House Bill 1247

21.0621.
01000
Sixty-seventh
Legislative Assembly HOUSE BILL NO. 1247
of North Dakota
Introduced by
Representatives Weisz, Devlin, Kreidt, Rohr, M. Ruby
Senators Anderson, Lee
1 A BILL for an Act to amend and reenact subsection 3 of section 4.1-26-20, sections 5-01-08 and
2 6-03-76, subsection 8 of section 6-08.1-03, sections 6-08.5-02 and 6-08.5-03, subsection 2 of
3 section 6-09.15-01, section 10-04-08.5, subsection 16 of section 11-16-01, subdivision n of
4 subsection 5 of section 11-19.1-01, subsection 2 of section 11-19.1-07, subsection 2 of section
5 11-19.1-16, subsection 2 of section 11-23-01, subdivision e of subsection 1 of section
6 12-44.1-28, subdivision b of subsection 1 of section 12-44.1-29, subsection 5 of section
7 12-47-36, section 12-52-02, subsection 2 of section 12-60-24, subsection 5 of section 12-60-26,
8 subsection 26 of section 12.1-01-04, subsection 4 of section 12.1-20-24, subsection 16 of
9 section 12.1-32-15, subsection 4 of section 12.1-41-17, section 13-05-02.2, subsection 8 of
10 section 14-02.1-02, sections 14-02.1-02.1 and 14-02.1-02.2, subsection 4 of section
11 14-02.1-03.4, sections 14-02.1-07, 14-02.1-07.1, 14-02.1-09, 14-07.1-01, and 14-07.1-17,
12 subdivision f of subsection 2 of section 14-07.1-20, section 14-09-08.21, subsection 1 of section
13 14-09-09.7, subsection 4 of section 14-09-09.10, sections 14-09-09.31, 14-09-12, and
14 14-10-05, subsection 2 of section 14-12.2-02, subsection 1 of section 14-12.2-22, sections
15 14-12.2-47.3 and 14-12.2-47.4, subsection 4 of section 14-12.2-47.5, subdivision b of
16 subsection 3 of section 14-12.2-47.8, section 14-13-03, subsection 6 of section 14-15-01,
17 subsection 4 of section 14-15.1-01, sections 14-19-01 and 14-19-05, subdivision d of
18 subsection 1 of section 14-19-06, section 14-19-08, subsection 3 of section 14-19-12,
19 paragraph 1 of subdivision d of subsection 1 of section 14-20-10, subdivision a of subsection 2
20 of section 14-20-12, subsection 3 of section 14-20-14, sections 14-20-15, 14-20-16, 14-20-18,
21 and 14-20-19, subsection 1 of section 14-20-22, sections 14-20-23, 14-20-24, 14-20-57, and
22 15-05-16, subsection 2 of section 15-52-03, section 15.1-02-19, subsection 3 of section
23 15.1-24-01, sections 15.1-32-03, 15.1-32-05, and 15.1-32-19, subsection 2 of section
24 15.1-34-01, section 15.1-34-04, subsection 1 of section 15.1-37-02, sections 18-01-03.1 and
25 18-01-03.2, subsection 1 of section 19-01-01, section 19-01-07, subsection 6 of section
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Legislative Assembly
1 19-02.1-01, section 19-02.1-07, subsection 5 of section 19-02.1-10, section 19-02.1-10.1,

3 19-03.1-45, subdivision e of subsection 3 of section 19-03.5-03, subdivision e of subsection 2 of
4 section 19-03.5-07, sections 19-05.1-05, 19-06.1-05, and 19-17-05, subsection 3 of section
5 19-21-01, subsection 16 of section 19-24.1-01, subdivision a of subsection 1 of section
6 19-24.1-14, subdivision a of subsection 1 of section 19-24.1-15, subsection 3 of section
7 19-24.1-24, subdivision e of subsection 2 of section 19-24.1-33, sections 19-24.1-36 and
8 20.1-01-26.1, subsection 4 of section 20.1-03-04, sections 23-01-01, 23-01-01.1, and 23-01-03,
9 subsection 1 of section 23-01-03.1, subsection 1 of section 23-01-03.3, sections 23-01-04,
10 23-01-05, 23-01-05.1, 23-01-05.2, 23-01-05.3, 23-01-05.4, 23-01-06, 23-01-08, 23-01-10,
11 23-01-11, 23-01-14, 23-01-15, 23-01-16, 23-01-22, 23-01-24, 23-01-25, 23-01-26, 23-01-27,
12 23-01-28, 23-01-29, 23-01-32, 23-01-33, 23-01-34, 23-01-35, and 23-01-37, subdivision a of
13 subsection 1 of section 23-01-39, sections 23-01-40 and 23-01-41, paragraph 1 of subdivision b
14 of subsection 1 of section 23-01-42, sections 23-01-44 and 23-01.2-01, subsection 2 of section
15 23-01.2-03, section 23-01.2-04, subsection 8 of section 23-01.3-01, sections 23-01.3-08,
16 23-02.1-01, 23-02.1-02, 23-02.1-03, and 23-02.1-04, subdivision c of subsection 1 of section
17 23-02.1-05, sections 23-02.1-11, 23-02.1-13, 23-02.1-15, and 23-02.1-16, subsection 2 of
18 section 23-02.1-17, subsection 4 of section 23-02.1-18, sections 23-02.1-19, 23-02.1-20,
19 23-02.1-20.1, 23-02.1-22, and 23-02.1-25, subsections 6 and 7 of section 23-02.1-27,
20 subsection 3 of section 23-02.1-28, section 23-02.1-29, subsection 3 of section 23-02.1-30,
21 subsection 6 of section 23-06-03, subsection 1 of section 23-06-04, sections 23-06-07,
22 23-06-20, 23-06-21, 23-06-22, and 23-06-23, subsection 7 of section 23-06-27, section
23 23-06-30, subsection 1 of section 23-06.6-19, sections 23-07-01, 23-07-01.1, 23-07-02,
24 23-07-02.1, and 23-07-02.2, subsection 3 of section 23-07-02.3, sections 23-07-03 and
25 23-07-05, subsection 2 of section 23-07-07.5, sections 23-07-07.6, 23-07-15, 23-07-17.1, and
26 23-07-21, subsection 2 of section 23-07.1-01.1, sections 23-07.1-04, 23-07.1-14, 23-07.2-02,
27 23-07.2-03, and 23-07.2-04, subsection 4 of section 23-07.4-01, subsection 3 of section
28 23-07.4-02, section 23-07.6-04, subsection 3 of section 23-07.7-02, subsection 4 of section
29 23-09-01, section 23-09-02, subsection 2 of section 23-09.1-01, section 23-09.1-02,
30 subsection 1 of section 23-09.2-01, subsection 2 of section 23-09.3-01, sections 23-09.3-01.1
31 and 23-09.3-05.1, subsection 2 of section 23-09.4-01, subsection 9 of section 23-09.5-02,
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1 subsection 2 of section 23-10-01, subsection 11 of section 23-12-09, subdivision a of

2 subsection 3 of section 23-12-10, subsection 1 of section 23-12-10.2, subsection 2 of section
3 23-12-10.4, subsection 2 of section 23-12-17, section 23-16-01, subsection 6 of section
4 23-16-01.1, sections 23-16-03, 23-16-04, 23-16-05, 23-16-06, 23-16-08, and 23-16-09,
5 subsection 2 of section 23-16-11, section 23-16-12, subsection 1 of section 23-16.1-01, section
6 23-17-08, subsection 2 of section 23-17.3-01, sections 23-17.3-08 and 23-17.3-10, subsection 2
7 of section 23-17.4-01, sections 23-21-16 and 23-21.1-02.1, subsection 1 of section 23-21.1-03,
