New Mexico § 24-1-15.1 - Protocol for management of active tuberculosis

§ 24-1-15.1. Protocol for management of active tuberculosis

A. When a physician or other person knows that a person has, or is reasonably believed

to be infected with, active tuberculosis, the physician or other person shall promptly

notify the department. B. Upon receiving notification that a person has active tuberculosis, the department

shall prescribe the person a treatment plan meeting the department's therapeutic specifications

for the infectious form of tuberculosis. The treatment plan shall include a notice to the person that failure to comply with

the treatment plan will result in immediate initiation of court action to ensure compliance,

as set forth in this section. C. The secretary, or a representative of the department whom the secretary designates,

may by public health order temporarily isolate a person or group of persons if delay

in isolating the person or group would significantly jeopardize the secretary's ability

to prevent or limit the transmission of tuberculosis to others. The public health order shall expire at the end of twenty-four hours from the time

of the commencement of isolation. The secretary may petition for a court order that authorizes the continued isolation. In the petition, the secretary shall present facts used to support the need to have

issued the public health order to isolate. D. Whether or not a public health order was issued pursuant to Subsection C of this

section, when the department has knowledge that a person who has active tuberculosis

has failed to comply with the department's treatment plan as described in Subsection

B of this section, the department shall petition for a court order for the person

who has active tuberculosis to comply with whichever of the following courses of action

the department deems appropriate: (1) a program of directly observed therapy; (2) isolation; or (3) directly observed therapy and isolation. E. A petition for a court order shall be made under oath or shall be accompanied by

a sworn affidavit setting out specific facts showing the basis upon which isolation

is justified, including whether the person to be isolated: (1) has active tuberculosis or presents a substantial likelihood of having active

tuberculosis based on credible medical evidence; (2) after being advised of the condition and the risks posed thereby, has failed to

comply with the department's treatment plan; and (3) poses a substantial likelihood of transmission of tuberculosis to others because

the person is actively infectious or poses a risk of relapse or development of a therapy-resistant

strain of tuberculosis. F. Upon the filing of a petition for a court order, the court shall: (1) in cases where there is probable cause established by the petition to give the

judge reason to believe that the person who has been alleged to have active tuberculosis

poses a substantial threat to the public health and safety because the person is actively

infectious, or poses a risk of relapse or development of a therapy-resistant strain

of tuberculosis because of a history of noncompliance, immediately grant ex parte

a court order to: (a) administer a program of directly observed therapy; (b) isolate the person and administer a program of directly observed therapy; or (c) isolate the person, if the person refuses a program of directly observed therapy; (2) cause the court order, notice of hearing and an advisement of the terms of the

court order, including the rights of the person alleged to have active tuberculosis

to representation and re-petition for termination of a court order, to be immediately

served on the person alleged to have active tuberculosis; and (3) within five days after the granting of the court order, hold an evidentiary hearing

to determine if the court shall continue the court order. G. A person held pursuant to a court order as set forth in Subsection F of this section

shall be: (1) entitled to representation by counsel at the evidentiary hearing and at all hearings

thereafter for the duration of the period of isolation or program of directly observed

therapy; and (2) permitted to communicate on any matter, including the person's isolation or program

of directly observed therapy, with persons by telephone or other reasonably available

means that do not expose other persons to the risk of infection, for the duration

of the period of isolation or program of directly observed therapy. H. Counsel may be retained by the person under the court order or shall be appointed

by the court if the court determines that the person held cannot afford legal representation

or if the court determines that appointment of counsel is required in the interest

of justice. I. At the evidentiary hearing, the court shall review the circumstances surrounding

the court order, and, if the petitioner can show by clear and convincing evidence

that the person being held has not complied or will not comply with appropriate treatment

and contagion precautions as the department deems necessary, the court shall continue

the court order for the person who has active tuberculosis until completion of therapy,

as deemed by the department. The court shall order regular review of the order by providing the person under

a court order with a subsequent hearing within ninety days of the court order's issuance

and every ninety days thereafter. The court order shall be terminated and the person shall be released if: (1) at a hearing, the petitioner has not met its burden of showing by clear and convincing

