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             modifying tuberculosis screening requirements; 
  1.8             amending Minnesota Statutes 1996, section 144.445, 
  1.9             subdivisions 1 and 3; proposing coding for new law in 
  1.10            Minnesota Statutes, chapter 144. 
  1.11  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.12     Section 1.  Minnesota Statutes 1996, section 144.445, 
  1.13  subdivision 1, is amended to read: 
  1.14     Subdivision 1.  [SCREENING OF INMATES.] All persons 
  1.15  detained or confined for ~~seven~~ 14 consecutive days or more in 
  1.16  facilities operated, licensed, or inspected by the department of 
  1.17  corrections shall be screened for tuberculosis with either a 
  1.18  Mantoux test or a chest roentgenogram (X-ray) as consistent with 
  1.19  screening and follow-up practices recommended by the United 
  1.20  States Public Health Service or the department of health, as 
  1.21  determined by the commissioner of health.  Administration of the 
  1.22  Mantoux test or chest roentgenogram (X-ray) must take place on 
  1.23  or before the ~~seventh~~ 14th day of detention or confinement. 
  1.24     Sec. 2.  Minnesota Statutes 1996, section 144.445, 
  1.25  subdivision 3, is amended to read: 
  1.26     Subd. 3.  [EXCEPTIONS.] Subdivisions 1 and 2 do not apply 
  1.27  to: 
  1.28     (1) a person who is detained or confined in a juvenile 
  2.1   temporary holdover facility, provided that the person has no 
  2.2   symptoms suggestive of tuberculosis, evidence of a new exposure 
  2.3   to active tuberculosis, or other health condition that may 
  2.4   require a chest roentgenogram (X-ray) be performed to rule out 
  2.5   active tuberculosis; 
  2.6      (2) a person who is detained or confined in a facility 
  2.7   operated, licensed, or inspected by the department of 
  2.8   corrections where the facility holds a written record of a 
  2.9   negative Mantoux test performed on the person (i) within three 
  2.10  months prior to intake into the facility; or (ii) within 12 
  2.11  months prior to intake into the facility if the person has 
  2.12  remained under the continuing jurisdiction of a correctional 
  2.13  facility since the negative Mantoux test, provided that the 
  2.14  person has no symptoms suggestive of tuberculosis, evidence of a 
  2.15  new exposure to active tuberculosis, or other health condition 
  2.16  that may require a chest roentgenogram (X-ray) be performed to 
  2.17  rule out active tuberculosis; 
  2.18     (3) a person who is detained or confined in a facility 
  2.19  operated, licensed, or inspected by the department of 
  2.20  corrections where the facility has a written record of (i) a 
  2.21  history of adequately treated active tuberculosis; (ii) 
  2.22  compliance with currently prescribed tuberculosis therapy or 
  2.23  preventive therapy; or (iii) completion of a course of 
  2.24  preventive therapy, provided the person has no symptoms 
  2.25  suggestive of tuberculosis, evidence of a new exposure to active 
  2.26  tuberculosis, or other health condition that may require a chest 
  2.27  roentgenogram (X-ray) to rule out active tuberculosis; 
  2.28     (4) a person who is detained or confined in a facility 
  2.29  operated, licensed, or inspected by the department of 
  2.30  corrections where the facility holds a written record of a 
  2.31  negative chest roentgenogram (X-ray) (i) within six months; or 
  2.32  (ii) within 12 months prior to intake in the facility if the 
  2.33  person has remained under the continuing jurisdiction of a 
  2.34  correctional facility since the negative chest roentgenogram 
  2.35  (X-ray), provided that the person has no symptoms suggestive of 
  2.36  tuberculosis, evidence of a new exposure to active tuberculosis, 
  3.1   or other health condition that may require a new chest 
  3.2   roentgenogram (X-ray) to rule out active tuberculosis; 
  3.3      (5) an employee with a record of either a past positive 
  3.4   Mantoux test reaction or active tuberculosis who is currently 
  3.5   completing or has a documented history of completing a course of 
  3.6   tuberculosis therapy or preventive therapy, provided the 
  3.7   employee has no symptoms suggestive of tuberculosis, evidence of 
  3.8   a new exposure to active tuberculosis, or other health condition 
  3.9   that may require a chest roentgenogram (X-ray) be performed to 
  3.10  rule out active tuberculosis; 
  3.11     (6) an employee with either a record of a past positive 
  3.12  Mantoux test reaction or a positive or significant Mantoux test 
  3.13  reaction in preemployment screening who does not complete a 
  3.14  course of preventive therapy may be exempt from annual Mantoux 
  3.15  testing or other screening~~.  This determination shall be made by~~ 
  3.16  ~~the commissioner of health based on currently accepted public~~ 
  3.17  ~~health standards and the person's health status~~ if the employee 
  3.18  has a documented negative chest roentgenogram (X-ray) performed 
  3.19  at any time since the initial positive Mantoux test, provided 
  3.20  the employee has no symptoms suggestive of tuberculosis, 
  3.21  evidence of a new exposure to active tuberculosis, or other 
  3.22  health condition that may require a chest roentgenogram (X-ray) 
  3.23  be performed to rule out active tuberculosis; and 
  3.24     (7) the commissioner may exempt additional employees or 
  3.25  persons detained or confined in facilities operated, licensed, 
  3.26  or inspected by the department of corrections based on currently 
  3.27  accepted public health standards or the person's health status. 
  3.28     Sec. 3.  [144.4801] [TITLE.] 
  3.29     Sections 144.4801 to 144.4813 may be cited as the 
  3.30  "Tuberculosis Health Threat Act." 
  3.31     Sec. 4.  [144.4802] [AUTHORITY.] 
  3.32     Subdivision 1.  [AUTHORITY TO COMMIT.] Under the powers and 
  3.33  duties assigned to the commissioner in this chapter and chapter 
  3.34  145, the commissioner may proceed under sections 144.4801 to 
  3.35  144.4813 whenever the commissioner has probable cause to believe 
  3.36  that a person who has active tuberculosis or is clinically 
  4.1   suspected of having active tuberculosis is an endangerment to 
  4.2   the public health.  
