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Office of the Revisor of Statutes

Key: (1) language to be deleted (2) new language

                             CHAPTER 164-S.F.No. 97 
                  An act relating to health; providing for the isolation 
                  and detention of persons with active tuberculosis who 
                  pose an endangerment to the public health; 
                  establishing standards and procedures for isolation 
                  and detention; requiring reporting by licensed health 
                  professionals; modifying tuberculosis screening 
                  requirements; amending Minnesota Statutes 1996, 
                  section 144.445, subdivisions 1 and 3; proposing 
                  coding for new law in Minnesota Statutes, chapter 144. 
        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
           Section 1.  Minnesota Statutes 1996, section 144.445, 
        subdivision 1, is amended to read: 
           Subdivision 1.  [SCREENING OF INMATES.] All persons 
        detained or confined for seven 14 consecutive days or more in 
        facilities operated, licensed, or inspected by the department of 
        corrections shall be screened for tuberculosis with either a 
        Mantoux test or a chest roentgenogram (X-ray) as consistent with 
        screening and follow-up practices recommended by the United 
        States Public Health Service or the department of health, as 
        determined by the commissioner of health.  Administration of the 
        Mantoux test or chest roentgenogram (X-ray) must take place on 
        or before the seventh 14th day of detention or confinement. 
           Sec. 2.  Minnesota Statutes 1996, section 144.445, 
        subdivision 3, is amended to read: 
           Subd. 3.  [EXCEPTIONS.] Subdivisions 1 and 2 do not apply 
        to: 
           (1) a person who is detained or confined in a juvenile 
        temporary holdover facility, provided that the person has no 
        symptoms suggestive of tuberculosis, evidence of a new exposure 
        to active tuberculosis, or other health condition that may 
        require a chest roentgenogram (X-ray) be performed to rule out 
        active tuberculosis; 
           (2) a person who is detained or confined in a facility 
        operated, licensed, or inspected by the department of 
        corrections where the facility holds a written record of a 
        negative Mantoux test performed on the person (i) within three 
        months prior to intake into the facility; or (ii) within 12 
        months prior to intake into the facility if the person has 
        remained under the continuing jurisdiction of a correctional 
        facility since the negative Mantoux test, provided that the 
        person has no symptoms suggestive of tuberculosis, evidence of a 
        new exposure to active tuberculosis, or other health condition 
        that may require a chest roentgenogram (X-ray) be performed to 
        rule out active tuberculosis; 
           (3) a person who is detained or confined in a facility 
        operated, licensed, or inspected by the department of 
        corrections where the facility has a written record of (i) a 
        history of adequately treated active tuberculosis; (ii) 
        compliance with currently prescribed tuberculosis therapy or 
        preventive therapy; or (iii) completion of a course of 
        preventive therapy, provided the person has no symptoms 
        suggestive of tuberculosis, evidence of a new exposure to active 
        tuberculosis, or other health condition that may require a chest 
        roentgenogram (X-ray) to rule out active tuberculosis; 
           (4) a person who is detained or confined in a facility 
        operated, licensed, or inspected by the department of 
        corrections where the facility holds a written record of a 
        negative chest roentgenogram (X-ray) (i) within six months; or 
        (ii) within 12 months prior to intake in the facility if the 
        person has remained under the continuing jurisdiction of a 
        correctional facility since the negative chest roentgenogram 
        (X-ray), provided that the person has no symptoms suggestive of 
        tuberculosis, evidence of a new exposure to active tuberculosis, 
        or other health condition that may require a new chest 
        roentgenogram (X-ray) to rule out active tuberculosis; 
           (5) an employee with a record of either a past positive 
        Mantoux test reaction or active tuberculosis who is currently 
        completing or has a documented history of completing a course of 
        tuberculosis therapy or preventive therapy, provided the 
        employee has no symptoms suggestive of tuberculosis, evidence of 
        a new exposure to active tuberculosis, or other health condition 
        that may require a chest roentgenogram (X-ray) be performed to 
        rule out active tuberculosis; 
           (6) an employee with either a record of a past positive 
        Mantoux test reaction or a positive or significant Mantoux test 
        reaction in preemployment screening who does not complete a 
        course of preventive therapy may be exempt from annual Mantoux 
        testing or other screening.  This determination shall be made by 
        the commissioner of health based on currently accepted public 
        health standards and the person's health status if the employee 
        has a documented negative chest roentgenogram (X-ray) performed 
        at any time since the initial positive Mantoux test, provided 
        the employee has no symptoms suggestive of tuberculosis, 
        evidence of a new exposure to active tuberculosis, or other 
        health condition that may require a chest roentgenogram (X-ray) 
        be performed to rule out active tuberculosis; and 
           (7) the commissioner may exempt additional employees or 
        persons detained or confined in facilities operated, licensed, 
        or inspected by the department of corrections based on currently 
        accepted public health standards or the person's health status. 
           Sec. 3.  [144.4801] [TITLE.] 
           Sections 144.4801 to 144.4813 may be cited as the 
        "Tuberculosis Health Threat Act." 
           Sec. 4.  [144.4802] [AUTHORITY.] 
