Minnesota Legislature
Office of the Revisor of Statutes
Minnesota Session Laws - 1997, Regular Session
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.
Official Publication of the State of Minnesota
Revisor of Statutes