8 sections 23-23-03 and 23-27-01, subsection 1 of section 23-27-02, section 23-27-03,
9 subsection 1 of section 23-27-04, sections 23-27-04.2, 23-27-04.3, and 23-27-04.7,
10 subsection 6 of section 23-27-04.10, sections 23-34-02 and 23-34-02.1, subsection 2 of section
11 23-35-01, section 23-35-02, subsection 4 of section 23-36-01, section 23-38.1-01,
12 subsections 1 and 3 of section 23-38.1-02, section 23-38.1-03, subsection 1 of section
13 23-39-01, sections 23-39-06, 23-39-07, and 23-41-01, subsection 1 of section 23-41-06,
14 sections 23-43-02, 23-43-03, 23-43-04, 23-43-05, and 23-43-06, subsection 2 of section
15 23-44-01, subsection 2 of section 23-44-02, subsection 2 of section 23-45-01, subsection 1 of
16 section 23-45-02, sections 23-46-02, 23-46-03, and 23-46-04, subsection 1 of section 23-47-01,
17 section 23-47-02, subsection 1 of section 23-47-03, section 23-50-01, subsection 4 of section
18 23.1-01-03, subsection 7 of section 25-01-01, section 25-01-01.1, subsection 2 of section
19 25-01.2-01, sections 25-01.2-18, 25-02-01, 25-02-01.1, and 25-02-03, subsection 5 of section
20 25-03.1-02, section 25-03.1-34.1, subsection 3 of section 25-03.2-01, subsection 2 of section
21 25-03.3-01, sections 25-03.3-07, 25-03.3-08, 25-03.3-12, and 25-03.3-17, subsection 3 of
22 section 25-03.3-18, sections 25-03.3-21, 25-03.3-22, 25-04-01, 25-04-02, 25-04-02.1, 25-04-04,
23 and 25-04-05, subsection 1 of section 25-04-05.1, subsection 3 of section 25-04-08, sections
24 25-04-08.1, 25-04-11, and 25-04-14, subsection 2 of section 25-04-15, subsection 5 of section
25 25-04-16, sections 25-11-02 and 25-14-02, subsection 1 of section 25-16-01, sections 25-16-07
26 and 25-16-12, subsection 1 of section 25-16.1-01, sections 25-16.2-01, 25-17-00.1, 25-17-01,
27 25-17-02, 25-17-03, and 25-17-06, subsection 1 of section 25-18-01, subdivision b of
28 subsection 1 of section 26.1-02-28, subdivision b of subsection 9 of section 26.1-26.4-02,
29 subsection 2 of section 26.1-36-09, subsection 4 of section 26.1-36-09.7, subdivision b of
30 subsection 1 of section 26.1-36-09.10, subsection 1 of section 26.1-36-12, subsection 2 of
31 section 26.1-36-12.2, section 26.1-36-30, subsection 1 of section 26.1-36-45, subsection 2 of
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1 section 26.1-36.5-03, subsection 2 of section 26.1-36.5-04, sections 26.1-45-13, 26.1-47-01,

2 26.1-47-10, 26.1-54-01, 26.1-54-02, 26.1-54-03, 26.1-54-04, and 27-20-11, subdivision c of
3 subsection 7 of section 27-20-20.1, section 27-20-30.1, subsection 7 of section 27-20-45,
4 subsection 1 of section 27-20-51, subsection 2 of section 27-20-54, section 27-21-09,
5 subdivision d of subsection 2 of section 27-21-12, sections 28-21-05.2, 30-16-04, 32-03-48, and
6 32-37-05, paragraph 3 of subdivision b of subsection 4 of section 34-13-01, subsection 2 of
7 section 34-15-01, subsection 2 of section 36-01-12.2, sections 37-17.4-01, 37-17.4-03, and
8 37-17.4-04, subsection 3 of section 37-17.4-07, sections 37-17.4-09 and 39-01-01, subsection 5
9 of section 39-01-15, section 39-01-19, subdivision b of subsection 1 of section 39-04-10.16,
10 subsection 1 of section 43-04-11, subsection 8 of section 43-10-12, sections 43-10-23,
11 43-11-11, and 43-12.1-04, subsection 14 of section 43-15-10, subsection 4 of section
12 43-15-31.5, subsection 5 of section 43-28-02, section 43-29.1-02, subsection 2 of section
13 43-34-01, subsection 1 of section 43-34-02, section 43-38-03, subsection 2 of section
14 43-41-04.2, sections 43-43-03, 43-43-04, 43-43-06, and 43-43-07, subsection 11 of section
15 43-48-03, subdivision e of subsection 3 of section 43-60-02, subsection 3 of section 44-04-18.4,
16 subdivision b of subsection 1 of section 44-04-18.30, subsection 2 of section 50-01-01, sections
17 50-01-13 and 50-01-17.2, subsection 1 of section 50-01.1-01, subsection 1 of section
18 50-01.2-00.1, subsection 3 of section 50-06-01, sections 50-06-01.1 and 50-06-01.4,
19 subsection 1 of section 50-06-01.7, sections 50-06-06.3, 50-06-06.4, 50-06-06.6, 50-06-06.10,
20 50-06-06.11, 50-06-14.1, 50-06-21, 50-06-24, 50-06-26, 50-06-29, 50-06-30, 50-06-31,
21 50-06-32, 50-06-32.1, 50-06-35, 50-06-37, 50-06-38, 50-06-41, 50-06-41.2, and 50-06-43.1,
22 subdivision e of subsection 1 of section 50-06-43.2, subsection 1 of section 50-06.1-01,
23 sections 50-06.1-15 and 50-06.1-16, subsection 8 of section 50-06.2-02, subsection 2 of section
25 50-06.5-01, subsection 12 of section 50-09-01, subsection 2 of section 50-10.1-01, subsection 4
26 of section 50-10.2-01, subsection 4 of section 50-11-00.1, sections 50-11-01.5, 50-11-01.6, and
27 50-11-03.1, subsection 3 of section 50-11.1-02, subsection 2 of section 50-11.1-07,
28 subdivision a of subsection 3 of section 50-11.1-18, sections 50-11.2-01, 50-11.2-02,
29 50-11.3-01, and 50-12-02, subsection 2 of section 50-12-02.1, sections 50-12-03, 50-12-03.1,
30 50-12-03.2, and 50-12-05, subsection 2 of section 50-12-06, subsection 2 of section 50-12-07,
31 sections 50-12-08, 50-12-10, 50-12-11, 50-12-14.1, 50-12-16, and 50-12-17, subsection 1 of
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1 section 50-19-01, sections 50-19-04, 50-19-10, 50-19-14, 50-21-02, 50-21-03, and 50-21-04,
2 subsection 1 of section 50-24.1-00.1, section 50-24.1-01.3, subdivision a of subsection 1 of
3 section 50-24.1-29, sections 50-24.1-34, 50-24.1-37, and 50-24.1-38, subsection 2 of section
4 50-24.1-40, sections 50-24.3-01, 50-24.3-03, and 50-24.3-03.1, subsection 3 of section
6 50-24.5-01, sections 50-24.5-02.2 and 50-24.5-10, subsection 3 of section 50-24.6-01,
8 50-25.1-02, subsection 17 of section 50-25.1-02, section 50-25.1-04.2, subsection 10 of section
9 50-25.1-15, subsection 5 of section 50-25.2-01, sections 50-27-01 and 50-27-03, subsection 5
10 of section 50-28-01, subsection 3 of section 50-29-01, subsection 2 of section 50-30-01,
11 subsection 1 of section 50-31-01, subsection 2 of section 50-32-01, section 50-32-02.1,
12 subsection 7 of section 50-33-01, subsection 1 of section 50-35-01, subsection 3 of section