           Subdivision 1.  [AUTHORITY TO COMMIT.] Under the powers and 
        duties assigned to the commissioner in this chapter and chapter 
        145, the commissioner may proceed under sections 144.4801 to 
        144.4813 whenever the commissioner has probable cause to believe 
        that a person who has active tuberculosis or is clinically 
        suspected of having active tuberculosis is an endangerment to 
        the public health.  
           Subd. 2.  [PREEMPTION.] Sections 144.4801 to 144.4813 
        preempt and supersede sections 144.4171 to 144.4186, 144.443, 
        and 144.444 with regard to a tuberculosis health threat.  
        Nothing in sections 144.4801 to 144.4813 restricts the 
        commissioner's authority to seek injunctive relief pursuant to 
        section 145.075, or any other relief under other statutes or at 
        common law. 
           Subd. 3.  [RELIANCE ON SPIRITUAL MEANS IN LIEU OF MEDICAL 
        TREATMENT.] Nothing in sections 144.4801 to 144.4813 shall be 
        construed to abridge the right of a carrier to refuse medical 
        treatment for tuberculosis if the carrier opposes medical 
        treatment on the basis of sincere religious beliefs and complies 
        with a monitoring plan developed by the commissioner for the 
        isolation of the carrier as defined in section 144.4803, 
        subdivision 14.  A carrier who meets the requirements of this 
        subdivision is not considered an endangerment under section 
        144.4803, subdivision 10, clauses (2) to (6) and (8).  Nothing 
        in this subdivision shall be construed to limit the authority of 
        the commissioner to take necessary actions to protect the public 
        health according to sections 144.4801 to 144.4813. 
           Sec. 5.  [144.4803] [DEFINITIONS.] 
           Subdivision 1.  [ACTIVE TUBERCULOSIS.] "Active tuberculosis"
        includes infectious and noninfectious tuberculosis and means: 
           (1) a condition evidenced by a positive culture for 
        mycobacterium tuberculosis taken from a pulmonary or laryngeal 
        source; 
           (2) a condition evidenced by a positive culture for 
        mycobacterium tuberculosis taken from an extrapulmonary source 
        when there is clinical evidence such as a positive skin test for 
        tuberculosis infection, coughing, sputum production, fever, or 
        other symptoms compatible with pulmonary tuberculosis; or 
           (3) a condition in which clinical specimens are not 
        available for culture, but there is radiographic evidence of 
        tuberculosis such as an abnormal chest X-ray, and clinical 
        evidence such as a positive skin test for tuberculosis 
        infection, coughing, sputum production, fever, or other symptoms 
        compatible with pulmonary tuberculosis, that lead a physician to 
        reasonably diagnose active tuberculosis according to currently 
        accepted standards of medical practice and to initiate treatment 
        for tuberculosis. 
           Subd. 2.  [BOARD OF HEALTH.] "Board of health" means an 
        administrative authority established under section 145A.03. 
           Subd. 3.  [CARRIER.] "Carrier" means a person who has 
        active tuberculosis or is clinically suspected of having active 
        tuberculosis. 
           Subd. 4.  [CLINICALLY SUSPECTED OF HAVING ACTIVE 
        TUBERCULOSIS.] "Clinically suspected of having active 
        tuberculosis" means presenting a reasonable possibility of 
        having active tuberculosis based upon epidemiologic, clinical, 
        or radiographic evidence, laboratory test results, or other 
        reliable evidence as determined by a physician using currently 
        accepted standards of medical practice. 
           Subd. 5.  [COMMISSIONER.] "Commissioner" means the 
        commissioner of health. 
           Subd. 6.  [CONTAGION PRECAUTIONS FOR TUBERCULOSIS.] 
        "Contagion precautions for tuberculosis" means those measures 
        under currently accepted standards of medical practice that 
        prevent a carrier from exposing others to tuberculosis. 
           Subd. 7.  [DEPARTMENT.] "Department" means the department 
        of health. 
           Subd. 8.  [DIRECTLY OBSERVED THERAPY.] "Directly observed 
        therapy" means a method for ensuring compliance with medication 
        directions in which a licensed health professional or designee 
        observes a person ingesting prescribed medications or 
        administers the prescribed medication to the person. 
           Subd. 9.  [DISEASE PREVENTION OFFICER.] "Disease prevention 
        officer" means a designated agent of the commissioner, or a 
        designated agent of a board of health that has express delegated 
        authority from the commissioner to proceed under sections 
        144.4801 to 144.4813. 
           Subd. 10.  [ENDANGERMENT TO THE PUBLIC HEALTH.] 
        "Endangerment to the public health" means a carrier who may 
        transmit tuberculosis to another person or persons because the 
        carrier has engaged or is engaging in any of the following 
        conduct: 
           (1) refuses or fails to submit to a diagnostic tuberculosis 
        examination that is ordered by a physician and is reasonable 
        according to currently accepted standards of medical practice; 
           (2) refuses or fails to initiate or complete treatment for 
        tuberculosis that is prescribed by a physician and is reasonable 
        according to currently accepted standards of medical practice; 
           (3) refuses or fails to keep appointments for treatment of 
        tuberculosis; 
           (4) refuses or fails to provide the commissioner, upon 
        request, with evidence showing the completion of a course of 
        treatment for tuberculosis that is prescribed by a physician and 
        is reasonable according to currently accepted standards of 
        medical practice; 
           (5) refuses or fails to initiate or complete a course of 
        directly observed therapy that is prescribed by a physician and 
        is reasonable according to currently accepted standards of 
        medical practice; 
           (6) misses at least 20 percent of scheduled appointments 
        for directly observed therapy, or misses at least two 
        consecutive appointments for directly observed therapy; 
           (7) refuses or fails to follow contagion precautions for 
        tuberculosis after being instructed on the precautions by a 
        licensed health professional or by the commissioner; 
           (8) based on evidence of the carrier's past or present 
        behavior, may not complete a course of treatment for 
        tuberculosis that is reasonable according to currently accepted 
        standards of medical practice; or 
           (9) may expose other persons to tuberculosis based on 
        epidemiological, medical, or other reliable evidence. 