  4.3      Subd. 2.  [PREEMPTION.] Sections 144.4801 to 144.4813 
  4.4   preempt and supersede sections 144.4171 to 144.4186, 144.443, 
  4.5   and 144.444 with regard to a tuberculosis health threat.  
  4.6   Nothing in sections 144.4801 to 144.4813 restricts the 
  4.7   commissioner's authority to seek injunctive relief pursuant to 
  4.8   section 145.075, or any other relief under other statutes or at 
  4.9   common law. 
  4.10     Subd. 3.  [RELIANCE ON SPIRITUAL MEANS IN LIEU OF MEDICAL 
  4.11  TREATMENT.] Nothing in sections 144.4801 to 144.4813 shall be 
  4.12  construed to abridge the right of a carrier to refuse medical 
  4.13  treatment for tuberculosis if the carrier opposes medical 
  4.14  treatment on the basis of sincere religious beliefs and complies 
  4.15  with a monitoring plan developed by the commissioner for the 
  4.16  isolation of the carrier as defined in section 144.4803, 
  4.17  subdivision 14.  A carrier who meets the requirements of this 
  4.18  subdivision is not considered an endangerment under section 
  4.19  144.4803, subdivision 10, clauses (2) to (6) and (8).  Nothing 
  4.20  in this subdivision shall be construed to limit the authority of 
  4.21  the commissioner to take necessary actions to protect the public 
  4.22  health according to sections 144.4801 to 144.4813. 
  4.23     Sec. 5.  [144.4803] [DEFINITIONS.] 
  4.24     Subdivision 1.  [ACTIVE TUBERCULOSIS.] "Active tuberculosis"
  4.25  includes infectious and noninfectious tuberculosis and means: 
  4.26     (1) a condition evidenced by a positive culture for 
  4.27  mycobacterium tuberculosis taken from a pulmonary or laryngeal 
  4.28  source; 
  4.29     (2) a condition evidenced by a positive culture for 
  4.30  mycobacterium tuberculosis taken from an extrapulmonary source 
  4.31  when there is clinical evidence such as a positive skin test for 
  4.32  tuberculosis infection, coughing, sputum production, fever, or 
  4.33  other symptoms compatible with pulmonary tuberculosis; or 
  4.34     (3) a condition in which clinical specimens are not 
  4.35  available for culture, but there is radiographic evidence of 
  4.36  tuberculosis such as an abnormal chest X-ray, and clinical 
  5.1   evidence such as a positive skin test for tuberculosis 
  5.2   infection, coughing, sputum production, fever, or other symptoms 
  5.3   compatible with pulmonary tuberculosis, that lead a physician to 
  5.4   reasonably diagnose active tuberculosis according to currently 
  5.5   accepted standards of medical practice and to initiate treatment 
  5.6   for tuberculosis. 
  5.7      Subd. 2.  [BOARD OF HEALTH.] "Board of health" means an 
  5.8   administrative authority established under section 145A.03. 
  5.9      Subd. 3.  [CARRIER.] "Carrier" means a person who has 
  5.10  active tuberculosis or is clinically suspected of having active 
  5.11  tuberculosis. 
  5.12     Subd. 4.  [CLINICALLY SUSPECTED OF HAVING ACTIVE 
  5.13  TUBERCULOSIS.] "Clinically suspected of having active 
  5.14  tuberculosis" means presenting a reasonable possibility of 
  5.15  having active tuberculosis based upon epidemiologic, clinical, 
  5.16  or radiographic evidence, laboratory test results, or other 
  5.17  reliable evidence as determined by a physician using currently 
  5.18  accepted standards of medical practice. 
  5.19     Subd. 5.  [COMMISSIONER.] "Commissioner" means the 
  5.20  commissioner of health. 
  5.21     Subd. 6.  [CONTAGION PRECAUTIONS FOR TUBERCULOSIS.] 
  5.22  "Contagion precautions for tuberculosis" means those measures 
  5.23  under currently accepted standards of medical practice that 
  5.24  prevent a carrier from exposing others to tuberculosis. 
  5.25     Subd. 7.  [DEPARTMENT.] "Department" means the department 
  5.26  of health. 
  5.27     Subd. 8.  [DIRECTLY OBSERVED THERAPY.] "Directly observed 
  5.28  therapy" means a method for ensuring compliance with medication 
  5.29  directions in which a licensed health professional or designee 
  5.30  observes a person ingesting prescribed medications or 
  5.31  administers the prescribed medication to the person. 
  5.32     Subd. 9.  [DISEASE PREVENTION OFFICER.] "Disease prevention 
  5.33  officer" means a designated agent of the commissioner, or a 
  5.34  designated agent of a board of health that has express delegated 
  5.35  authority from the commissioner to proceed under sections 
  5.36  144.4801 to 144.4813. 
  6.1      Subd. 10.  [ENDANGERMENT TO THE PUBLIC HEALTH.] 
  6.2   "Endangerment to the public health" means a carrier who may 
  6.3   transmit tuberculosis to another person or persons because the 
  6.4   carrier has engaged or is engaging in any of the following 
  6.5   conduct: 
  6.6      (1) refuses or fails to submit to a diagnostic tuberculosis 
  6.7   examination that is ordered by a physician and is reasonable 
  6.8   according to currently accepted standards of medical practice; 
  6.9      (2) refuses or fails to initiate or complete treatment for 
  6.10  tuberculosis that is prescribed by a physician and is reasonable 
  6.11  according to currently accepted standards of medical practice; 
  6.12     (3) refuses or fails to keep appointments for treatment of 
  6.13  tuberculosis; 
  6.14     (4) refuses or fails to provide the commissioner, upon 
  6.15  request, with evidence showing the completion of a course of 
  6.16  treatment for tuberculosis that is prescribed by a physician and 
  6.17  is reasonable according to currently accepted standards of 
  6.18  medical practice; 
  6.19     (5) refuses or fails to initiate or complete a course of 
  6.20  directly observed therapy that is prescribed by a physician and 
  6.21  is reasonable according to currently accepted standards of 
  6.22  medical practice; 
  6.23     (6) misses at least 20 percent of scheduled appointments 
  6.24  for directly observed therapy, or misses at least two 
  6.25  consecutive appointments for directly observed therapy; 
  6.26     (7) refuses or fails to follow contagion precautions for 
  6.27  tuberculosis after being instructed on the precautions by a 
  6.28  licensed health professional or by the commissioner; 
  6.29     (8) based on evidence of the carrier's past or present 
  6.30  behavior, may not complete a course of treatment for 
  6.31  tuberculosis that is reasonable according to currently accepted 
  6.32  standards of medical practice; or 
  6.33     (9) may expose other persons to tuberculosis based on 
  6.34  epidemiological, medical, or other reliable evidence. 