13 52-01-03, subsection 5 of section 53-12.1-12, subsection 1 of section 54-06-04, subsection 3 of
14 section 54-12-08, section 54-23.3-10, subsection 1 of section 54-23.3-12, subsection 3 of
15 section 54-38-01, paragraph 2 of subdivision b of subsection 1 of section 54-44.1-12, sections
16 54-44.3-30, 54-44.3-31, and 54-44.3-32, subsection 3 of section 54-44.8-03, sections
17 54-44.8-06 and 54-46-13, subsection 1 of section 54-59-25, subdivision i of subsection 2 of
18 section 54-59-26, subdivision g of subsection 1 of section 54-59-33, subdivision a of
19 subsection 1 of section 54-60-19, section 57-38-01.16, subsection 1 of section 57-38.3-02,
20 subsection 3 of section 57-38.3-04, subsection 24 of section 57-39.2-04, subdivision f of
21 subsection 4 of section 57-40.6-10, section 57-63-03, subdivision n of subsection 2 of section
22 59-09-02, section 61-38-03, paragraph 3 of subdivision a of subsection 16 of section 65-01-02,
23 and section 65-05.1-06.3 of the North Dakota Century Code, relating to merging of the state
24 department of health and the department of human services; to provide a statement of
25 legislative intent; to provide for a legislative management report; to provide a penalty; and to
26 provide a continuing appropriation.
27 BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
28 SECTION 1. AMENDMENT. Subsection 3 of section 4.1-26-20 of the North Dakota Century

29 Code is amended and reenacted as follows:
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1 3. Before a dairy farmer may be licensed by the board, as required by this chapter, the
2 dairy farmer shall provide proof of inspection by the agriculture commissioner or the
3 state department of health and human services, as provided for in accordance with
4 section 23-01-16.
5 SECTION 2. AMENDMENT. Section 5-01-08 of the North Dakota Century Code is amended
6 and reenacted as follows:
7 5-01-08. Individuals under twenty-one years of age prohibited from using alcoholic
8 beverages or entering licensed premises - Penalty.
9 1. Except as permitted in this section and section 5-02-06, an individual under
10 twenty-one years of age may not manufacture or attempt to manufacture, purchase or
11 attempt to purchase, consume or have recently consumed other than during a
12 religious service, be under the influence of, be in possession of, or furnish money to
13 any individual for the purchase of an alcoholic beverage.
14 2. An individual under twenty-one years of age may not enter any licensed premises
15 where alcoholic beverages are being sold or displayed, except:
16 a. A restaurant if accompanied by a parent or legal guardian;
17 b. In accordance with section 5-02-06;
18 c. If the individual is an independent contractor or the independent contractor's
19 employee engaged in contract work and is not engaged in selling, dispensing,
20 delivering, or consuming alcoholic beverages;
21 d. If the individual is a law enforcement officer or other public official who enters the
22 premises in the performance of official duty; or
23 e. If the individual enters the premises for training, education, or research purposes
24 under the supervision of an individual twenty-one or more years of age with prior
25 notification of the local licensing authority.
26 3. A violation of this section is a class B misdemeanor. For a violation of subsection 1
27 or 2, the court also shall sentence a violator to an evidence-based alcohol and drug
28 education program operated under rules adopted by the department of health and
29 human services under section 50-06-44.
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1 4. The court, under this section, may refer the individual to an outpatient addiction facility
2 licensed by the department of health and human services for evaluation and
3 appropriate counseling or treatment.
4 5. The offense of consumption occurs in the county of consumption or the county where
5 the offender is arrested.
6 6. An individual under twenty-one years of age is immune from criminal prosecution
7 under this section if that individual contacted law enforcement or emergency medical
8 services and reported that another individual under twenty-one years of age was in
9 need of medical assistance due to alcohol consumption, provided assistance to the
10 individual in need of medical assistance until assistance arrived and remained on the
11 scene, or was the individual in need of medical assistance and cooperated with
12 medical assistance and law enforcement personnel on the scene. The maximum
13 number of individuals that may be immune for any one occurrence is five individuals.
14 SECTION 3. AMENDMENT. Section 6-03-76 of the North Dakota Century Code is amended
15 and reenacted as follows:
16 6-03-76. Records search reimbursement.
17 Any financial institution authorized to do business in this state must be reimbursed as
18 follows for all records searches done at the request of any state agency or any branch of the
19 state government except the department of health and human services. Further, any federal
20 agency or any branch of the federal government must also make such reimbursement if
21 authorized to do so:
22 1. For search and processing time at the rate of thirty dollars per hour per person,
23 computed on the basis of seven dollars and fifty cents per quarter hour, limited to the
24 total amount of personnel time spent in locating, retrieving, reproducing, packaging,
25 and preparing for shipment documents or information requested.
26 2. For making copies of duplicates of required or requested documents at the rate of
27 fifteen cents per page.
28 3. For making copies of photographs, films, and other materials at the actual cost
29 incurred by the financial institution.
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1 The financial institution must be reimbursed for all actual mailing or transportation expenses
2 incurred in conveying the requested or required materials to the requesting agency. The
3 reimbursement provisions of this section shall not apply to standard confirmations.