           Subd. 11.  [EPIDEMIOLOGICAL DATA OR EPIDEMIOLOGICAL 
        EVIDENCE.] "Epidemiological data" or "epidemiological evidence" 
        means data or evidence relating to the occurrence, distribution, 
        clinical characteristics, and control of disease within a group 
        of people or within a specified population. 
           Subd. 12.  [HEALTH ORDER.] "Health order" means an order 
        issued by the commissioner or a board of health with express 
        delegated authority from the commissioner. 
           Subd. 13.  [INFECTIOUS TUBERCULOSIS.] "Infectious 
        tuberculosis" means the stage of tuberculosis where 
        mycobacterial organisms are capable of being expelled into the 
        air by a person, as determined by laboratory, epidemiological, 
        or clinical findings. 
           Subd. 14.  [ISOLATION.] "Isolation" means placing a carrier 
        who has infectious tuberculosis in: 
           (1) a hospital or other treatment facility; 
           (2) the carrier's residence or current location; or 
           (3) any other place approved by the commissioner, provided 
        that the place of isolation prevents or limits the transmission 
        of the infectious tuberculosis agent to others during the period 
        of infectiousness. 
           Subd. 15.  [LICENSED HEALTH PROFESSIONAL.] "Licensed health 
        professional" means a person licensed by one of the 
        health-related licensing boards listed in section 214.01, 
        subdivision 2. 
           Subd. 16.  [PEACE OFFICER.] "Peace officer" means an 
        employee or an elected or appointed official of a political 
        subdivision or law enforcement agency who is licensed by the 
        board of peace officer standards and training, is charged with 
        the prevention and detection of crime and the enforcement of the 
        general criminal laws of the state, and has the full power of 
        arrest.  "Peace officer" includes an officer of the Minnesota 
        state patrol. 
           Subd. 17.  [PHYSICIAN.] "Physician" means a person who is 
        licensed by the board of medical practice under chapter 147 to 
        practice medicine. 
           Subd. 18.  [RESPONDENT.] "Respondent" means a person or 
        group of persons to whom the commissioner has issued a health 
        order, excluding the carrier. 
           Subd. 19.  [TREATMENT FACILITY.] "Treatment facility" means 
        a hospital or other treatment provider that is qualified to 
        provide care, treatment, and appropriate contagion precautions 
        for tuberculosis. 
           Sec. 6.  [144.4804] [REPORTING RELATING TO TUBERCULOSIS.] 
           Subdivision 1.  [MANDATORY REPORTING.] A licensed health 
        professional must report to the commissioner or a disease 
        prevention officer within 24 hours of obtaining knowledge of a 
        reportable person as specified in subdivision 3, unless the 
        licensed health professional is aware that the facts causing the 
        person to be a reportable person have previously been reported.  
        Within 72 hours of making a report, excluding Saturdays, 
        Sundays, and legal holidays, the licensed health professional 
        shall submit to the commissioner or to the disease prevention 
        officer a certified copy of the reportable person's medical 
        records relating to the carrier's tuberculosis and status as an 
        endangerment to the public health if the person is reportable 
        under subdivision 3, clause (3), (4), or (5).  A reporting 
        facility may designate an infection control practitioner to make 
        reports and to send certified medical records relating to the 
        carrier's tuberculosis and status as an endangerment to the 
        public health under this subdivision. 
           Subd. 2.  [VOLUNTARY REPORTING.] A person other than a 
        licensed health professional may report to the commissioner or a 
        disease prevention officer if the person has knowledge of a 
        reportable person as specified in subdivision 3, or has probable 
        cause to believe that a person should be reported under 
        subdivision 3. 
           Subd. 3.  [REPORTABLE PERSONS.] A licensed health 
        professional must report to the commissioner or a disease 
        prevention officer if the licensed health professional has 
        knowledge of: 
           (1) a person who has been diagnosed with active 
        tuberculosis; 
           (2) a person who is clinically suspected of having active 
        tuberculosis; 
           (3) a person who refuses or fails to submit to a diagnostic 
        tuberculosis examination when the person is clinically suspected 
        of having tuberculosis; 
           (4) a carrier who has refused or failed to initiate or 
        complete treatment for tuberculosis, including refusal or 
        failure to take medication for tuberculosis or keep appointments 
        for directly observed therapy or other treatment of 
        tuberculosis; or 
           (5) a person who refuses or fails to follow contagion 
        precautions for tuberculosis after being instructed on the 
        precautions by a licensed health professional or by the 
        commissioner. 
