23-07.6 Communicable Disease Confinement Procedure

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CHAPTER 23-07.6COMMUNICABLE DISEASE CONFINEMENT PROCEDURE23-07.6-01. Definitions. As used in this chapter, unless the context otherwise requires:1.&quot;Communicable disease&quot; means a disease or condition that causes serious illness,<br>serious disability, or death, the infectious agent of which may pass or be carried,<br>directly or indirectly, from the body of one person to the body of another.2.&quot;Confinement&quot; means quarantine or isolation.3.&quot;Isolation&quot; means the physical separation and restrictions on movement or travel of<br>an individual or groups of individuals who are infected or reasonably believed to be<br>infected with a contagious or possibly contagious disease from nonisolated<br>individuals, to prevent or limit the transmission of the disease to nonisolated<br>individuals.4.&quot;Local board&quot; means a board of health as defined under section 23-35-01.5.&quot;Local health officer&quot; means the health officer of a local board.6.&quot;Quarantine&quot; means the physical separation and restrictions on movement or travel<br>of an individual or groups of individuals, who are or may have been exposed to a<br>contagious or possibly contagious disease and who do not show signs or symptoms<br>of a contagious disease, from nonquarantined individuals to prevent or limit the<br>transmission of the disease to nonquarantined individuals.7.&quot;Respondent&quot; means the person or group of persons ordered to be confined or<br>restricted under this chapter.23-07.6-02. Confinement order - Penalty.1.The state health officer or any local health officer may order any person or group into<br>confinement by a written directive if there are reasonable grounds to believe that the<br>person or group is infected with any communicable disease, the state health officer<br>or local health officer determines that the person or group poses a substantial threat<br>to the public health, and confinement is necessary and is the least restrictive<br>alternative to protect or preserve the public health.2.Conditions and principles.The state or local health officer shall adhere to thefollowing conditions and principles when isolating or quarantining individuals or<br>groups of individuals:a.Isolation and quarantine must be by the least restrictive means necessary to<br>prevent the spread of a contagious or possibly contagious disease to others<br>and may include confinement to private homes or other private and public<br>premises.b.Isolated individuals must be confined separately from quarantined individuals.c.The health status of isolated and quarantined individuals must be monitored<br>regularly to determine if they require isolation or quarantine.d.If a quarantined individual subsequently becomes infected or is reasonably<br>believed to have become infected with a contagious or possibly contagious<br>disease the individual must promptly be removed to isolation.Page No. 1e.Isolated and quarantined individuals must be immediately released when they<br>pose no substantial risk of transmitting a contagious or possibly contagious<br>disease to others.f.The needs of persons isolated and quarantined must be addressed in a<br>systematic and competent fashion, including providing adequate food, clothing,<br>shelter, means of communication with those in isolation or quarantine and<br>outside these settings, medication, and competent medical care.g.Premises used for isolation and quarantine must be maintained in a safe and<br>hygienic manner and be designed to minimize the likelihood of further<br>transmission of infection or other harm to persons isolated and quarantined.h.To the extent possible, cultural and religious beliefs must be considered in<br>addressing the needs of individuals and establishing and maintaining isolation<br>and quarantine premises.3.Cooperation.Persons subject to isolation or quarantine shall obey the healthofficer's rules and orders and must not go beyond the isolation or quarantine<br>premises. Failure to obey these provisions is a class B misdemeanor.4.Entry into isolation or quarantine premises.a.Authorized entry. The state or local health officer may authorize physicians,<br>health care workers, or others access to individuals in isolation or quarantine as<br>necessary to meet the needs of isolated or quarantined individuals.b.Unauthorized entry. A person, other than a person authorized by the state or<br>local health officer, must not enter isolation or quarantine premises. Failure to<br>obey this provision is a class B misdemeanor.c.Potential isolation or quarantine. A person entering an isolation or quarantine<br>premises with or without authorization of the state or local health officer may be<br>isolated or quarantined pursuant to subsection 1.5.This section does not authorize the state health officer or a local public health officer<br>to commandeer, in whole or in part, any hospital or other medical facility.23-07.6-03. Procedures for isolation and quarantine. The isolation and quarantine ofan individual or groups of individuals shall be undertaken in accordance with the following<br>procedures:1.Temporary isolation and quarantine without notice.a.Authorization. The state or a local health officer, within that officer's jurisdiction,<br>may temporarily isolate or quarantine an individual or groups of individuals<br>through a written directive if delay in imposing the isolation or quarantine would<br>significantly jeopardize the health officer's ability to prevent or limit the<br>transmission of a contagious or possibly contagious disease to others.b.Content of directive.The written directive must specify the identity of theindividual or groups of individuals subject to isolation or quarantine, including<br>identification by characteristics if actual identification is impossible or<br>impracticable; the premises subject to isolation or quarantine; the date and time<br>at which isolation or quarantine commences; the suspected contagious disease<br>if known; and decontamination, treatment, or prevention measures that must be<br>followed. The directive must be accompanied by a copy of this chapter and<br>relevant definitions.Page No. 2c.Copies. A copy of the written directive must be given to the individual to be<br>isolated or quarantined or, if the order applies to a group of individuals and it is<br>impractical to provide individual copies, it may be posted in a conspicuous<br>place in the isolation or quarantine premises. The state or local health officer<br>may also use any available mass media, including broadcasting, to provide<br>notice and information about the written directive.d.Petition for continued isolation or quarantine. Within ten days after issuing the<br>written directive, the state or local health officer shall file a petition under<br>subsection 2 for a court order authorizing the continued isolation or quarantine<br>of the isolated or quarantined individual or groups of individuals.2.Isolation or quarantine with notice.a.Authorization. The state or a local health officer may make a written petition to<br>the trial court for an order authorizing the isolation or quarantine of an individual<br>or groups of individuals.b.Content of petition. A petition under subdivision a must specify the identity of<br>the individual or groups of individuals subject to isolation or