4 SECTION 4. AMENDMENT. Subsection 8 of section 6-08.1-03 of the North Dakota Century
6 8. For purposes of reporting suspected financial exploitation of an eligible adult under
7 chapter 6-08.5 to a law enforcement agency or the department of health and human
8 services. This subsection may not be construed to impose a duty on a financial
9 institution to investigate a suspected financial exploitation of an eligible adult or to
10 make a report to the department of health and human services or law enforcement
11 agency.
12 SECTION 5. AMENDMENT. Section 6-08.5-02 of the North Dakota Century Code is
13 amended and reenacted as follows:
14 6-08.5-02. Eligible adult financial exploitation prevention - Duration of refusal or
15 hold - Notification and reporting - Immunity.
16 1. If a financial service provider has a good faith belief to suspect financial exploitation
17 occurred, was attempted, or is being attempted, the financial service provider may
18 refuse a financial transaction or hold a financial transaction on an account:
19 a. Belonging to the eligible adult;
20 b. On which the eligible adult is a beneficiary, including a trust, guardianship, or
21 conservatorship account; or
22 c. Belonging to a person suspected of perpetrating financial exploitation.
23 2. A financial service provider may refuse a financial transaction or hold a financial
24 transaction under this section if the department of health and human services or a law
25 enforcement agency provides information to the financial service provider
26 demonstrating it is reasonable to believe financial exploitation occurred, was
27 attempted, or is being attempted.
28 3. Subsection 2 does not require a financial service provider to refuse a financial
29 transaction or hold a financial transaction if provided with information by the
30 department of health and human services or a law enforcement agency alleging
31 financial exploitation occurred, was attempted, or is being attempted. Except as
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1 ordered by a court, a financial service provider may determine whether to refuse a

2 financial transaction or hold a financial transaction based on the information available
3 to the financial service provider.
4 4. A financial service provider refusing a financial transaction or holding a financial
5 transaction based on a good faith belief to suspect financial exploitation occurred, was
6 attempted, or is being attempted shall:
7 a. Except with regard to an account administered by a bank or trust company in a
8 fiduciary capacity, make a reasonable effort to notify, orally or in writing, one or
9 more parties authorized to transact business on the account; and
10 b. Report the incident to the department of health and human services, if the
11 incident involves financial exploitation of a vulnerable adult as defined in section
12 50-25.2-01.
13 5. Notice under this section is not required to be provided to a party authorized to
14 conduct business on the account if the party is the suspected perpetrator of financial
15 exploitation.
16 6. A financial service provider, or an employee, officer, or director of a financial service
17 provider, is immune from all criminal, civil, and administrative liability:
18 a. For refusing or not refusing a financial transaction, or for holding or not holding a
19 financial transaction under this section; or
20 b. For actions taken in furtherance of the determination made under subdivision a, if
21 the determination is based upon a good faith belief financial exploitation
22 occurred, was attempted, or is being attempted.
25 6-08.5-03. Reporting to a law enforcement agency or the department of health and
26 human services - Immunity.
27 1. If a financial service provider, or an employee, officer, or director of a financial service
28 provider has a good faith belief to suspect financial exploitation of an eligible adult
29 occurred, was attempted, or is being attempted, the financial service provider, or an
30 employee, officer, or director of a financial service provider may report the information
31 to a law enforcement agency or the department of health and human services.
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1 2. This section does not impose a duty on a financial institution to investigate a

2 suspected financial exploitation of an eligible adult or to make a report to a law
3 enforcement agency or the department of health and human services.
4 3. A financial service provider, or an employee, officer, or director of a financial service
5 provider, is immune from all criminal, civil, and administrative liability for reporting or
6 not reporting under this section if the determination is made based on a good faith
7 belief that financial exploitation occurred, was attempted, or is being attempted.
8 SECTION 7. AMENDMENT. Subsection 2 of section 6-09.15-01 of the North Dakota
9 Century Code is amended and reenacted as follows:
10 2. "Child care provider" means a child care home, group, or center licensed by the
11 department of health and human services.
12 SECTION 8. AMENDMENT. Section 10-04-08.5 of the North Dakota Century Code is
14 10-04-08.5. Financial exploitation - Vulnerable adult.
15 1. As used in this section:
16 a. "Eligible adult" means an adult who is at least sixty-five years old or a vulnerable
17 adult as defined in section 50-25.2-01.
18 b. "Financial exploitation" means:
19 (1) The wrongful or unauthorized taking, withholding, appropriation, or use of
20 money, assets, or property of an eligible adult; or
21 (2) Any act or omission taken by a person, including through the use of a power
22 of attorney, guardianship, or conservatorship of an eligible adult, to:
23 (a) Obtain control, through deception, intimidation, or undue influence,
24 over the eligible adult's money, assets, or property, to deprive the
25 eligible adult of the ownership, use, benefit, or possession of the
26 eligible adult's money, assets, or property; or
27 (b) Convert money, assets, or property of the eligible adult to deprive the
28 eligible adult of the ownership, use, benefit, or possession of the
29 eligible adult's money, assets, or property.
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1 c. "Qualified individual" means any agent, investment adviser representative, or

2 person who serves in a supervisory, compliance, or legal capacity for a broker-
3 dealer or investment adviser.
4 2. If a qualified individual reasonably believes financial exploitation of an eligible adult
5 may have occurred, may have been attempted, or is being attempted, the qualified
6 individual shall notify the department of health and human services and the
7 commissioner.
8 3. If a qualified individual reasonably believes financial exploitation of an eligible adult
9 may have occurred, may have been attempted, or is being attempted, a qualified
10 individual may notify a third party reasonably associated with the eligible adult or any
11 other person permitted under state or federal law or rule, rules of a self-regulating
12 organization, or customer agreement. Disclosure may not be made to a designated
13 third party who is suspected of financial exploitation or other abuse of the eligible
14 adult.
15 4. A qualified individual who in good faith and exercising reasonable care discloses
16 information under this section is immune from administrative or civil liability that might
17 otherwise result from disclosure or for any failure to notify the customer of the
18 disclosure.
19 5. a. A broker-dealer or investment adviser may delay a transaction or disbursement of
20 funds or securities from an account of an eligible adult or an account on which an
21 eligible adult is a beneficiary if:
22 (1) The broker-dealer or investment adviser reasonably believes the requested
23 transaction or disbursement may result in financial exploitation of an eligible
24 adult after initiating an internal review of the requested transaction or
25 disbursement and the suspected financial exploitation; and
26 (2) The broker-dealer or investment adviser:
27 (a) Provides written notification of the delay and the reason for the delay
28 to all parties authorized to transact business on the account, unless a
29 party is reasonably believed to have engaged in suspected or
30 attempted financial exploitation of the eligible adult, within two days
31 after the requested transaction or disbursement;
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1 (b) Notifies the department of health and human services and the
2 commissioner within two days after the requested transaction or
3 disbursement; and
4 (c) Continues its internal review of the suspected or attempted financial
5 exploitation of the eligible adult as necessary.