           Subd. 4.  [REPORTING INFORMATION.] The report by a licensed 
        health professional under subdivision 1 or by a person under 
        subdivision 2 must contain the following information, to the 
        extent known: 
           (1) the reportable person's name, birth date, address or 
        last known location, and telephone number; 
           (2) the date and specific circumstances that cause the 
        person to be a reportable person; 
           (3) the reporting person's name, title, address, and 
        telephone number; and 
           (4) any other information relevant to the reportable 
        person's case of tuberculosis. 
           Subd. 5.  [IMMUNITY FOR REPORTING.] A licensed health 
        professional who is required to report under subdivision 1 or a 
        person who voluntarily reports in good faith under subdivision 2 
        is immune from liability in a civil, administrative, 
        disciplinary, or criminal action for reporting under this 
        section. 
           Subd. 6.  [FALSIFIED REPORTS.] A person who knowingly or 
        recklessly makes a false report under this section is liable in 
        a civil suit for actual damages suffered by the person or 
        persons reported and for punitive damages. 
           Subd. 7.  [WAIVER OF PRIVILEGE.] A person who is the 
        subject of a report under subdivision 1 is deemed to have waived 
        any privilege created in section 595.02, subdivision 1, 
        paragraphs (d), (e), (g), (i), (j), and (k), with respect to any 
        information provided under this section. 
           Sec. 7.  [144.4805] [ISSUANCE OF HEALTH ORDER; RIGHTS OF 
        CARRIER AND RESPONDENT.] 
           Subdivision 1.  [AUTHORITY.] Only the commissioner, or a 
        board of health with express delegated authority from the 
        commissioner, may issue a health order under this section. 
           Subd. 2.  [GROUNDS FOR HEALTH ORDER.] Whenever the 
        commissioner has probable cause to believe that a carrier is an 
        endangerment to the public health, the commissioner may issue a 
        health order that the commissioner deems necessary to protect 
        the public health.  The commissioner may petition the court for 
        enforcement of the health order.  In a court proceeding for 
        enforcement of the health order, the commissioner shall 
        demonstrate the particularized circumstances constituting the 
        necessity for the health order.  The health order may be issued 
        to any person, including to a carrier, physician, licensed 
        health professional, or treatment facility.  The health order 
        may be in the form of a subpoena by the commissioner for 
        certified medical records relating to the carrier's tuberculosis 
        and status as an endangerment to the public health. 
           Subd. 3.  [CONTENTS OF HEALTH ORDER.] A health order must 
        include: 
           (1) a citation to this section as the legal authority under 
        which the order is issued; 
           (2) a summary of evidence upon which the person is alleged 
        to be a carrier; 
           (3) a description of the alleged conduct of the carrier 
        that makes the carrier an endangerment to the public health; 
           (4) a description of less restrictive alternatives that the 
        commissioner considered and rejected, together with the reasons 
        for the rejection, or a description of less restrictive 
        alternatives that the commissioner used and that were 
        unsuccessful; 
           (5) the preventive measure ordered; and 
           (6) a notice advising the carrier or respondent that: 
           (i) a hearing will be held if the carrier or respondent 
        petitions the court for a hearing, or if the commissioner 
        determines that the carrier has not complied with the health 
        order; 
           (ii) the carrier or respondent has the right to appear at 
        the hearing; 
           (iii) the carrier or respondent has the right to present 
        and cross-examine witnesses at the hearing; 
           (iv) the carrier has the right to court-appointed counsel 
        in a proceeding under sections 144.4801 to 144.4813; and 
           (v) the carrier or respondent has the right to the 
        assistance of an interpreter in a proceeding under sections 
        144.4801 to 144.4813. 
           Subd. 4.  [RIGHT TO COUNSEL.] (a) The carrier or respondent 
        has the right to counsel in any proceeding under sections 
        144.4801 to 144.4813.  The court shall promptly appoint counsel 
        for a carrier if the carrier does not have counsel: 
           (1) at the time the court issues an order under section 
        144.4807, subdivision 7, authorizing the continued detention of 
        the carrier; 
           (2) at the time the court issues an order under section 
        144.4808, subdivision 2, authorizing the carrier to be 
        apprehended and held; or 
           (3) in all other cases, at the time either party files a 
        notice for a preliminary hearing under section 144.4810, 
        subdivision 2. 
           The court shall appoint counsel for the carrier.  The cost 
        of court-appointed counsel shall be paid by the court. 
           (b) Upon being notified of the name and address of counsel 
        for the carrier, the commissioner shall promptly forward to the 
        carrier and the carrier's counsel the following: 
           (1) a copy of the health order; 
           (2) a certified copy of relevant portions of the carrier's 
        medical records; and 
           (3) the name and address of the licensed health 
        professional, including the carrier's attending physician or 
        nurse, or the public health physician or nurse whom the 
        commissioner intends to have testify at the preliminary hearing, 
        and a summary of the witness' testimony, including a copy of the 
        witness' affidavit, if any. 
           Subd. 5.  [DUTY TO COMMUNICATE.] The commissioner's counsel 
        and the carrier's counsel shall make every effort to communicate 
        prior to any hearing and to stipulate as to undisputed facts, 
        witnesses, and exhibits. 
           Subd. 6.  [RIGHT TO INTERPRETER.] The carrier or respondent 
        has the right to the assistance of an interpreter in a 
        proceeding under sections 144.4801 to 144.4813. 