  6.35     Subd. 11.  [EPIDEMIOLOGICAL DATA OR EPIDEMIOLOGICAL 
  6.36  EVIDENCE.] "Epidemiological data" or "epidemiological evidence" 
  7.1   means data or evidence relating to the occurrence, distribution, 
  7.2   clinical characteristics, and control of disease within a group 
  7.3   of people or within a specified population. 
  7.4      Subd. 12.  [HEALTH ORDER.] "Health order" means an order 
  7.5   issued by the commissioner or a board of health with express 
  7.6   delegated authority from the commissioner. 
  7.7      Subd. 13.  [INFECTIOUS TUBERCULOSIS.] "Infectious 
  7.8   tuberculosis" means the stage of tuberculosis where 
  7.9   mycobacterial organisms are capable of being expelled into the 
  7.10  air by a person, as determined by laboratory, epidemiological, 
  7.11  or clinical findings. 
  7.12     Subd. 14.  [ISOLATION.] "Isolation" means placing a carrier 
  7.13  who has infectious tuberculosis in: 
  7.14     (1) a hospital or other treatment facility; 
  7.15     (2) the carrier's residence or current location; or 
  7.16     (3) any other place approved by the commissioner, provided 
  7.17  that the place of isolation prevents or limits the transmission 
  7.18  of the infectious tuberculosis agent to others during the period 
  7.19  of infectiousness. 
  7.20     Subd. 15.  [LICENSED HEALTH PROFESSIONAL.] "Licensed health 
  7.21  professional" means a person licensed by one of the 
  7.22  health-related licensing boards listed in section 214.01, 
  7.23  subdivision 2. 
  7.24     Subd. 16.  [PEACE OFFICER.] "Peace officer" means an 
  7.25  employee or an elected or appointed official of a political 
  7.26  subdivision or law enforcement agency who is licensed by the 
  7.27  board of peace officer standards and training, is charged with 
  7.28  the prevention and detection of crime and the enforcement of the 
  7.29  general criminal laws of the state, and has the full power of 
  7.30  arrest.  "Peace officer" includes an officer of the Minnesota 
  7.31  state patrol. 
  7.32     Subd. 17.  [PHYSICIAN.] "Physician" means a person who is 
  7.33  licensed by the board of medical practice under chapter 147 to 
  7.34  practice medicine. 
  7.35     Subd. 18.  [RESPONDENT.] "Respondent" means a person or 
  7.36  group of persons to whom the commissioner has issued a health 
  8.1   order, excluding the carrier. 
  8.2      Subd. 19.  [TREATMENT FACILITY.] "Treatment facility" means 
  8.3   a hospital or other treatment provider that is qualified to 
  8.4   provide care, treatment, and appropriate contagion precautions 
  8.5   for tuberculosis. 
  8.6      Sec. 6.  [144.4804] [REPORTING RELATING TO TUBERCULOSIS.] 
  8.7      Subdivision 1.  [MANDATORY REPORTING.] A licensed health 
  8.8   professional must report to the commissioner or a disease 
  8.9   prevention officer within 24 hours of obtaining knowledge of a 
  8.10  reportable person as specified in subdivision 3, unless the 
  8.11  licensed health professional is aware that the facts causing the 
  8.12  person to be a reportable person have previously been reported.  
  8.13  Within 72 hours of making a report, excluding Saturdays, 
  8.14  Sundays, and legal holidays, the licensed health professional 
  8.15  shall submit to the commissioner or to the disease prevention 
  8.16  officer a certified copy of the reportable person's medical 
  8.17  records relating to the carrier's tuberculosis and status as an 
  8.18  endangerment to the public health if the person is reportable 
  8.19  under subdivision 3, clause (3), (4), or (5).  A reporting 
  8.20  facility may designate an infection control practitioner to make 
  8.21  reports and to send certified medical records relating to the 
  8.22  carrier's tuberculosis and status as an endangerment to the 
  8.23  public health under this subdivision. 
  8.24     Subd. 2.  [VOLUNTARY REPORTING.] A person other than a 
  8.25  licensed health professional may report to the commissioner or a 
  8.26  disease prevention officer if the person has knowledge of a 
  8.27  reportable person as specified in subdivision 3, or has probable 
  8.28  cause to believe that a person should be reported under 
  8.29  subdivision 3. 
  8.30     Subd. 3.  [REPORTABLE PERSONS.] A licensed health 
  8.31  professional must report to the commissioner or a disease 
  8.32  prevention officer if the licensed health professional has 
  8.33  knowledge of: 
  8.34     (1) a person who has been diagnosed with active 
  8.35  tuberculosis; 
  8.36     (2) a person who is clinically suspected of having active 
  9.1   tuberculosis; 
  9.2      (3) a person who refuses or fails to submit to a diagnostic 
  9.3   tuberculosis examination when the person is clinically suspected 
  9.4   of having tuberculosis; 
  9.5      (4) a carrier who has refused or failed to initiate or 
  9.6   complete treatment for tuberculosis, including refusal or 
  9.7   failure to take medication for tuberculosis or keep appointments 
  9.8   for directly observed therapy or other treatment of 
  9.9   tuberculosis; or 
  9.10     (5) a person who refuses or fails to follow contagion 
  9.11  precautions for tuberculosis after being instructed on the 
  9.12  precautions by a licensed health professional or by the 
  9.13  commissioner. 
  9.14     Subd. 4.  [REPORTING INFORMATION.] The report by a licensed 
  9.15  health professional under subdivision 1 or by a person under 
  9.16  subdivision 2 must contain the following information, to the 
  9.17  extent known: 
  9.18     (1) the reportable person's name, birth date, address or 
  9.19  last known location, and telephone number; 
  9.20     (2) the date and specific circumstances that cause the 
  9.21  person to be a reportable person; 
  9.22     (3) the reporting person's name, title, address, and 
  9.23  telephone number; and 
  9.24     (4) any other information relevant to the reportable 
  9.25  person's case of tuberculosis. 