6 b. Any delay of a transaction or disbursement authorized by this section expires
7 upon the earlier of:
8 (1) A determination by the broker-dealer or investment adviser that the
9 transaction or disbursement will not result in financial exploitation of the
10 eligible adult; or
11 (2) Fifteen business days after the date on which the broker-dealer or
12 investment adviser first delayed the transaction or disbursement of the
13 funds or securities, unless the department of health and human services or
14 the commissioner requests the broker-dealer or investment adviser extend
15 the delay, in which case the delay expires within twenty-five business days
16 after the date the broker-dealer or investment adviser first delayed the
17 transaction or disbursement of the funds or securities unless the delay is
18 terminated by either of the agencies or an order of a court of competent
19 jurisdiction.
20 c. A court of competent jurisdiction or the commissioner may enter an order
21 extending the delay of the transaction or disbursement of funds or securities or
22 may order other protective relief based on the broker-dealer, investment adviser,
23 or other interested party's petition that initiated the delay under this section.
24 6. A broker-dealer or investment adviser who in good faith and exercising reasonable
25 care complies with this section is immune from any administrative or civil liability that
26 may otherwise arise from a delay in the transaction or disbursement in accordance
27 with this section.
28 7. A broker-dealer or investment adviser shall provide access to or copies of records that
29 are relevant to the suspected or attempted financial exploitation of an eligible adult to
30 the department of health and human services and to law enforcement, either as part of
31 a referral to the department or to law enforcement, or upon request of the department
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1 or law enforcement pursuant to an investigation. The records may include historical

2 records and records relating to the most recent transaction that may comprise financial
3 exploitation of an eligible adult. Any record provided to the department of health and
4 human services or law enforcement under this section is an exempt record under
5 chapter 44-04. This section does not limit or otherwise impede the authority of the
6 commissioner to access or examine the books and records of a broker-dealer or
7 investment adviser as otherwise provided by law.
8 SECTION 9. AMENDMENT. Subsection 16 of section 11-16-01 of the North Dakota Century
10 16. Institute and defend proceedings under sections 14-09-12 and 14-09-19 and chapters
11 14-15, 27-20, and 50-01 upon consultation with the human service zone director or the
12 executive director of the department of health and human services.
13 SECTION 10. AMENDMENT. Subdivision n of subsection 5 of section 11-19.1-01 of the
14 North Dakota Century Code is amended and reenacted as follows:
15 n. Victim is in the custody of the department of health and human services, county
16 social services, the department of corrections and rehabilitation or other
17 correctional facility, or law enforcement;
20 2. Any person who discovers the deceased human body or acquires the first knowledge
21 of the death of any minor who has received or is eligible to receive a birth record,
22 when the minor died suddenly when in apparent good health, shall notify immediately
23 law enforcement or the office of coroner of the known facts concerning the time, place,
24 manner, and circumstances of the death. The death of a minor must be reported to the
25 department of health and human services as provided under chapter 50-25.1. The
26 coroner shall take custody of the body and immediately consult with a law
27 enforcement agency. The law enforcement agency shall investigate the death and
28 notify the state's attorney of the findings. The coroner shall notify the state forensic
29 examiner of each such death, and shall provide the state forensic examiner the
30 information concerning the death as the state forensic examiner requires. The coroner
31 or the assistant or deputy coroner shall notify the parent or guardian of a child under
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1 the age of one year of the right to the performance of an autopsy, at state expense, as
2 provided by this chapter.
5 2. The state department of health and human services shall audit, and if found correct,
6 certify for payment by the state treasurer duly itemized and verified claims of the
7 coroner, the coroner's medical deputy, and pathologist for the necessary expenses
8 incurred or paid in the performance of an autopsy of a child whose cause of death was
9 suspected to have been the sudden infant death syndrome.
10 SECTION 13. AMENDMENT. Subsection 2 of section 11-23-01 of the North Dakota Century
12 2. a. The departmental budget submitted by the human service zone may not exceed
13 an amount determined by the department of health and human services and the
14 human service zone director pursuant to section 50-35-04 and must include the
15 county's cost allocation of indirect costs based on a formula established by the
17 b. The county share of the human service zone's indirect costs must be funded
18 entirely from the county's general fund.
19 c. The department of health and human services shall develop a process to review
20 a request from a human service zone for any proposed increase in staff. As part
21 of its review process, the department of health and human services shall review
22 pertinent factors, which may include caseload information. If the department of
23 health and human services approves a request for a proposed increase in staff,
24 the human service zone budget may be increased by the amount determined
25 necessary by the department of health and human services to fund the approved
26 additional staff. The human service zone director shall submit the proposed
27 increase in staff to the human service zone board for review. The human service
28 zone director shall work with the department to achieve equitable compensation
29 and salary increases for all human service zone team members within the human
30 service zone. The human service zone director shall notify appropriate host
31 county staff of all staffing changes for administrative purposes.
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1 SECTION 14. AMENDMENT. Subdivision e of subsection 1 of section 12-44.1-28 of the

3 e. The department of health and human services, a public hospital or treatment
4 facility, or a licensed private hospital or treatment facility.
5 SECTION 15. AMENDMENT. Subdivision b of subsection 1 of section 12-44.1-29 of the
7 b. A correctional facility staff member who has successfully completed a medication
8 assistant I training and competency evaluation program approved by the state
9 department of health and human services under chapter 23-44. The requirements
10 for a medication assistant I training and competency evaluation program must be
11 met, except for the requirement a correctional facility staff member must be a
12 nurse aide or certified nurse aide on the department registry prior to entry into the
13 medication assistant I training and competency evaluation program or following
14 successful completion of the program.
15 SECTION 16. AMENDMENT. Subsection 5 of section 12-47-36 of the North Dakota
17 5. Medical, psychological, or treatment records may be disclosed without prior
18 application to the court to a public hospital or treatment facility, the department of
19 health and human services, a community behavioral health program, a vocational
20 rehabilitation program, a transitional living facility, or a licensed private medical or
21 treatment facility, when necessary for the evaluation, treatment, or care of a person
22 who is or who has been in the custody of, or is or who has been under the supervision
23 and management of, the adult services division of the department of corrections and
24 rehabilitation.
25 SECTION 17. AMENDMENT. Section 12-52-02 of the North Dakota Century Code is
27 12-52-02. Aftercare granted on recommendation of superintendent.
28 No aftercare program may be provided for any person committed to the North Dakota youth
29 correctional center or placed under the guardianship, control, and custody of the
30 superintendent, unless the superintendent recommends the program to the director of the
31 division of juvenile services and some suitable person will receive the person to be placed in the
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1 aftercare program under conditions approved by the superintendent. Nothing in this chapter
2 prevents the placing of any person into the person's own home or into a licensed foster home
3 under any program administered by the department of health and human services.