           Subd. 7.  [SERVICE OF ORDER.] A health order may be served 
        by a disease prevention officer or peace officer. 
           Sec. 8.  [144.4806] [PREVENTIVE MEASURES UNDER HEALTH 
        ORDER.] 
           A health order may include, but need not be limited to, an 
        order: 
           (1) requiring the carrier's attending physician or 
        treatment facility to isolate and detain the carrier for 
        treatment or for a diagnostic examination for tuberculosis, 
        pursuant to section 144.4807, subdivision 1, if the carrier is 
        an endangerment to the public health and is in a treatment 
        facility; 
           (2) requiring a carrier who is an endangerment to the 
        public health to submit to diagnostic examination for 
        tuberculosis and to remain in the treatment facility until the 
        commissioner receives the results of the examination; 
           (3) requiring a carrier who is an endangerment to the 
        public health to remain in or present at a treatment facility 
        until the carrier has completed a course of treatment for 
        tuberculosis that is prescribed by a physician and is reasonable 
        according to currently accepted standards of medical practice; 
           (4) requiring a carrier who is an endangerment to the 
        public health to complete a course of treatment for tuberculosis 
        that is prescribed by a physician and is reasonable according to 
        currently accepted standards of medical practice and, if 
        necessary, to follow contagion precautions for tuberculosis; 
           (5) requiring a carrier who is an endangerment to the 
        public health to follow a course of directly observed therapy 
        that is prescribed by a physician and is reasonable according to 
        currently accepted standards of medical practice; 
           (6) excluding a carrier who is an endangerment to the 
        public health from the carrier's place of work or school, or 
        from other premises if the commissioner determines that 
        exclusion is necessary because contagion precautions for 
        tuberculosis cannot be maintained in a manner adequate to 
        protect others from being exposed to tuberculosis; 
           (7) requiring a licensed health professional or treatment 
        facility to provide to the commissioner certified copies of all 
        medical and epidemiological data relevant to the carrier's 
        tuberculosis and status as an endangerment to the public health; 
           (8) requiring the diagnostic examination for tuberculosis 
        of other persons in the carrier's household, workplace, or 
        school, or other persons in close contact with the carrier if 
        the commissioner has probable cause to believe that the persons 
        may have active tuberculosis or may have been exposed to 
        tuberculosis based on epidemiological, medical, or other 
        reliable evidence; or 
           (9) requiring a carrier or other persons to follow 
        contagion precautions for tuberculosis. 
           Sec. 9.  [144.4807] [NOTICE OF OBLIGATION TO ISOLATE OR 
        EXAMINE.] 
           Subdivision 1.  [OBLIGATION TO ISOLATE.] If the carrier is 
        in a treatment facility, the commissioner or a carrier's 
        attending physician, after obtaining approval from the 
        commissioner, may issue a notice of obligation to isolate to a 
        treatment facility if the commissioner or attending physician 
        has probable cause to believe that a carrier is an endangerment 
        to the public health.  
           Subd. 2.  [OBLIGATION TO EXAMINE.] If the carrier is 
        clinically suspected of having active tuberculosis, the 
        commissioner may issue a notice of obligation to examine to the 
        carrier's attending physician to conduct a diagnostic 
        examination for tuberculosis on the carrier. 
           Subd. 3.  [PRECAUTIONS TO AVOID EXPOSURE.] Upon receiving a 
        notice of obligation to isolate or notice of obligation to 
        examine, a treatment facility shall immediately take all 
        reasonable precautions to prevent the carrier from exposing 
        other persons to tuberculosis, including the use of guards or 
        locks, if appropriate. 
           Subd. 4.  [SERVICE OF HEALTH ORDER ON CARRIER.] When 
        issuing a notice of obligation to isolate or examine to the 
        carrier's physician or a treatment facility, the commissioner 
        shall simultaneously serve a health order on the carrier 
        ordering the carrier to remain in the treatment facility for 
        treatment or examination. 
           Subd. 5.  [DURATION OF DETENTION.] No carrier may be 
        detained under subdivision 1 or 2 longer than 72 hours, 
        excluding Saturdays, Sundays, and legal holidays, unless the 
        court issues an order authorizing continued detention of the 
        carrier pursuant to subdivision 7.  A carrier may not be 
        released prior to the expiration of the 72-hour hold without the 
        express consent of the commissioner. 
           Subd. 6.  [APPLICATION FOR EXTENSION OF 72-HOUR HOLD.] The 
        commissioner may seek an order extending the hold under 
        subdivision 5 by filing an ex parte application with the probate 
        division of the district court of the county in which the 
        carrier resides.  The application may be filed orally by 
        telephone or by facsimile, provided that a written application 
        is filed within 72 hours, excluding Saturdays, Sundays, and 
        legal holidays. 