  9.26     Subd. 5.  [IMMUNITY FOR REPORTING.] A licensed health 
  9.27  professional who is required to report under subdivision 1 or a 
  9.28  person who voluntarily reports in good faith under subdivision 2 
  9.29  is immune from liability in a civil, administrative, 
  9.30  disciplinary, or criminal action for reporting under this 
  9.31  section. 
  9.32     Subd. 6.  [FALSIFIED REPORTS.] A person who knowingly or 
  9.33  recklessly makes a false report under this section is liable in 
  9.34  a civil suit for actual damages suffered by the person or 
  9.35  persons reported and for punitive damages. 
  9.36     Subd. 7.  [WAIVER OF PRIVILEGE.] A person who is the 
 10.1   subject of a report under subdivision 1 is deemed to have waived 
 10.2   any privilege created in section 595.02, subdivision 1, 
 10.3   paragraphs (d), (e), (g), (i), (j), and (k), with respect to any 
 10.4   information provided under this section. 
 10.5      Sec. 7.  [144.4805] [ISSUANCE OF HEALTH ORDER; RIGHTS OF 
 10.6   CARRIER AND RESPONDENT.] 
 10.7      Subdivision 1.  [AUTHORITY.] Only the commissioner, or a 
 10.8   board of health with express delegated authority from the 
 10.9   commissioner, may issue a health order under this section. 
 10.10     Subd. 2.  [GROUNDS FOR HEALTH ORDER.] Whenever the 
 10.11  commissioner has probable cause to believe that a carrier is an 
 10.12  endangerment to the public health, the commissioner may issue a 
 10.13  health order that the commissioner deems necessary to protect 
 10.14  the public health.  The commissioner may petition the court for 
 10.15  enforcement of the health order.  In a court proceeding for 
 10.16  enforcement of the health order, the commissioner shall 
 10.17  demonstrate the particularized circumstances constituting the 
 10.18  necessity for the health order.  The health order may be issued 
 10.19  to any person, including to a carrier, physician, licensed 
 10.20  health professional, or treatment facility.  The health order 
 10.21  may be in the form of a subpoena by the commissioner for 
 10.22  certified medical records relating to the carrier's tuberculosis 
 10.23  and status as an endangerment to the public health. 
 10.24     Subd. 3.  [CONTENTS OF HEALTH ORDER.] A health order must 
 10.25  include: 
 10.26     (1) a citation to this section as the legal authority under 
 10.27  which the order is issued; 
 10.28     (2) a summary of evidence upon which the person is alleged 
 10.29  to be a carrier; 
 10.30     (3) a description of the alleged conduct of the carrier 
 10.31  that makes the carrier an endangerment to the public health; 
 10.32     (4) a description of less restrictive alternatives that the 
 10.33  commissioner considered and rejected, together with the reasons 
 10.34  for the rejection, or a description of less restrictive 
 10.35  alternatives that the commissioner used and that were 
 10.36  unsuccessful; 
 11.1      (5) the preventive measure ordered; and 
 11.2      (6) a notice advising the carrier or respondent that: 
 11.3      (i) a hearing will be held if the carrier or respondent 
 11.4   petitions the court for a hearing, or if the commissioner 
 11.5   determines that the carrier has not complied with the health 
 11.6   order; 
 11.7      (ii) the carrier or respondent has the right to appear at 
 11.8   the hearing; 
 11.9      (iii) the carrier or respondent has the right to present 
 11.10  and cross-examine witnesses at the hearing; 
 11.11     (iv) the carrier has the right to court-appointed counsel 
 11.12  in a proceeding under sections 144.4801 to 144.4813; and 
 11.13     (v) the carrier or respondent has the right to the 
 11.14  assistance of an interpreter in a proceeding under sections 
 11.15  144.4801 to 144.4813. 
 11.16     Subd. 4.  [RIGHT TO COUNSEL.] (a) The carrier or respondent 
 11.17  has the right to counsel in any proceeding under sections 
 11.18  144.4801 to 144.4813.  The court shall promptly appoint counsel 
 11.19  for a carrier if the carrier does not have counsel: 
 11.20     (1) at the time the court issues an order under section 
 11.21  144.4807, subdivision 7, authorizing the continued detention of 
 11.22  the carrier; 
 11.23     (2) at the time the court issues an order under section 
 11.24  144.4808, subdivision 2, authorizing the carrier to be 
 11.25  apprehended and held; or 
 11.26     (3) in all other cases, at the time either party files a 
 11.27  notice for a preliminary hearing under section 144.4810, 
 11.28  subdivision 2. 
 11.29     The court shall appoint counsel for the carrier.  The cost 
 11.30  of court-appointed counsel shall be paid by the court. 
 11.31     (b) Upon being notified of the name and address of counsel 
 11.32  for the carrier, the commissioner shall promptly forward to the 
 11.33  carrier and the carrier's counsel the following: 
 11.34     (1) a copy of the health order; 
 11.35     (2) a certified copy of relevant portions of the carrier's 
 11.36  medical records; and 
 12.1      (3) the name and address of the licensed health 
 12.2   professional, including the carrier's attending physician or 
 12.3   nurse, or the public health physician or nurse whom the 
 12.4   commissioner intends to have testify at the preliminary hearing, 
 12.5   and a summary of the witness' testimony, including a copy of the 
 12.6   witness' affidavit, if any. 
 12.7      Subd. 5.  [DUTY TO COMMUNICATE.] The commissioner's counsel 
 12.8   and the carrier's counsel shall make every effort to communicate 
 12.9   prior to any hearing and to stipulate as to undisputed facts, 
 12.10  witnesses, and exhibits. 
 12.11     Subd. 6.  [RIGHT TO INTERPRETER.] The carrier or respondent 
 12.12  has the right to the assistance of an interpreter in a 
 12.13  proceeding under sections 144.4801 to 144.4813. 
 12.14     Subd. 7.  [SERVICE OF ORDER.] A health order may be served 
 12.15  by a disease prevention officer or peace officer. 