6 2. The bureau of criminal investigation shall provide to each agency, official, or entity
7 listed in this subsection who has requested a statewide and nationwide criminal history
8 record check, the response of the federal bureau of investigation and any statewide
9 criminal history record information that may lawfully be made available under this
10 chapter:
11 a. The governing body of a city or a county, by ordinance or resolution, for a final
12 applicant for a specified occupation with the city or county.
13 b. The agriculture commissioner for each applicant for a license to grow or process
14 hemp under section 4.1-18.1-02.
15 c. The education standards and practices board for initial, re-entry, and reciprocal
16 teacher licenses under sections 15.1-13-14 and 15.1-13-20 and school guidance
17 and counseling services under section 15.1-13-23.
18 d. The North Dakota board of medicine for licenses or disciplinary investigations
19 under section 43-17-07.1, except that criminal history record checks need not be
20 made unless required by the board.
21 e. The private investigative and security board for licenses or registrations under
22 section 43-30-06.
23 f. The department of health and human services for foster care licenses, approvals,
24 and identified relatives under chapter 50-11, appointments of legal guardians
25 under chapter 50-11.3, and petitions for adoptions under chapter 50-12, except
26 that the criminal history record investigation must be conducted in accordance
27 with those chapters. A criminal history record investigation completed under
28 chapter 50-11, 50-11.3, or 50-12 may be used to satisfy the requirements of a
29 criminal history record investigation under either of the other two chapters.
30 g. The department of health and human services for criminal history record checks
31 authorized under section 50-06-01.9.
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1 h. The chief information officer of the information technology department for certain
2 individuals under section 54-59-20.
3 i. A public peace officer training school that has been approved by the peace officer
4 standards and training board for enrollees in the school. The school may only
5 disclose the criminal history record information as authorized by law. The school
6 shall pay the costs for securing the fingerprints, any criminal history record
7 information made available under this chapter, and for the nationwide criminal
8 history record check. This subdivision does not apply to the highway patrol law
9 enforcement training center and enrollees who have a limited license under
10 section 12-63-09.
11 j. The North Dakota public employees retirement board for individuals first
12 employed by the public employees retirement board after July 31, 2005, who
13 have unescorted physical access to the office or any security-sensitive area of
14 the office as designated by the executive director.
15 k. The executive director of the retirement and investment office for individuals first
16 employed by the retirement and investment office after July 31, 2005, who have
17 unescorted physical access to the office or any security-sensitive area of the
18 office as designated by the executive director.
19 l. The Bank of North Dakota for a final applicant for a specified occupation with the
20 Bank as designated by the president.
21 m. Job service North Dakota for all employees, final applicants for employment with
22 job service, and contractors with access to federal tax information.
23 n. The state department of health and human services for a final applicant for or an
24 employee in a specified occupation with the department as designated by the
25 state health officer; an individual being investigated by the department; or, when
26 requested by the department, an applicant for registration, certification, or
27 licensure by the department.
28 o. The state board of nursing for applicants, licensees, registrants, or disciplinary
29 investigations under chapter 43-12.1, except that criminal history record checks
30 need not be made unless required by the board.
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1 p. The state board of pharmacy for applicants or disciplinary investigations under

2 chapter 43-15 and registrations, or revocation or suspension of registrations,
3 under chapter 19-03.1, except that criminal history record checks need not be
5 q. The state real estate commission for applicants, licensees, or investigations
6 under chapter 43-23, except that criminal history record checks need not be
7 made unless required by the commission.
8 r. The North Dakota board of social work examiners for applicants for initial
9 licensure or licensees under chapter 43-41, except that criminal history record
10 checks for licensees need not be made unless required by the board.
11 s. All agencies, departments, bureaus, boards, commissions, or institutions of the
12 state, including the North Dakota university system, for all employees or final
13 applicants for employment as a security guard or to otherwise provide security.
14 t. The office of management and budget for each individual who has access to
15 personal information as designated by the director.
16 u. The department of corrections and rehabilitation for all agents and employees
17 and a final applicant for employment designated by the director and for each
18 agent, employee, or a final applicant for employment of a privately operated
19 entity providing contract correctional services for the department who exercises
20 direct authority over juveniles, inmates, probationers, or parolees.
21 v. A city, county, or combination of cities or counties that operates a correctional
22 facility subject to chapter 12-44.1, for each agent and employee and a final
23 applicant for employment of the correctional facility who has direct contact with or
24 exercises direct authority over any juvenile or inmate of the correctional facility,
25 and for each agent, employee, or a final applicant for employment of a privately
26 operated entity providing contract correctional services for the correctional facility
27 who exercises direct authority over juveniles, inmates, probationers, or parolees.
28 w. The North Dakota university system for a final applicant for or employee in a
29 specified position in the university system or a university system institution or for
30 each student applying for or admitted to a specified program of study, as
31 designated by the chancellor.
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1 x. (1) The board of a school district, for employees designated by the board,
2 provided the board is responsible for paying the costs associated with
3 obtaining a criminal history record check;
4 (2) The board of a multidistrict special education unit, for employees designated
5 by the board, provided the board is responsible for paying the costs
6 associated with obtaining a criminal history record check;
7 (3) The board of an area career and technology center, for employees
8 designated by the board, provided the board is responsible for paying the
9 costs associated with obtaining a criminal history record check;
10 (4) The board of a regional education association, for employees designated by
11 the board, provided the board is responsible for paying the costs associated
12 with obtaining a criminal history record check; and
13 (5) The superintendent of public instruction in the case of a nonpublic school or
14 a state school with a superintendent appointed by or reporting to the
15 superintendent of public instruction, for employees designated by the
16 nonpublic or state school, provided the nonpublic or state school is
17 responsible for paying the costs associated with obtaining a criminal history
18 record check.
19 y. (1) The board of a school district, for a final applicant seeking employment with
20 the district or otherwise providing services to the district, if that individual
21 has unsupervised contact with students, provided the board is responsible
22 for paying the costs associated with obtaining a criminal history record
23 check;
24 (2) The board of a multidistrict special education unit, for a final applicant
25 seeking employment with the unit or otherwise providing services to the unit,
26 if that individual has unsupervised contact with students, provided the board
27 is responsible for paying the costs associated with obtaining a criminal
28 history record check;
29 (3) The board of an area career and technology center, for a final applicant
30 seeking employment with the center or otherwise providing services to the
31 center, if that individual has unsupervised contact with students, provided
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1 the board is responsible for paying the costs associated with obtaining a
2 criminal history record check;
3 (4) The board of a regional education association, for a final applicant seeking
4 employment with the association or otherwise providing services to the
5 association if that individual has unsupervised contact with students,
6 provided the board is responsible for paying the costs associated with
7 obtaining a criminal history record check; and
8 (5) The superintendent of public instruction in the case of a nonpublic school or
9 a state school with a superintendent appointed by or reporting to the
10 superintendent of public instruction, for a final applicant seeking
11 employment with the school or otherwise providing services to the school, if
12 that individual has unsupervised contact with students, provided the board is
13 responsible for paying the costs associated with obtaining a criminal history
14 record check.