           Subd. 7.  [COURT ORDER EXTENDING 72-HOUR HOLD.] The court 
        may extend the hold under subdivision 5 by up to six days, 
        excluding Saturdays, Sundays, and legal holidays, if the court 
        finds that there is probable cause to believe that the carrier 
        is an endangerment to the public health.  The court may find 
        probable cause to detain, examine, and isolate the carrier based 
        upon a written statement by facsimile or upon an oral statement 
        by telephone from the carrier's attending physician or nurse, a 
        public health physician or nurse, other licensed health 
        professional, or disease prevention officer, stating the grounds 
        and facts that demonstrate that the carrier is an endangerment 
        to the public health, provided that an affidavit from such 
        witness is filed with the court within 72 hours, excluding 
        Saturdays, Sundays, and legal holidays.  The order may be issued 
        orally by telephone, or by facsimile, provided that a written 
        order is issued within 72 hours, excluding Saturdays, Sundays, 
        and legal holidays.  The oral and written order shall contain a 
        notice of the carrier's rights contained in section 144.4805, 
        subdivision 3, clause (6).  A carrier may not be released prior 
        to the hold extended under this subdivision without the express 
        consent of the commissioner. 
           Subd. 8.  [APPOINTMENT OF COUNSEL.] If the carrier does not 
        have counsel at the time the court issues an order to extend the 
        hold under subdivision 7, the court shall promptly appoint 
        counsel for the carrier. 
           Subd. 9.  [IMMUNITY.] A disease prevention officer, peace 
        officer, physician, licensed health professional, or treatment 
        facility that acts in good faith under this section is immune 
        from liability in any civil, administrative, disciplinary, or 
        criminal action for acting under this section. 
           Sec. 10.  [144.4808] [APPREHEND AND HOLD ORDER.] 
           Subdivision 1.  [APPLICATION FOR APPREHEND AND HOLD ORDER.] 
        The commissioner may make an ex parte application for an order 
        to apprehend and hold a carrier who is not in a treatment 
        facility if the commissioner has probable cause to believe that 
        a carrier is: 
           (1) an endangerment to the public health; and 
           (2) either in imminent danger of exposing another person or 
        persons to tuberculosis, or may flee or become unlocatable. 
           The commissioner shall file the application in the probate 
        division of the district court of the county in which the 
        carrier resides.  The application may be filed orally by 
        telephone or by facsimile, provided that a written application 
        is filed within 72 hours, excluding Saturdays, Sundays, and 
        legal holidays. 
           Subd. 2.  [COURT ORDER TO APPREHEND AND HOLD.] The court 
        may find probable cause to apprehend and hold the carrier based 
        upon a written statement by facsimile or oral statement by 
        telephone from the carrier's attending physician or nurse, a 
        public health physician or nurse, other licensed health 
        professional, or disease prevention officer, stating the grounds 
        and facts that demonstrate that the carrier is an endangerment 
        to the public health, provided that an affidavit from such 
        witness is filed with the court within 72 hours, excluding 
        Saturdays, Sundays, and legal holidays.  The court may issue an 
        order to a peace officer or to a disease prevention officer, or 
        both to: 
           (1) apprehend and transport the carrier to a designated 
        treatment facility, and detain the carrier until the carrier is 
        admitted to the treatment facility; or 
           (2) apprehend and isolate the carrier. 
           The order may be issued orally by telephone, or by 
        facsimile, provided that a written order is issued within 72 
        hours, excluding Saturdays, Sundays, and legal holidays.  The 
        oral and written order shall contain a notice of the carrier's 
        rights contained in section 144.4805, subdivision 3, clause (6). 
           Subd. 3.  [DURATION OF DETENTION.] A carrier may be 
        detained under this subdivision up to six days, excluding 
        Saturdays, Sundays, and legal holidays.  A carrier may not be 
        released prior to the expiration of the hold authorized under 
        this section without the express consent of the commissioner. 
           Subd. 4.  [APPREHENSION OF CARRIER.] If the carrier flees 
        or forcibly resists the peace officer or disease prevention 
        officer, the officer may use all necessary and lawful means to 
        apprehend, hold, transport, or isolate the carrier.  This 
        subdivision is authority for the officer to carry out the duties 
        specified in this section.  The commissioner shall provide any 
        information and equipment necessary to protect the officer from 
        becoming exposed to tuberculosis. 
           Subd. 5.  [APPOINTMENT OF COUNSEL.] If the carrier does not 
        have counsel at the time the court issues an apprehend and hold 
        order under subdivision 2, the court shall promptly appoint 
        counsel for the carrier. 
           Subd. 6.  [IMMUNITY.] A disease prevention officer, peace 
        officer, physician, licensed health professional, or treatment 
        facility that acts in good faith under this section is immune 
        from liability in any civil, administrative, disciplinary, or 
        criminal action for acting under this section. 
           Sec. 11.  [144.4809] [PRELIMINARY HEARING.] 
           Subdivision 1.  [GROUNDS FOR HEARING.] A party may petition 
        the court for an order for enforcement of or relief from a 
        health order or judicial order. 
           Subd. 2.  [PETITION FOR PRELIMINARY HEARING.] The 
        petitioning party shall serve on the commissioner and file in 
        the probate division of the district court of the county in 
        which the carrier or respondent resides a petition and notice of 
        preliminary hearing.  The court shall hold a preliminary hearing 
        no later than 15 days from the date of the filing and service of 
        the petition for a preliminary hearing.  If a carrier detained 
        under section 144.4807 or 144.4808 files a petition for a 
        preliminary hearing, the hearing must be held no later than five 
        days from the date of the filing and service of the petition, 
        excluding Saturdays, Sundays, and legal holidays. 