 12.16     Sec. 8.  [144.4806] [PREVENTIVE MEASURES UNDER HEALTH 
 12.17  ORDER.] 
 12.18     A health order may include, but need not be limited to, an 
 12.19  order: 
 12.20     (1) requiring the carrier's attending physician or 
 12.21  treatment facility to isolate and detain the carrier for 
 12.22  treatment or for a diagnostic examination for tuberculosis, 
 12.23  pursuant to section 144.4807, subdivision 1, if the carrier is 
 12.24  an endangerment to the public health and is in a treatment 
 12.25  facility; 
 12.26     (2) requiring a carrier who is an endangerment to the 
 12.27  public health to submit to diagnostic examination for 
 12.28  tuberculosis and to remain in the treatment facility until the 
 12.29  commissioner receives the results of the examination; 
 12.30     (3) requiring a carrier who is an endangerment to the 
 12.31  public health to remain in or present at a treatment facility 
 12.32  until the carrier has completed a course of treatment for 
 12.33  tuberculosis that is prescribed by a physician and is reasonable 
 12.34  according to currently accepted standards of medical practice; 
 12.35     (4) requiring a carrier who is an endangerment to the 
 12.36  public health to complete a course of treatment for tuberculosis 
 13.1   that is prescribed by a physician and is reasonable according to 
 13.2   currently accepted standards of medical practice and, if 
 13.3   necessary, to follow contagion precautions for tuberculosis; 
 13.4      (5) requiring a carrier who is an endangerment to the 
 13.5   public health to follow a course of directly observed therapy 
 13.6   that is prescribed by a physician and is reasonable according to 
 13.7   currently accepted standards of medical practice; 
 13.8      (6) excluding a carrier who is an endangerment to the 
 13.9   public health from the carrier's place of work or school, or 
 13.10  from other premises if the commissioner determines that 
 13.11  exclusion is necessary because contagion precautions for 
 13.12  tuberculosis cannot be maintained in a manner adequate to 
 13.13  protect others from being exposed to tuberculosis; 
 13.14     (7) requiring a licensed health professional or treatment 
 13.15  facility to provide to the commissioner certified copies of all 
 13.16  medical and epidemiological data relevant to the carrier's 
 13.17  tuberculosis and status as an endangerment to the public health; 
 13.18     (8) requiring the diagnostic examination for tuberculosis 
 13.19  of other persons in the carrier's household, workplace, or 
 13.20  school, or other persons in close contact with the carrier if 
 13.21  the commissioner has probable cause to believe that the persons 
 13.22  may have active tuberculosis or may have been exposed to 
 13.23  tuberculosis based on epidemiological, medical, or other 
 13.24  reliable evidence; or 
 13.25     (9) requiring a carrier or other persons to follow 
 13.26  contagion precautions for tuberculosis. 
 13.27     Sec. 9.  [144.4807] [NOTICE OF OBLIGATION TO ISOLATE OR 
 13.28  EXAMINE.] 
 13.29     Subdivision 1.  [OBLIGATION TO ISOLATE.] If the carrier is 
 13.30  in a treatment facility, the commissioner or a carrier's 
 13.31  attending physician, after obtaining approval from the 
 13.32  commissioner, may issue a notice of obligation to isolate to a 
 13.33  treatment facility if the commissioner or attending physician 
 13.34  has probable cause to believe that a carrier is an endangerment 
 13.35  to the public health.  
 13.36     Subd. 2.  [OBLIGATION TO EXAMINE.] If the carrier is 
 14.1   clinically suspected of having active tuberculosis, the 
 14.2   commissioner may issue a notice of obligation to examine to the 
 14.3   carrier's attending physician to conduct a diagnostic 
 14.4   examination for tuberculosis on the carrier. 
 14.5      Subd. 3.  [PRECAUTIONS TO AVOID EXPOSURE.] Upon receiving a 
 14.6   notice of obligation to isolate or notice of obligation to 
 14.7   examine, a treatment facility shall immediately take all 
 14.8   reasonable precautions to prevent the carrier from exposing 
 14.9   other persons to tuberculosis, including the use of guards or 
 14.10  locks, if appropriate. 
 14.11     Subd. 4.  [SERVICE OF HEALTH ORDER ON CARRIER.] When 
 14.12  issuing a notice of obligation to isolate or examine to the 
 14.13  carrier's physician or a treatment facility, the commissioner 
 14.14  shall simultaneously serve a health order on the carrier 
 14.15  ordering the carrier to remain in the treatment facility for 
 14.16  treatment or examination. 
 14.17     Subd. 5.  [DURATION OF DETENTION.] No carrier may be 
 14.18  detained under subdivision 1 or 2 longer than 72 hours, 
 14.19  excluding Saturdays, Sundays, and legal holidays, unless the 
 14.20  court issues an order authorizing continued detention of the 
 14.21  carrier pursuant to subdivision 7.  A carrier may not be 
 14.22  released prior to the expiration of the 72-hour hold without the 
 14.23  express consent of the commissioner. 
 14.24     Subd. 6.  [APPLICATION FOR EXTENSION OF 72-HOUR HOLD.] The 
 14.25  commissioner may seek an order extending the hold under 
 14.26  subdivision 5 by filing an ex parte application with the probate 
 14.27  division of the district court of the county in which the 
 14.28  carrier resides.  The application may be filed orally by 
 14.29  telephone or by facsimile, provided that a written application 
 14.30  is filed within 72 hours, excluding Saturdays, Sundays, and 
 14.31  legal holidays. 