15 (6) For purposes of this subdivision, "unsupervised contact" with students
16 means being in proximity to one or more students, on school grounds or at
17 school functions, outside the presence of an individual who has been
18 subject to a criminal history record check.
19 z. The racing commission for applicants for licenses under chapter 53-06.2, except
20 that criminal history record checks need not be made unless required by the
21 commission.
22 aa. A district court for a petition to change a name under chapter 32-28.
23 bb. The state board of pharmacy for a wholesale drug distributor seeking licensure
24 under chapter 43-15.3.
25 cc. The board of dental examiners for investigations of applicants or dentists under
26 section 43-28-11.2, except that criminal history record checks need not be made
27 unless required by the board.
28 dd. The department of financial institutions for each applicant for a specified
29 occupation with the department as specified by the commissioner and principal
30 owners and managing officers of applicants for a license from the department of
31 financial institutions.
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1 ee. The office of tax commissioner for all employees, final applicants for employment
2 with the tax commissioner, and contractors with access to federal tax information.
3 ff. The state board of examiners for nursing home administrators for applicants for
4 licensure or licensees under chapter 43-34, except that criminal history record
6 gg. The marriage and family therapy licensure board for applicants, licensees, or
7 investigations under chapter 43-53, except that criminal history record checks
9 hh. The state board of chiropractic examiners for applicants, licensees, certificates,
10 or investigations under chapter 43-06, except that criminal history record checks
12 ii. Workforce safety and insurance for a final applicant for a specified occupation
13 with workforce safety and insurance as designated by the director, or for
14 contractors who may have access to confidential information as designated by
15 the director.
16 jj. The board of counselor examiners for applicants for licensure or licensees under
17 chapter 43-47, except that criminal history record checks for licensees need not
18 be made unless required by the board.
19 kk. The state board of respiratory care for applicants, licensees, or investigations
20 under chapter 43-42, except that criminal history record checks need not be
22 ll. The North Dakota real estate appraiser qualifications and ethics board for
23 applicants for permits or registration or permittees, registrants, owners, or
24 controlling persons under chapters 43-23.3 and 43-23.5, except that criminal
25 history record checks for permittees, registrants, owners, or controlling persons
27 mm. The insurance department for criminal history record checks authorized under
28 chapters 26.1-26 and 26.1-26.8.
29 nn. The office of the adjutant general for employees and volunteers working with the
30 recruiting and retention, sexual assault, and youth programs.
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1 oo. The parks and recreation department for volunteers and final applicants for
2 employment, as determined by the director of the parks and recreation
3 department.
4 pp. The North Dakota medical imaging and radiation therapy board of examiners for
5 licensure and licensees under chapter 43-62, except that criminal history record
7 qq. The game and fish department for volunteers and final applicants for
8 employment, as determined by the director of the game and fish department.
9 rr. The North Dakota board of massage for applicants, licensees, or investigations
10 under chapter 43-25.
11 ss. The North Dakota board of physical therapy for physical therapist and physical
12 therapist assistant applicants and for licensees under investigation, except that
13 criminal history record checks need not be made unless required by the board.
14 tt. The department of commerce for volunteers and employees providing services
15 through eligible organizations, as determined by the commissioner of commerce.
16 uu. The state court administrator for a guardian ad litem who provides direct services
17 to youth.
18 vv. The department of environmental quality for a final applicant for or an employee
19 specified in occupation with the department; an individual being investigated by
20 the department; or, when requested by the department, an applicant for
21 registration, certification, or licensure by the department.
22 ww. The housing finance agency for criminal history record checks authorized under
23 section 54-17-07.13.
24 xx. The office of state treasurer for each individual who has access to federal tax
25 information.
28 5. When the division of vital records of the state department of health and human
29 services receives a notice from a law enforcement authority that a child is reported as
30 lost, missing, or runaway, the division of vital records shall:
31 a. Flag the records of the individual; and
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1 b. Notify the bureau and a local law enforcement authority if a request for records is
2 received from any source.
3 SECTION 20. AMENDMENT. Subsection 26 of section 12.1-01-04 of the North Dakota
5 26. "Risk assessment" means an initial phase with a secondary process approved by the
6 department of health and human services for the evaluation of the likelihood a person
7 that committed an offense will commit another similar offense. The initial phase is an
8 assessment tool that is administered by a trained probation and parole officer. A
9 predetermined score on the initial phase initiates the secondary process that includes
10 a clinical interview, psychological testing, and verification through collateral information
11 or psychophysiological testing, or both. The department of health and human services
12 shall perform the secondary process of the risk assessment.
15 4. The state department of health and human services or the state's attorney having
16 jurisdiction may bring an action to enjoin a pattern of violations of this section.
19 16. If a juvenile is adjudicated delinquent and required or ordered to register as a sexual
20 offender or as an offender against a child under this section, the juvenile shall comply
21 with the registration requirements in this section. Notwithstanding any other provision
22 of law, a law enforcement agency shall register a juvenile offender in the same manner
23 as adult offenders and may release any relevant and necessary information on file to
24 other law enforcement agencies, the department of health and human services, or the
25 public if disclosure is necessary to protect public health or safety. The law enforcement
26 agency shall release any relevant and necessary information on file to the
27 superintendent or principal of the school the juvenile attends. The school
28 administration shall notify others in similar positions if the juvenile transfers to another
29 learning institution in or outside the state.
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1 4. For purposes of this section, "a benefit or service available through the state" does not
2 include a benefit or service of a program administered by the department of health and
3 human services using federal or special funds, if the victim or minor does not meet
4 program eligibility requirements including an eligibility requirement that is based on
5 immigration status.
8 13-05-02.2. Child support collection agencies.
9 1. Notwithstanding sections 13-05-02 and 13-05-02.3, a collection agency attempting in
10 any manner to collect child support as defined in section 14-09-09.10 must be licensed
11 under this chapter if either the child support debtor or creditor reside within this state, if
12 the child support debt arises under an order issued by a court of this state, or if a
13 record of the child support debt is being maintained on the statewide automated data
14 processing system under section 50-09-02.1.
15 2. A collection agency licensed under this section may not:
16 a. Impose a fee or charge for any child support collected primarily through the
17 efforts of a governmental agency;
18 b. Impose a fee or charge for collection of a current child support payment; or
19 c. Designate a current child support payment as past-due support or other amount
20 owed.
21 3. If the child support debt arises under an order issued by a court of this state, or if a
22 record of the child support debt is being maintained on the statewide automated data
23 processing system under section 50-09-02.1, all child support payments collected by a
24 collection agency must be paid to the department of health and human services within
25 five business days for disbursement under section 14-09-25. Child support payments
26 disbursed under section 14-09-25 may not be redirected to a collection agency unless
27 specifically permitted by rules adopted by the department of health and human
28 services.
29 4. A collection agency failing to pay child support payments to the department of health
30 and human services as required in this section is liable to the obligor for three times
31 the amount improperly withheld by the collection agency or five hundred dollars,
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1 whichever is greater, in addition to any other remedy or damages permitted by law.