           Subd. 3.  [COMMISSIONER'S NOTICE OF HEARING.] If the 
        commissioner petitions the court to enforce the health order, 
        the notice of the preliminary hearing must contain the following 
        information: 
           (1) the date, time, and place of the hearing; 
           (2) the right of the carrier to be represented by 
        court-appointed counsel during any proceeding under sections 
        144.4801 to 144.4813; 
           (3) the right of the carrier or respondent to the 
        assistance of an interpreter in any proceeding under sections 
        144.4801 to 144.4813; 
           (4) the right of the carrier or respondent to appear at the 
        hearing; 
           (5) the right of the carrier or respondent to present and 
        cross-examine witnesses; 
           (6) a statement of any disputed facts, or a statement of 
        the nature of any other disputed matter; and 
           (7) the name and address of any witness that the 
        petitioning party intends to call to testify at the hearing, and 
        a brief summary of the witness' testimony. 
           Subd. 4.  [CARRIER'S OR RESPONDENT'S NOTICE OF HEARING.] If 
        the carrier or respondent petitions the court for relief from 
        the health order or court order, the notice of preliminary 
        hearing must contain the information in subdivision 3, clauses 
        (1), (6), and (7). 
           Subd. 5.  [DUTY TO COMMUNICATE.] (a) At least five days 
        before the date of the preliminary hearing, excluding Saturdays, 
        Sundays, and legal holidays, the nonpetitioning party shall 
        respond to the petition for hearing by filing and serving on the 
        petitioning party:  
           (1) a statement of any disputed facts, or a statement of 
        the nature of any other disputed matter; and 
           (2) the name and address of any witness that the 
        nonpetitioning party intends to call to testify at the hearing, 
        and a brief summary of the witness' testimony.  
           If the carrier seeks release from an emergency hold ordered 
        under section 144.4807, subdivision 7, or under section 
        144.4808, subdivision 2, the commissioner shall file and serve 
        on the carrier's counsel the items in clauses (1) and (2) at 
        least 48 hours prior to the preliminary hearing, excluding 
        Saturdays, Sundays, and legal holidays. 
           (b) At the hearing, the parties shall identify the efforts 
        they made to resolve the matter prior to the preliminary hearing.
           Subd. 6.  [HEARING ROOM IN TREATMENT FACILITY.] If the 
        carrier is infectious, the treatment facility in which the 
        carrier is sought to be detained or to which the carrier is 
        sought to be removed shall make reasonable accommodations to 
        provide a room where the hearing may be held that minimizes the 
        risk of exposing persons attending the hearing to tuberculosis.  
        If a room is not available at the treatment facility, the court 
        may designate another location for the hearing. 
           Subd. 7.  [STANDARD OF PROOF.] The commissioner must prove 
        by a preponderance of the evidence that the carrier is an 
        endangerment to the public health. 
           Subd. 8.  [RULES OF EVIDENCE.] The court shall admit all 
        reliable relevant evidence.  Medical and epidemiological data 
        must be admitted if it conforms with section 145.31, chapter 
        600, Minnesota Rules of Evidence, rule 803(6), or other statutes 
        or rules that permit reliable evidence to be admitted in civil 
        cases.  The court may rely on medical and epidemiological data, 
        including hearsay, if it finds that physicians and other 
        licensed health professionals rely on the data in the regular 
        course of providing health care and treatment. 
           Subd. 9.  [SUFFICIENCY OF EVIDENCE.] It is a sufficient 
        basis for the court to order continued confinement of the 
        carrier or other preventive measures requested by the 
        commissioner if reliable testimony is provided solely by the 
        carrier's attending physician or nurse, a public health 
        physician or nurse, other licensed health professional, or 
        disease prevention officer. 
           Subd. 10.  [FAILURE TO APPEAR AT HEARING.] If the carrier 
        or respondent fails to appear at the hearing without prior court 
        approval, the hearing may proceed without the carrier or 
        respondent and the court may make its determination on the basis 
        of all reliable evidence submitted at the hearing. 
           Sec. 12.  [144.4810] [FINAL HEARING.] 
           Subdivision 1.  [GROUNDS FOR HEARING.] After the 
        preliminary hearing, the commissioner, carrier, or respondent 
        may petition the court for relief from or enforcement of the 
        court order issued pursuant to the preliminary hearing.  The 
        commissioner may petition the court for additional preventive 
        measures if the carrier or respondent has not complied with the 
        court order issued pursuant to the preliminary hearing.  The 
        petitioning party shall serve and file a petition and notice of 
        hearing with the probate division of the district court.  The 
        court shall hold the final hearing no later than 15 days from 
        the date of the filing and service of the petition for a final 
        hearing. 
           Subd. 2.  [NOTICE OF HEARING.] The notice of the final 
        hearing must contain the same information as for the preliminary 
        hearing in section 144.4809, subdivision 3 or 4. 
           Subd. 3.  [DUTY TO COMMUNICATE.] The parties have a duty to 
        communicate and exchange information as provided in section 
        144.4809, subdivision 5. 
           Subd. 4.  [HEARING ROOM IN TREATMENT FACILITY.] The hearing 
        room for the final hearing is governed by section 144.4809, 
        subdivision 6. 
           Subd. 5.  [STANDARD OF PROOF.] The commissioner must prove 
        by clear and convincing evidence that the carrier is an 
        endangerment to the public health. 
           Subd. 6.  [RULES OF EVIDENCE.] The rules of evidence are 
        governed by section 144.4809, subdivision 8. 