 14.32     Subd. 7.  [COURT ORDER EXTENDING 72-HOUR HOLD.] The court 
 14.33  may extend the hold under subdivision 5 by up to six days, 
 14.34  excluding Saturdays, Sundays, and legal holidays, if the court 
 14.35  finds that there is probable cause to believe that the carrier 
 14.36  is an endangerment to the public health.  The court may find 
 15.1   probable cause to detain, examine, and isolate the carrier based 
 15.2   upon a written statement by facsimile or upon an oral statement 
 15.3   by telephone from the carrier's attending physician or nurse, a 
 15.4   public health physician or nurse, other licensed health 
 15.5   professional, or disease prevention officer, stating the grounds 
 15.6   and facts that demonstrate that the carrier is an endangerment 
 15.7   to the public health, provided that an affidavit from such 
 15.8   witness is filed with the court within 72 hours, excluding 
 15.9   Saturdays, Sundays, and legal holidays.  The order may be issued 
 15.10  orally by telephone, or by facsimile, provided that a written 
 15.11  order is issued within 72 hours, excluding Saturdays, Sundays, 
 15.12  and legal holidays.  The oral and written order shall contain a 
 15.13  notice of the carrier's rights contained in section 144.4805, 
 15.14  subdivision 3, clause (6).  A carrier may not be released prior 
 15.15  to the hold extended under this subdivision without the express 
 15.16  consent of the commissioner. 
 15.17     Subd. 8.  [APPOINTMENT OF COUNSEL.] If the carrier does not 
 15.18  have counsel at the time the court issues an order to extend the 
 15.19  hold under subdivision 7, the court shall promptly appoint 
 15.20  counsel for the carrier. 
 15.21     Subd. 9.  [IMMUNITY.] A disease prevention officer, peace 
 15.22  officer, physician, licensed health professional, or treatment 
 15.23  facility that acts in good faith under this section is immune 
 15.24  from liability in any civil, administrative, disciplinary, or 
 15.25  criminal action for acting under this section. 
 15.26     Sec. 10.  [144.4808] [APPREHEND AND HOLD ORDER.] 
 15.27     Subdivision 1.  [APPLICATION FOR APPREHEND AND HOLD ORDER.] 
 15.28  The commissioner may make an ex parte application for an order 
 15.29  to apprehend and hold a carrier who is not in a treatment 
 15.30  facility if the commissioner has probable cause to believe that 
 15.31  a carrier is: 
 15.32     (1) an endangerment to the public health; and 
 15.33     (2) either in imminent danger of exposing another person or 
 15.34  persons to tuberculosis, or may flee or become unlocatable. 
 15.35     The commissioner shall file the application in the probate 
 15.36  division of the district court of the county in which the 
 16.1   carrier resides.  The application may be filed orally by 
 16.2   telephone or by facsimile, provided that a written application 
 16.3   is filed within 72 hours, excluding Saturdays, Sundays, and 
 16.4   legal holidays. 
 16.5      Subd. 2.  [COURT ORDER TO APPREHEND AND HOLD.] The court 
 16.6   may find probable cause to apprehend and hold the carrier based 
 16.7   upon a written statement by facsimile or oral statement by 
 16.8   telephone from the carrier's attending physician or nurse, a 
 16.9   public health physician or nurse, other licensed health 
 16.10  professional, or disease prevention officer, stating the grounds 
 16.11  and facts that demonstrate that the carrier is an endangerment 
 16.12  to the public health, provided that an affidavit from such 
 16.13  witness is filed with the court within 72 hours, excluding 
 16.14  Saturdays, Sundays, and legal holidays.  The court may issue an 
 16.15  order to a peace officer or to a disease prevention officer, or 
 16.16  both to: 
 16.17     (1) apprehend and transport the carrier to a designated 
 16.18  treatment facility, and detain the carrier until the carrier is 
 16.19  admitted to the treatment facility; or 
 16.20     (2) apprehend and isolate the carrier. 
 16.21     The order may be issued orally by telephone, or by 
 16.22  facsimile, provided that a written order is issued within 72 
 16.23  hours, excluding Saturdays, Sundays, and legal holidays.  The 
 16.24  oral and written order shall contain a notice of the carrier's 
 16.25  rights contained in section 144.4805, subdivision 3, clause (6). 
 16.26     Subd. 3.  [DURATION OF DETENTION.] A carrier may be 
 16.27  detained under this subdivision up to six days, excluding 
 16.28  Saturdays, Sundays, and legal holidays.  A carrier may not be 
 16.29  released prior to the expiration of the hold authorized under 
 16.30  this section without the express consent of the commissioner. 
 16.31     Subd. 4.  [APPREHENSION OF CARRIER.] If the carrier flees 
 16.32  or forcibly resists the peace officer or disease prevention 
 16.33  officer, the officer may use all necessary and lawful means to 
 16.34  apprehend, hold, transport, or isolate the carrier.  This 
 16.35  subdivision is authority for the officer to carry out the duties 
 16.36  specified in this section.  The commissioner shall provide any 
 17.1   information and equipment necessary to protect the officer from 
 17.2   becoming exposed to tuberculosis. 
 17.3      Subd. 5.  [APPOINTMENT OF COUNSEL.] If the carrier does not 
 17.4   have counsel at the time the court issues an apprehend and hold 
 17.5   order under subdivision 2, the court shall promptly appoint 
 17.6   counsel for the carrier. 
 17.7      Subd. 6.  [IMMUNITY.] A disease prevention officer, peace 
 17.8   officer, physician, licensed health professional, or treatment 
 17.9   facility that acts in good faith under this section is immune 
 17.10  from liability in any civil, administrative, disciplinary, or 
 17.11  criminal action for acting under this section. 
 17.12     Sec. 11.  [144.4809] [PRELIMINARY HEARING.] 
 17.13     Subdivision 1.  [GROUNDS FOR HEARING.] A party may petition 
 17.14  the court for an order for enforcement of or relief from a 
 17.15  health order or judicial order. 
 17.16     Subd. 2.  [PETITION FOR PRELIMINARY HEARING.] The 
 17.17  petitioning party shall serve on the commissioner and file in 
 17.18  the probate division of the district court of the county in 
 17.19  which the carrier or respondent resides a petition and notice of 
 17.20  preliminary hearing.  The court shall hold a preliminary hearing 
 17.21  no later than 15 days from the date of the filing and service of 
 17.22  the petition for a preliminary hearing.  If a carrier detained 
 17.23  under section 144.4807 or 144.4808 files a petition for a 
 17.24  preliminary hearing, the hearing must be held no later than five 
 17.25  days from the date of the filing and service of the petition, 
 17.26  excluding Saturdays, Sundays, and legal holidays. 
