# Title 23 — Health and Safety

## Chapter 23-07.1 — Tuberculosis Treatment

### § 23-07.1-01. Declaration of legislative intent.

Repealed by S.L. 2011, ch. 187, § 4.
### § 23-07.1-01.1. Definitions.

As used in this chapter:
1. "Appropriate facility" includes a licensed hospital, a public or private outpatient clinic, a
long-term care facility, a correctional facility, or an individual's home, and may also
include directly observed therapy under the supervision of the department.
2. "Department" means the department of health and human services, including local
public health units.
3. "Infectious tuberculosis" means tuberculosis disease in any part of the body, capable
of producing infection or disease in others as demonstrated by laboratory evidence of
tuberculosis bacteria in a specimen from any source in an individual's body or by
radiographic or clinical findings.
4. "Medically approved course of treatment" means ongoing monitoring for a disease,
treatment regimen, or therapy prescribed by a licensed physician and approved by the
department.
5. "Noninfectious tuberculosis" or "latent TB infection" means the presence of
tuberculosis bacteria in the body of an individual as evidenced by testing, such as
significant reaction to a tuberculin skin test or a positive interferon gamma release
assay, but without any other clinical findings of illness and without the capability of
producing infection or disease in others.
6. "Substantial threat to the public health" means an individual with infectious or suspect
tuberculosis who has not completed a medically approved course of therapy and does
not adhere or threatens to not adhere to a recommended treatment regimen or does
not adhere or threatens to not adhere to infection control measures.
7. "Suspect tuberculosis" means an illness marked by symptoms and laboratory tests
that may be indicative of tuberculosis, such as a prolonged cough, prolonged fever,
hemoptysis, compatible roentgenographic findings, or other appropriate medical
imaging findings.
8. "Tuberculosis" includes infectious tuberculosis, suspect tuberculosis, noninfectious
tuberculosis, and any other case in which an individual is found to have tuberculosis
based upon laboratory testing, clinical evidence, or as diagnosed by a physician, the
department, or a local health officer.
### § 23-07.1-02. Care and treatment of tuberculosis patients or suspects provided without

charge by state.
Care and treatment provided by the state of North Dakota for persons suffering from
tuberculosis, including diagnosis, tests, studies, and analyses for the discovery of tuberculosis,
must be available without cost or charge to anyone who is suffering from tuberculosis or is
suspected of having tuberculosis. Any such person who volunteers to assume and pay for the
cost of such care and treatment or for the cost of such diagnosis, test, studies, or analyses must
be permitted to do so; but no state, county, or other public official may request or require such
payment or make or cause to be made any inquiry or investigation for the purpose of
determining the ability of such person or of the person's legally responsible relatives to pay
therefor. This section in no way bars freedom of the individual to seek treatment from a
physician or in an institution of the individual's choice at the individual's own expense.
### § 23-07.1-03. State has prior claim on patient benefits.

Notwithstanding any provision in this chapter, this state has prior claim on benefits for the
care and treatment of tuberculosis, including diagnosis, tests, studies, and analyses, accruing to
patients for whom care and treatment is provided by the state of North Dakota under entitlement

by the federal government, medical or hospital insurance contracts, workforce safety and
insurance, or the medical care and disability provisions of programs under the supervision of the
department of human services.
### § 23-07.1-04. State health officer - Designee - Responsibility.

The state health officer or designee is responsible for the inpatient and outpatient care of
persons afflicted or suspected of being afflicted with tuberculosis. If the state health officer
determines that suspected or actual tuberculous patients may be adequately cared for on an
inpatient basis by contract with general hospitals or other appropriate facilities, authority for
contracting with such facilities is granted to the department of health and human services. In
addition, the department of health and human services is authorized to establish and maintain
the necessary outpatient clinics for diagnostic workup and evaluation on all suspected or actual
tuberculous patients in the state. The department of health and human services shall pay the
contract fee to general hospitals or other appropriate facilities and provide funds to the
outpatient evaluation clinics from funds to be appropriated for this purpose by the legislative
assembly. The state's claim on patient benefits as provided in section 23-07.1-03 applies insofar
as applicable to tuberculous patients in general hospitals and for services rendered in outpatient
clinics. The state health officer or a designee has the power to:
1. Do any act necessary and proper in the performance of the functions imposed upon
the state health officer by the provisions of this chapter.
2. Issue orders and compel obedience thereto.
3. Administer oaths.
### § 23-07.1-05. Reports - Orders for the custody of individuals.