proof that the person under a court order has not completed therapy; or (2) exceptional circumstances exist warranting the termination of the court order. J. The provisions of this section do not permit the forcible administration of medications. K. A person isolated pursuant to this section has the right to refuse any medical

treatment, physical or mental examination, treatment program or invasive specimen

collection. A person who has been directed by the secretary to submit to medical procedures

and protocols because the person has active tuberculosis and refuses to submit to

the procedures and protocols may be subject to continued isolation pursuant to this

section. L. A person who is isolated pursuant to a court order may petition the court to contest

the order or the conditions of isolation at any time prior to the expiration of the

court order. If a petition is filed, the court shall hold a hearing within five business days

after the date of filing. At a hearing pursuant to a petition to contest, the secretary shall offer: (1) clear and convincing evidence that the isolation is warranted; or (2) proof that the conditions of isolation are compliant with the provisions of this

section. M. When isolating a person or group of persons, the secretary shall ensure that: (1) isolation is imposed by the least restrictive means necessary to protect against

the spread of tuberculosis to others and may include confinement to the isolated person's

private home, if practicable, or, if not practicable, a private or public premises; (2) the health status of an isolated person is monitored regularly to determine if

continued isolation is required; (3) the needs of a person isolated are addressed in a systematic and orderly manner,

including the provision of adequate food, clothing, shelter, sanitation and comfort; (4) there are methods of communication available to a person placed in isolation to

enable communication with family members, household members, legal representatives,

advocates, the media and any licensed health care provider; (5) the premises used for isolation are maintained in a manner that minimizes the

likelihood of further transmission of infection or other injury to other persons who

are isolated; and (6) to the extent possible, cultural and religious beliefs shall be respected in addressing

the needs of persons and establishing and maintaining isolation premises. N. The proceedings of any hearing held pursuant to this section shall be recorded

stenographically, electronically or mechanically or by other appropriate means. The proceedings shall be closed to the general public and the records shall be sealed

from public inspection. O. A person who in good faith reports that another person has active tuberculosis

shall not be held liable for civil damages as a result of the report; provided that

the person reported as having active tuberculosis shall have the right to sue for

damages sustained as a result of negligent or intentional reporting of inaccurate

information or the disclosure of information to an unauthorized person. P. During the period of isolation, an employer shall not discharge from employment

a person who is placed in isolation pursuant to this section. Q. For purposes of this section: (1) “ active tuberculosis ” means a disease caused by mycobacterium tuberculosis or other members of the mycobacterium

tuberculosis complex family that has been determined, through current clinical, bacteriological

or radiographic evidence, or whichever diagnostic procedures the department deems

appropriate, to be present in a person who has not completed an appropriate course

of antituberculosis medication, regardless of the state of communicability of the

disease. A person with active tuberculosis includes a person with: (a) tuberculosis that is resistant to the prescribed treatment plan; (b) infectious tuberculosis or who presents a substantial likelihood of having infectious

tuberculosis based on credible medical evidence; (c) noninfectious tuberculosis who is at high risk of developing an infectious form

of tuberculosis; and (d) pulmonary or extrapulmonary tuberculosis; (2) “ completion of therapy ” means completion of the prescribed therapy, as determined by the department based

upon published national consensus tuberculosis treatment guidelines; (3) “ court ” means the district court of the judicial district where the person who is alleged

to have active tuberculosis resides or is found or a district court designated by

the New Mexico supreme court; (4) “ department ” means the department of health or a person designated by the secretary of health

to carry out the duties provided in this section; (5) “ directly observed therapy ” means a methodology for promoting patient adherence in which a health care provider

or trained designee witnesses the patient ingest each dose of medication until the

completion of prescribed therapy for tuberculosis; and (6) “ isolation ” means: (a) home isolation; (b) home isolation with electronic monitoring; (c) isolation in a hospital or other health care facility negative pressure room where

appropriate security measures are undertaken to prevent the transmission of tuberculosis;

or (d) isolation in a prison or detention center negative pressure room with an appropriate

level of medical care.