 17.27     Subd. 3.  [COMMISSIONER'S NOTICE OF HEARING.] If the 
 17.28  commissioner petitions the court to enforce the health order, 
 17.29  the notice of the preliminary hearing must contain the following 
 17.30  information: 
 17.31     (1) the date, time, and place of the hearing; 
 17.32     (2) the right of the carrier to be represented by 
 17.33  court-appointed counsel during any proceeding under sections 
 17.34  144.4801 to 144.4813; 
 17.35     (3) the right of the carrier or respondent to the 
 17.36  assistance of an interpreter in any proceeding under sections 
 18.1   144.4801 to 144.4813; 
 18.2      (4) the right of the carrier or respondent to appear at the 
 18.3   hearing; 
 18.4      (5) the right of the carrier or respondent to present and 
 18.5   cross-examine witnesses; 
 18.6      (6) a statement of any disputed facts, or a statement of 
 18.7   the nature of any other disputed matter; and 
 18.8      (7) the name and address of any witness that the 
 18.9   petitioning party intends to call to testify at the hearing, and 
 18.10  a brief summary of the witness' testimony. 
 18.11     Subd. 4.  [CARRIER'S OR RESPONDENT'S NOTICE OF HEARING.] If 
 18.12  the carrier or respondent petitions the court for relief from 
 18.13  the health order or court order, the notice of preliminary 
 18.14  hearing must contain the information in subdivision 3, clauses 
 18.15  (1), (6), and (7). 
 18.16     Subd. 5.  [DUTY TO COMMUNICATE.] (a) At least five days 
 18.17  before the date of the preliminary hearing, excluding Saturdays, 
 18.18  Sundays, and legal holidays, the nonpetitioning party shall 
 18.19  respond to the petition for hearing by filing and serving on the 
 18.20  petitioning party:  
 18.21     (1) a statement of any disputed facts, or a statement of 
 18.22  the nature of any other disputed matter; and 
 18.23     (2) the name and address of any witness that the 
 18.24  nonpetitioning party intends to call to testify at the hearing, 
 18.25  and a brief summary of the witness' testimony.  
 18.26     If the carrier seeks release from an emergency hold ordered 
 18.27  under section 144.4807, subdivision 7, or under section 
 18.28  144.4808, subdivision 2, the commissioner shall file and serve 
 18.29  on the carrier's counsel the items in clauses (1) and (2) at 
 18.30  least 48 hours prior to the preliminary hearing, excluding 
 18.31  Saturdays, Sundays, and legal holidays. 
 18.32     (b) At the hearing, the parties shall identify the efforts 
 18.33  they made to resolve the matter prior to the preliminary hearing.
 18.34     Subd. 6.  [HEARING ROOM IN TREATMENT FACILITY.] If the 
 18.35  carrier is infectious, the treatment facility in which the 
 18.36  carrier is sought to be detained or to which the carrier is 
 19.1   sought to be removed shall make reasonable accommodations to 
 19.2   provide a room where the hearing may be held that minimizes the 
 19.3   risk of exposing persons attending the hearing to tuberculosis.  
 19.4   If a room is not available at the treatment facility, the court 
 19.5   may designate another location for the hearing. 
 19.6      Subd. 7.  [STANDARD OF PROOF.] The commissioner must prove 
 19.7   by a preponderance of the evidence that the carrier is an 
 19.8   endangerment to the public health. 
 19.9      Subd. 8.  [RULES OF EVIDENCE.] The court shall admit all 
 19.10  reliable relevant evidence.  Medical and epidemiological data 
 19.11  must be admitted if it conforms with section 145.31, chapter 
 19.12  600, Minnesota Rules of Evidence, rule 803(6), or other statutes 
 19.13  or rules that permit reliable evidence to be admitted in civil 
 19.14  cases.  The court may rely on medical and epidemiological data, 
 19.15  including hearsay, if it finds that physicians and other 
 19.16  licensed health professionals rely on the data in the regular 
 19.17  course of providing health care and treatment. 
 19.18     Subd. 9.  [SUFFICIENCY OF EVIDENCE.] It is a sufficient 
 19.19  basis for the court to order continued confinement of the 
 19.20  carrier or other preventive measures requested by the 
 19.21  commissioner if reliable testimony is provided solely by the 
 19.22  carrier's attending physician or nurse, a public health 
 19.23  physician or nurse, other licensed health professional, or 
 19.24  disease prevention officer. 
 19.25     Subd. 10.  [FAILURE TO APPEAR AT HEARING.] If the carrier 
 19.26  or respondent fails to appear at the hearing without prior court 
 19.27  approval, the hearing may proceed without the carrier or 
 19.28  respondent and the court may make its determination on the basis 
 19.29  of all reliable evidence submitted at the hearing. 
 19.30     Sec. 12.  [144.4810] [FINAL HEARING.] 
 19.31     Subdivision 1.  [GROUNDS FOR HEARING.] After the 
 19.32  preliminary hearing, the commissioner, carrier, or respondent 
 19.33  may petition the court for relief from or enforcement of the 
 19.34  court order issued pursuant to the preliminary hearing.  The 
 19.35  commissioner may petition the court for additional preventive 
 19.36  measures if the carrier or respondent has not complied with the 
 20.1   court order issued pursuant to the preliminary hearing.  The 
 20.2   petitioning party shall serve and file a petition and notice of 
 20.3   hearing with the probate division of the district court.  The 
 20.4   court shall hold the final hearing no later than 15 days from 
 20.5   the date of the filing and service of the petition for a final 
 20.6   hearing. 
 20.7      Subd. 2.  [NOTICE OF HEARING.] The notice of the final 
 20.8   hearing must contain the same information as for the preliminary 
 20.9   hearing in section 144.4809, subdivision 3 or 4. 
 20.10     Subd. 3.  [DUTY TO COMMUNICATE.] The parties have a duty to 
 20.11  communicate and exchange information as provided in section 
 20.12  144.4809, subdivision 5. 
 20.13     Subd. 4.  [HEARING ROOM IN TREATMENT FACILITY.] The hearing 
 20.14  room for the final hearing is governed by section 144.4809, 
 20.15  subdivision 6. 
 20.16     Subd. 5.  [STANDARD OF PROOF.] The commissioner must prove 
 20.17  by clear and convincing evidence that the carrier is an 
 20.18  endangerment to the public health. 