quarantine,<br>including identification by characteristics if actual identification is impossible or<br>impractical; the premises subject to isolation or quarantine; the date and time at<br>which isolation or quarantine commences; the suspected contagious disease if<br>known; recommended decontamination, treatment, or preventative measures<br>for the suspected contagious disease; a statement of compliance with the<br>conditions and principles authorizing isolation and quarantine under this<br>chapter; and a statement of the basis upon which isolation or quarantine is<br>justified in compliance with this chapter. The petition must be accompanied by<br>the sworn affidavit of the state or local health officer attesting to the facts<br>asserted in the petition, with any further information that may be relevant and<br>material to the court's consideration.c.Notice. Notice to the individuals or groups of individuals identified in the petition<br>must be accomplished within twenty-four hours in accordance with the North<br>Dakota Rules of Civil Procedure. The notice must include a statement that the<br>respondent has the right to counsel, including counsel provided at public<br>expense if indigent and must include a copy of this chapter.23-07.6-04.Place of confinement.A respondent must be confined in a placedesignated in the written directive until the health officer who issued the written directive<br>determines that the respondent no longer poses a substantial threat to the public health or until a<br>court of competent jurisdiction orders the release of the respondent. The state department of<br>health or the local board may establish and maintain places of confinement.23-07.6-05.Court hearing.A hearing must be held on a petition filed undersubsection 2 of section 23-07.6-03 within five days of filing the petition. For a good cause shown,<br>the court may continue the hearing for up to ten days. A respondent has the right to a court<br>hearing in the district court serving the county in which the respondent resides. A record of the<br>proceedings pursuant to this section must be made and retained. If parties cannot personally<br>appear before the court due to risks of contamination or the spread of disease, proceedings may<br>be conducted by their authorized representatives and be held via any means that allows all<br>parties to fully participate.The respondent has a right to counsel and if the respondent isindigent, the respondent has the right to have counsel provided at public expense.Therespondent, respondent's representative, or respondent's counsel has the right to cross-examine<br>witnesses testifying at the hearing. A petition for a hearing does not stay a written directive<br>ordering confinement.The court shall determine by a preponderance of the evidence if therespondent is infected with a communicable disease, if the respondent poses a substantial threat<br>to the public health, and if confinement is necessary and is the least restrictive alternative to<br>protect or preserve the public health.The court shall also determine whether to order thePage No. 3respondent to follow the state or local health officer's directive for decontamination, treatment, or<br>preventative measures if the petition is granted. If the written directive was issued by a local<br>health officer, the state health officer has the right to be made a party to the proceedings.23-07.6-06. Notice of hearing. Notice of the hearing must be given to the respondentand must inform the respondent of the respondent's right to counsel or counsel at public expense<br>under this chapter and must include a copy of this chapter.23-07.6-07. Access to records. Before a hearing conducted under this chapter, therespondent, respondent's representative, or respondent's counsel, and the attorney for the state<br>or local health officer must be afforded access to all records including hospital records if the<br>respondent is hospitalized.If the respondent is hospitalized at the time of the hearing, thehospital shall make available at the hearing for use by the respondent, respondent's<br>representative, respondent's counsel, and the attorney for the state or local health officer all<br>records in its possession relating to the conditions of the respondent.23-07.6-08. Burden of proof. At a hearing conducted under this chapter, the healthofficer who ordered confinement has the burden of showing by a preponderance of the evidence<br>that the respondent is infected with a communicable disease, poses a substantial threat to the<br>public health, and that confinement of the respondent is necessary and is the least restrictive<br>alternative to protect or preserve the public health.23-07.6-09. Court findings and orders. If the court finds by a preponderance of theevidence that the respondent is infected with a communicable disease, poses a substantial threat<br>to the public health, and that confinement of the respondent is necessary and is the least<br>restrictive alternative to protect or preserve the public health, the court may order the continued<br>confinement of the respondent under any conditions and restrictions the court determines<br>appropriate for decontamination, treatment, or prevention, including remand to the health officer<br>that petitioned the court or issued the original directive, until the health officer that issued the<br>original written directive for confinement determines that the respondent's release would not<br>constitute a substantial threat to the public health, or may order the release of the respondent<br>under any conditions and restrictions the court determines appropriate to protect the public<br>health. If the court fails to find that the conditions required for an order for confinement have<br>been proven, the court shall order the immediate release of the respondent.23-07.6-10.Request to terminate or modify an order - Review of confinementorders. A respondent may, at any time, request the court to terminate or modify an order of the<br>court, in which case a hearing must be held in accordance with this chapter. Upon its own<br>motion, the court may conduct a hearing to determine if the conditions requiring the confinement<br>or restriction of the respondent continue to exist. Notice of at least five days, but no more than<br>ten business days, must be provided to all parties to the hearing under this section. If the court,<br>at a hearing held upon motion of the respondent or its own motion, finds that the conditions<br>requiring confinement or restriction no longer exist, the court shall order the immediate release of<br>the respondent. If the court finds that the conditions continue to exist but that a different remedy<br>is appropriate under this chapter, the court may modify its order accordingly.23-07.6-11. Closed hearing - Confidentiality of information. At the request of therespondent, a hearing conducted under this chapter must be closed and any report, transcript,<br>record, or other information relating to actions taken under this chapter must be kept confidential.<br>Deidentified information may be released to the public under chapter 23-01.3.23-07.6-12. Right of appeal. Any party aggrieved by an order of the district court underthis section may appeal to the supreme court. An order of confinement continues in effect while<br>the matter is on appeal.Page No. 4Document Outlinechapter 23-07.6 communicable disease confinement procedure