           Subd. 7.  [SUFFICIENCY OF EVIDENCE.] The sufficiency of 
        evidence is governed by section 144.4809, subdivision 9. 
           Subd. 8.  [FAILURE TO APPEAR AT HEARING.] The failure of 
        the carrier or respondent to appear at the hearing is governed 
        by section 144.4809, subdivision 10. 
           Subd. 9.  [RIGHT OF APPEAL.] The commissioner, carrier, or 
        respondent may appeal the decision of the district court.  The 
        court of appeals shall hear the appeal within 60 days after 
        filing and service of the notice of appeal. 
           Subd. 10.  [RIGHT OF COMMISSIONER TO ISSUE SUBSEQUENT 
        ORDER.] Notwithstanding any ruling by the district court, the 
        commissioner may issue a subsequent health order if the 
        commissioner has probable cause to believe that a health order 
        is necessary based on additional facts not known or present at 
        the time of the district court hearing. 
           Sec. 13.  [144.4811] [PERIODIC REVIEW AND RELEASE FROM 
        DETENTION.] 
           Subdivision 1.  [PERIODIC REVIEW.] If the carrier has been 
        detained in a treatment facility or has been isolated pursuant 
        to a court order, the commissioner shall submit a report to the 
        court, the carrier, and the carrier's counsel within 90 days of 
        the date of the court-ordered detention and every 90 days 
        thereafter, until the carrier is released.  The report must 
        state the treatment the carrier receives, whether the carrier is 
        cured or noninfectious, and whether the carrier will continue to 
        be detained.  If the carrier contests the commissioner's 
        determination for continued detention, the carrier may request a 
        hearing.  The hearing on continued detention is governed by the 
        provisions for a final hearing under section 144.4810, excluding 
        subdivision 5 of that section.  The court shall order continued 
        detention of the carrier if it finds that such detention is 
        reasonable.  This subdivision does not apply to consent orders 
        or other confinement that has been voluntarily agreed upon by 
        the parties. 
           Subd. 2.  [CARRIER'S PETITION FOR RELEASE.] If the carrier 
        is detained in a treatment facility or isolated pursuant to a 
        court order, the carrier may make a good faith request for 
        release from confinement prior to the 90-day review under 
        subdivision 1 by filing a petition and notice of hearing with 
        the court that ordered the confinement and by serving the 
        petition and notice on the commissioner.  The hearing on 
        continued confinement is governed by the provisions for a final 
        hearing under section 144.4810, excluding subdivision 5 of that 
        section.  The court shall order continued detention of the 
        carrier if it finds that such detention is reasonable. 
           Subd. 3.  [RELEASE FROM DETENTION BASED ON ORDER TO COMPEL 
        EXAMINATION.] A carrier who has been detained in a treatment 
        facility under a court order to compel the carrier to submit to 
        a diagnostic tuberculosis examination shall be released only 
        after: 
           (1) the commissioner determines that the carrier does not 
        have active tuberculosis; or 
           (2) the commissioner determines that the carrier is not an 
        endangerment to the public health. 
           Subd. 4.  [RELEASE FROM DETENTION BASED ON ENDANGERMENT.] A 
        carrier who is detained in a treatment facility or isolated 
        under a court order because the carrier is an endangerment to 
        the public health shall be released only after: 
           (1) the commissioner determines that the carrier is cured; 
        or 
           (2) the commissioner determines that the carrier is no 
        longer an endangerment to the public health. 
           Sec. 14.  [144.4812] [COSTS OF CARE.] 
           The costs incurred by the treatment facility and other 
        providers of services to diagnose or treat the carrier for 
        tuberculosis must be borne by the carrier, the carrier's health 
        plan, or public programs.  During the period of insurance 
        coverage, a health plan may direct the implementation of the 
        care required by the health order or court order and shall pay 
        at the contracted rate of payment, which shall be considered 
        payment in full.  Inpatient hospital services required by the 
        health order or court order and covered by medical assistance or 
        general assistance medical care are not billable to any other 
        governmental entity.  If the carrier cannot pay for treatment, 
        and the carrier does not have public or private health insurance 
        coverage, the carrier shall apply for financial assistance with 
        the aid of the county.  For persons not otherwise eligible for 
        public assistance, the commissioner of human services shall 
        determine what, if any, costs the carrier shall pay.  The 
        commissioner of human services shall make payments at the 
        general assistance medical care rate, which will be considered 
        payment in full. 
           Sec. 15.  [144.4813] [DATA PRIVACY.] 
           Subdivision 1.  [NONPUBLIC DATA.] Data on individuals 
        contained in the health order are health data under section 
        13.38.  Other data on individuals collected by the commissioner 
        as part of an investigation of a carrier under sections 144.4801 
        to 144.4813 are investigative data under section 13.39. 
           Subd. 2.  [PROTECTIVE ORDER.] After a judicial action is 
        commenced, a party may seek a protective order to protect the 
        disclosure of portions of the court record identifying 
        individuals or entities. 
           Subd. 3.  [RECORDS RETENTION.] A records retention schedule 
        for records developed under sections 144.4801 to 144.4813 must 
        be established pursuant to section 138.17, subdivision 7. 
           Presented to the governor May 16, 1997 
           Signed by the governor May 19, 1997, 1:02 p.m.