 20.19     Subd. 6.  [RULES OF EVIDENCE.] The rules of evidence are 
 20.20  governed by section 144.4809, subdivision 8. 
 20.21     Subd. 7.  [SUFFICIENCY OF EVIDENCE.] The sufficiency of 
 20.22  evidence is governed by section 144.4809, subdivision 9. 
 20.23     Subd. 8.  [FAILURE TO APPEAR AT HEARING.] The failure of 
 20.24  the carrier or respondent to appear at the hearing is governed 
 20.25  by section 144.4809, subdivision 10. 
 20.26     Subd. 9.  [RIGHT OF APPEAL.] The commissioner, carrier, or 
 20.27  respondent may appeal the decision of the district court.  The 
 20.28  court of appeals shall hear the appeal within 60 days after 
 20.29  filing and service of the notice of appeal. 
 20.30     Subd. 10.  [RIGHT OF COMMISSIONER TO ISSUE SUBSEQUENT 
 20.31  ORDER.] Notwithstanding any ruling by the district court, the 
 20.32  commissioner may issue a subsequent health order if the 
 20.33  commissioner has probable cause to believe that a health order 
 20.34  is necessary based on additional facts not known or present at 
 20.35  the time of the district court hearing. 
 20.36     Sec. 13.  [144.4811] [PERIODIC REVIEW AND RELEASE FROM 
 21.1   DETENTION.] 
 21.2      Subdivision 1.  [PERIODIC REVIEW.] If the carrier has been 
 21.3   detained in a treatment facility or has been isolated pursuant 
 21.4   to a court order, the commissioner shall submit a report to the 
 21.5   court, the carrier, and the carrier's counsel within 90 days of 
 21.6   the date of the court-ordered detention and every 90 days 
 21.7   thereafter, until the carrier is released.  The report must 
 21.8   state the treatment the carrier receives, whether the carrier is 
 21.9   cured or noninfectious, and whether the carrier will continue to 
 21.10  be detained.  If the carrier contests the commissioner's 
 21.11  determination for continued detention, the carrier may request a 
 21.12  hearing.  The hearing on continued detention is governed by the 
 21.13  provisions for a final hearing under section 144.4810, excluding 
 21.14  subdivision 5 of that section.  The court shall order continued 
 21.15  detention of the carrier if it finds that such detention is 
 21.16  reasonable.  This subdivision does not apply to consent orders 
 21.17  or other confinement that has been voluntarily agreed upon by 
 21.18  the parties. 
 21.19     Subd. 2.  [CARRIER'S PETITION FOR RELEASE.] If the carrier 
 21.20  is detained in a treatment facility or isolated pursuant to a 
 21.21  court order, the carrier may make a good faith request for 
 21.22  release from confinement prior to the 90-day review under 
 21.23  subdivision 1 by filing a petition and notice of hearing with 
 21.24  the court that ordered the confinement and by serving the 
 21.25  petition and notice on the commissioner.  The hearing on 
 21.26  continued confinement is governed by the provisions for a final 
 21.27  hearing under section 144.4810, excluding subdivision 5 of that 
 21.28  section.  The court shall order continued detention of the 
 21.29  carrier if it finds that such detention is reasonable. 
 21.30     Subd. 3.  [RELEASE FROM DETENTION BASED ON ORDER TO COMPEL 
 21.31  EXAMINATION.] A carrier who has been detained in a treatment 
 21.32  facility under a court order to compel the carrier to submit to 
 21.33  a diagnostic tuberculosis examination shall be released only 
 21.34  after: 
 21.35     (1) the commissioner determines that the carrier does not 
 21.36  have active tuberculosis; or 
 22.1      (2) the commissioner determines that the carrier is not an 
 22.2   endangerment to the public health. 
 22.3      Subd. 4.  [RELEASE FROM DETENTION BASED ON ENDANGERMENT.] A 
 22.4   carrier who is detained in a treatment facility or isolated 
 22.5   under a court order because the carrier is an endangerment to 
 22.6   the public health shall be released only after: 
 22.7      (1) the commissioner determines that the carrier is cured; 
 22.8   or 
 22.9      (2) the commissioner determines that the carrier is no 
 22.10  longer an endangerment to the public health. 
 22.11     Sec. 14.  [144.4812] [COSTS OF CARE.] 
 22.12     The costs incurred by the treatment facility and other 
 22.13  providers of services to diagnose or treat the carrier for 
 22.14  tuberculosis must be borne by the carrier, the carrier's health 
 22.15  plan, or public programs.  During the period of insurance 
 22.16  coverage, a health plan may direct the implementation of the 
 22.17  care required by the health order or court order and shall pay 
 22.18  at the contracted rate of payment, which shall be considered 
 22.19  payment in full.  Inpatient hospital services required by the 
 22.20  health order or court order and covered by medical assistance or 
 22.21  general assistance medical care are not billable to any other 
 22.22  governmental entity.  If the carrier cannot pay for treatment, 
 22.23  and the carrier does not have public or private health insurance 
 22.24  coverage, the carrier shall apply for financial assistance with 
 22.25  the aid of the county.  For persons not otherwise eligible for 
 22.26  public assistance, the commissioner of human services shall 
 22.27  determine what, if any, costs the carrier shall pay.  The 
 22.28  commissioner of human services shall make payments at the 
 22.29  general assistance medical care rate, which will be considered 
 22.30  payment in full. 
 22.31     Sec. 15.  [144.4813] [DATA PRIVACY.] 
 22.32     Subdivision 1.  [NONPUBLIC DATA.] Data on individuals 
 22.33  contained in the health order are health data under section 
 22.34  13.38.  Other data on individuals collected by the commissioner 
 22.35  as part of an investigation of a carrier under sections 144.4801 
 22.36  to 144.4813 are investigative data under section 13.39. 
 23.1      Subd. 2.  [PROTECTIVE ORDER.] After a judicial action is 
 23.2   commenced, a party may seek a protective order to protect the 
 23.3   disclosure of portions of the court record identifying 
 23.4   individuals or entities. 
 23.5      Subd. 3.  [RECORDS RETENTION.] A records retention schedule 
 23.6   for records developed under sections 144.4801 to 144.4813 must 
 23.7   be established pursuant to section 138.17, subdivision 7.