32.1-50.1 - Treatment plan; submission of plan and mediation of disagreements; determination of cure.

§ 32.1-50.1. Treatment plan; submission of plan and mediation ofdisagreements; determination of cure.

A. Each physician practicing in the Commonwealth who assumes responsibilityfor the treatment of a person for active tuberculosis as defined in thisarticle and each person in charge of a medical care facility providinginpatient or outpatient treatment to a person with active tuberculosis shall,with the assistance and acknowledgement of that person, develop, maintain,and update as indicated, an individualized written plan of treatment tailoredto the person's medical and personal needs and identifying the method foreffective treatment and prevention of transmission. At a minimum, the planshall specifically include verified patient address, name of the medicalprovider who has assumed responsibility for treatment, planned course ofanti-tuberculosis drug therapy, estimated date of treatment completion, andmeans of ensuring successful completion of that treatment.

B. The written treatment plan shall upon request be submitted by the medicalprovider to the local health director in a manner determined by the Board andshall be subject to approval of the local health director. The Commissionershall have the authority to settle, based on statewide standards,disagreements between the written plan so submitted and standards of careestablished by the local health director.

C. Each treating physician of or person in charge of a medical facilityproviding outpatient or inpatient care to a person with active tuberculosisdisease shall maintain and submit to the local health director, upon hisrequest, written documentation of that person's adherence to the treatmentplan.

D. Each person in charge of a medical care facility providing inpatienttreatment to a person with active tuberculosis disease and each person incharge of a state correctional or local correctional or detention facilitythat has in its custody a person with active tuberculosis shall submit to thelocal health director, in the manner determined by the Board, the plan oftreatment for such person as required in this article. The person in chargeshall encourage the person to comply with such treatment plan; however, ifsuch person with active tuberculosis indicates an unwillingness to complywith the treatment plan upon release, or exhibits behavior that indicatesnoncompliance, the person in charge, in conjunction with the local healthdirector, may request the Commissioner to issue an emergency order requiringsuch person to be taken into custody pursuant to § 32.1-48.02 or otherdetention or custody options available pursuant to § 32.1-48.03 or §32.1-48.04.

E. Once established in a person, active tuberculosis disease shall beconsidered present until (i) the person has received a complete and adequatecourse of antituberculosis drug therapy as established by the Commissioner inaccordance with guidelines developed by the American Thoracic Society andCenters for Disease Control and Prevention and (ii) three successive culturesof specimens of sputum or other bodily fluid or tissue collected at intervalsof no less than one week, or other definitive diagnostic test as establishedby the Commissioner demonstrate no viable tubercle bacilli, or theCommissioner or his designee determines that the clinical, laboratory, orradiographic evidence leads to a diagnosis other than active tuberculosisdisease.

(2001, c. 459.)