence legal action against a 
 11.34  respondent to enforce a health order by filing a petition with 
 11.35  the district court in the county in which the respondent resides 
 11.36  and serving the respondent with the petition and a notice of 
 12.1   hearing containing the following information: 
 12.2      (1) the time, date, and place of the hearing; 
 12.3      (2) the respondent's right to appear at the hearing; 
 12.4      (3) the respondent's right to present and cross-examine 
 12.5   witnesses; 
 12.6      (4) the respondent's right to be represented by counsel, 
 12.7   and if the respondent is a carrier and is unable to pay for 
 12.8   counsel, the right to court-appointed counsel; and 
 12.9      (5) the respondent's right to the assistance of an 
 12.10  interpreter. 
 12.11     Subd. 2.  [HEARING ROOM IN HOSPITAL.] The hospital or other 
 12.12  treatment facility in which the carrier is sought to be detained 
 12.13  or to which the carrier is sought to be removed shall make 
 12.14  reasonable accommodations to provide a room where the hearing 
 12.15  may be held which minimizes the risk of exposing those persons 
 12.16  attending the hearing to tuberculosis.  If a room is not 
 12.17  available at the hospital or treatment facility, the court may 
 12.18  designate another location for the hearing. 
 12.19     Subd. 3.  [STANDARD OF PROOF.] The commissioner must prove 
 12.20  the allegations in the health order by clear and convincing 
 12.21  evidence. 
 12.22     Subd. 4.  [RULES OF EVIDENCE.] The court shall admit all 
 12.23  reliable relevant evidence.  Medical and epidemiological data 
 12.24  must be admitted if it otherwise conforms with section 145.31, 
 12.25  chapter 600, Minnesota Rules of Evidence 803(6), or other 
 12.26  statutes or rules that permit reliable evidence to be admitted 
 12.27  in civil cases.  The court may rely on medical and 
 12.28  epidemiological data if it finds that physicians and other 
 12.29  licensed health professionals rely on the data in the regular 
 12.30  course of providing health care and treatment. 
 12.31     Subd. 5.  [DUTY TO COMMUNICATE PRIOR TO HEARING.] The 
 12.32  commissioner or the commissioner's agent and the respondent and 
 12.33  the respondent's counsel shall make every effort to communicate 
 12.34  prior to any hearing to stipulate as to undisputed facts, 
 12.35  witnesses, and exhibits.  A party who refuses in bad faith to 
 12.36  communicate with the other party may be subject to sanctions or 
 13.1   other appropriate action by the court. 
 13.2      Subd. 6.  [FAILURE TO APPEAR AT HEARING.] If the respondent 
 13.3   fails to appear at the hearing without prior court approval, the 
 13.4   hearing may proceed without the respondent and the court may 
 13.5   make its determination on the basis of all reliable evidence 
 13.6   submitted at the hearing. 
 13.7      Subd. 7.  [RIGHT TO APPEAL.] The commissioner or respondent 
 13.8   may appeal the decision of the district court.  The court of 
 13.9   appeals shall hear the appeal within 90 days after service of 
 13.10  the notice of appeal.  The district court's determination shall 
 13.11  remain in full force and effect until a decision has been 
 13.12  rendered by the court of appeals. 
 13.13     Subd. 8.  [RIGHT OF COMMISSIONER TO ISSUE SUBSEQUENT 
 13.14  ORDER.] Notwithstanding any ruling by the district court, the 
 13.15  commissioner may issue a subsequent order if the commissioner 
 13.16  has reasonable cause to believe that an order is necessary based 
 13.17  on additional facts not known or present at the time of the 
 13.18  district court hearing. 
 13.19     Sec. 8.  [144.4197] [RELEASE FROM DETENTION AND 
 13.20  COMMITMENT.] 
 13.21     Subdivision 1.  [DETENTION BASED ON ORDER TO COMPEL 
 13.22  EXAMINATION.] A carrier who has been detained in a hospital or 
 13.23  treatment facility under a health order or a judicial order to 
 13.24  compel the carrier to submit to a diagnostic tuberculosis 
 13.25  examination shall be released only after: 
 13.26     (1) a medical determination has been made that the carrier 
 13.27  does not have active tuberculosis; or 
 13.28     (2) a medical determination has been made that the carrier 
 13.29  has active tuberculosis, but the carrier has demonstrated to the 
 13.30  commissioner that the carrier is not an endangerment to the 
 13.31  public health or to the health of any other person. 
 13.32     Subd. 2.  [DETENTION BASED ON ENDANGERMENT.] A carrier who 
 13.33  has been detained in a hospital or treatment facility under a 
 13.34  health order or judicial order because the carrier was an 
 13.35  endangerment to the public health or to the health of any other 
 13.36  person shall be released only after:  
 14.1      (1) a medical determination has been made that the carrier 
 14.2   has been cured; or 
 14.3      (2) the carrier has demonstrated to the commissioner that 
 14.4   the carrier is no longer an endangerment to the public health or 
 14.5   to the health of any other person. 
 14.6      Sec. 9.  [144.4198] [COSTS OF CARE.] 
 14.7      The court shall determine what portion of the cost of care 
 14.8   or treatment ordered by the court, if any, the carrier can pay.  
 14.9   The carrier shall provide the court with documents or other 
 14.10  information necessary to determine financial ability.  If the 
 14.11  carrier cannot pay the full cost, the balance must be paid by 
 14.12  the county in which the carrier resides.  If the carrier 
 14.13  provides inaccurate or misleading information, or later becomes 
 14.14  able to pay the full cost of care or any portion thereof, the 
 14.15  carrier shall be liable to the county for that portion of the 
 14.16  county-paid costs that the carrier is determined to be able to 
 14.17  pay. 
 14.18     Sec. 10.  [144.4199] [DATA PRIVACY.] 
 14.19     Subdivision 1.  [NONPUBLIC DATA.] Data contained in a 
 14.20  health order are classified as protected nonpublic data under 
 14.21  section 13.02, subdivision 13, in the case of data not on 
 14.22  individuals, and private data under section 13.02, subdivision 
 14.23  12, in the case of data on individuals.  Investigative data 
 14.24  shall have the classification accorded it under section 13.39. 
 14.25     Subd. 2.  [PROTECTIVE ORDER.] Once a judicial action is 
 14.26  commenced, any party may seek a protective order to protect the 
 14.27  disclosure of portions of the court record identifying 
 14.28  individuals or entities. 
 14.29     Subd. 3.  [RECORDS RETENTION.] A records retention schedule 
 14.30  for records developed under sections 144.419 to 144.4199 shall 
 14.31  be established pursuant to section 138.17, subdivision 7.