1. Upon the receipt of a report that any individual is reasonably suspected to have or to
have been exposed to tuberculosis, the state health officer shall investigate the matter
and if the state health officer determines that the individual may have, or may have
been exposed to, tuberculosis, the state health officer shall request the individual to
voluntarily seek appropriate evaluation and care and a medically approved course of
treatment. If the individual refuses to accept voluntary evaluation and care and a
medically approved course of treatment, and the individual has infectious or suspect
tuberculosis, the state health officer may order the individual or group of individuals
into confinement under sections 23-07.6-02 and 23-07.6-03, and may order further
isolation or quarantine as authorized under chapter 23-07.6. An order under this
section may designate an appropriate facility for confinement, including the individual's
home.
2. The state health officer may immediately investigate all reported or suspected cases of
tuberculosis in the state and determine the sources of those infections.
3. The state health officer may conduct screening programs of populations that are at
increased risk of developing tuberculosis or having latent tuberculosis infection and
offer treatment as appropriate. Any such screening program may be implemented by a
local health officer with the approval of the state health officer.
### § 23-07.1-06. Physician's examination - Findings - Final order.

Repealed by S.L. 2011, ch. 187, § 4.
### § 23-07.1-07. Sheriff's execution of state health officer's final order.

Repealed by S.L. 2011, ch. 187, § 4.
### § 23-07.1-08. Hearing - Order.

Repealed by S.L. 2011, ch. 187, § 4.
### § 23-07.1-09. Appeal to supreme court - Habeas corpus - Hearing.

Repealed by S.L. 2011, ch. 187, § 4.

### § 23-07.1-10. Discharge - Release.

Repealed by S.L. 2011, ch. 187, § 4.
### § 23-07.1-11. Liability of officers.

Repealed by S.L. 2011, ch. 187, § 4.
### § 23-07.1-12. Confinement exception - Quarantine.

Repealed by S.L. 2011, ch. 187, § 4.
### § 23-07.1-13. Indian jurisdiction.

Nothing in this chapter requires the admission of an enrolled Indian, resident on any
reservation in this state, to any off-reservation institution except upon written request and
authorization of the superintendent of the reservation on which said Indian is enrolled. However,
in the public interest and with the objective of eradication of tuberculosis in the state of North
Dakota, an Indian with tuberculosis off any reservation is subject to this chapter. It is the
responsibility of the Indian affairs commission pursuant to the commission's powers and duties,
stated in section 54-36-03, to work closely with the tribal councils and other reservation officials
to adopt any agreements found necessary in assisting the state health officer in carrying out
responsibilities under this chapter so that all residents of this state will benefit, and eradication
of tuberculosis in North Dakota can be achieved.
### § 23-07.1-14. Care of tubercular patients - Acceptance of federal funds - General

hospital.
The department may contract with public or private agencies for the care of persons having
tuberculosis. The department is hereby authorized to accept any federal funds or to enter into
any federal programs on behalf of persons having tuberculosis in North Dakota. The department
may also utilize general hospitals or other appropriate facilities in the placement of recalcitrant
persons having tuberculosis.
### § 23-07.1-15. Penalty.

1. An individual is guilty of a class A misdemeanor if:
a. That individual fails to undertake diagnostic examination for tuberculosis upon the
request of the state health officer which is based upon the reasonable suspicion
that the individual has or has been exposed to tuberculosis;
b. That individual has been diagnosed with infectious or suspect tuberculosis and
fails to undertake a medically approved course of treatment for tuberculosis; or
c. That individual is the parent of a minor or guardian of an individual who violates
subdivision a or b.
2. Upon conviction, the court may order that individual to obtain a supervised medically
approved course of treatment for tuberculosis until the treatment is completed, in
addition to other penalties or conditions provided by law.