2 The department of health and human services is not required to give credit for
3 payments withheld by a collection agency in violation of this section.
4 5. Any person contracting for services with a collection agency for the collection of child
5 support may cancel the contract without a fee or charge upon thirty days' written
6 notice.
9 8. "Hospital" means an institution licensed by the state department of health and human
10 services under chapter 23-16 and any hospital operated by the United States or this
11 state.
12 SECTION 26. AMENDMENT. Section 14-02.1-02.1 of the North Dakota Century Code is
14 14-02.1-02.1. Printed information - Referral service.
15 1. The state department of health and human services shall publish in English, and in
16 every other language that the department determines is the primary language of a
17 significant number of state residents, the following easily comprehensible printed
18 materials:
19 a. Geographically indexed materials designed to inform the woman of public and
20 private agencies and services available to assist a woman through pregnancy,
21 upon childbirth, and while the child is dependent, including adoption agencies.
22 The materials must include a comprehensive list of the agencies available, a
23 description of the services they offer and a description of the manner, including
24 telephone numbers, in which they might be contacted, or, at the option of the
25 department, printed materials, including a toll-free, twenty-four-hour-a-day
26 telephone number that may be called to obtain, orally, such a list and description
27 of agencies in the locality of the caller and of the services they offer. The
28 materials must state that it is unlawful for any individual to coerce a woman to
29 undergo an abortion and that if a minor is denied financial support by the minor's
30 parent, guardian, or custodian due to the minor's refusal to have an abortion
31 performed, the minor is deemed to be emancipated for the purposes of eligibility
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1 for public assistance benefits, except that those benefits may not be used to
2 obtain an abortion. The materials also must state that any physician who
3 performs an abortion upon a woman without her informed consent may be liable
4 to her for damages in a civil action and that the law permits adoptive parents to
5 pay costs of prenatal care, childbirth, and neonatal care. The materials must
6 include the following statement: There are many public and private agencies
7 willing and able to help you to carry your child to term and to assist you and your
8 child after your child is born, whether you choose to keep your child or to place
9 your child for adoption. The state of North Dakota strongly urges you to contact
10 one or more of these agencies before making a final decision about abortion. The
11 law requires that your physician or your physician's agent give you the
12 opportunity to call agencies like these before you undergo an abortion.
13 b. Materials, published in a booklet format, designed to inform the woman of the
14 probable anatomical and physiological characteristics of the unborn child at
15 two-week gestational increments from the time when a woman can be known to
16 be pregnant to full term, including any relevant information on the possibility of
17 the survival of the unborn child and color photographs of the development of an
18 unborn child at two-week gestational increments. The descriptions must include
19 information about brain and heart function, the presence of external members
20 and internal organs during the applicable states of development, and any
21 relevant information on the possibility of the unborn child's survival. The materials
22 must be objective, nonjudgmental, and designed to convey only accurate
23 scientific information about the unborn child at the various gestational ages. The
24 materials required under this subsection must be reviewed, updated, and
25 reprinted as needed.
26 c. Materials that include information on the support obligations of the father of a
27 child who is born alive, including the father's legal duty to support his child, which
28 may include child support payments and health insurance, and the fact that
29 paternity may be established by the father's signature on an acknowledgment of
30 paternity or by court action. The printed material must also state that more
31 information concerning paternity establishment and child support services and
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1 enforcement may be obtained by calling state public assistance agencies or

2 human service zones.
3 d. Materials that contain objective information describing the various surgical and
4 drug-induced methods of abortion as well as the immediate and long-term
5 medical risks commonly associated with each abortion method, including the
6 risks of infection, hemorrhage, cervical or uterine perforation or rupture, danger to
7 subsequent pregnancies, the possible increased risk of breast cancer, the
8 possible adverse psychological effects associated with an abortion, and the
9 medical risks associated with carrying a child to term.
10 e. Materials including information it may be possible to reverse the effects of an
11 abortion-inducing drug but time is of the essence. The materials must include
12 information directing the patient where to obtain further information and
13 assistance in locating a medical professional who can aid in the reversal of
14 abortion-inducing drugs, such as mifepristone and misoprostol.
15 2. The materials required under subsection 1 must be available at no cost from the state
16 department of health and human services upon request and in appropriate number to
17 any person, facility, or hospital, and, except for copyrighted material, must be available
18 on the department's internet website. The department may make the copyrighted
19 material available on its internet website if the department pays the copyright royalties.
22 14-02.1-02.2. Abortion report form.
23 The state department of health and human services shall prepare an abortion compliance
24 report form and an abortion data report form to be used by the physician for each abortion
25 performed, as required by section 14-02.1-07. The abortion compliance report form must
26 include a checklist designed to confirm compliance with all provisions of this chapter, chapter
27 14-02.3, chapter 14-02.6, and section 23-16-14. The abortion data report form must include the
28 data called for in the United States standard report of induced termination of pregnancy as
29 recommended by the national center for health statistics.
30 SECTION 28. AMENDMENT. Subsection 4 of section 14-02.1-03.4 of the North Dakota
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1 4. The state department of health and human services shall make the signs required by
2 this section available for download in a printable format on its internet website.
5 14-02.1-07. Records required - Reporting of practice of abortion.
6 1. Records:
7 a. All abortion facilities and hospitals in which abortions are performed shall keep
8 records, including admission and discharge notes, histories, results of tests and
9 examinations, nurses' worksheets, social service records, and progress notes,
10 and shall further keep a copy of all written certifications provided for in this
11 chapter as well as a copy of the constructive notice forms, consent forms, court
12 orders, abortion data reports, adverse event reports, abortion compliance reports,
13 and complication reports. All abortion facilities shall keep the following records:
14 (1) The number of women who availed themselves of the opportunity to receive
15 and view an ultrasound image of their unborn children pursuant to section
16 14-02.1-04, and the number who did not; and of each of those numbers, the
17 number who, to the best of the reporting abortion facility's information and
18 belief, went on to obtain the abortion.
19 (2) Postfertilization age:
20 (a) If a determination of probable postfertilization age was not made, the
21 basis of the determination that a medical emergency existed.
22 (b) If the probable postfertilization age was determined to be twenty or
23 more weeks and an abortion was performed, the basis of the
24 determination that a medical emergency existed.
25 b. The medical records of abortion facilities and hospitals in which abortions are
26 performed and all information contained therein must remain confidential and
27 may be used by the state department of health and human services only for
28 gathering statistical data and ensuring compliance with the provisions of this
29 chapter.
30 c. Records must be maintained in the permanent files of the hospital or abortion
31 facility for a period of not less than seven years.
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1 2. Reporting:
2 a. An individual abortion compliance report and an individual abortion data report for
3 each abortion performed upon a woman must be completed by her attending
4 physician. The abortion data report must be confidential and may not contain the
5 name of the woman. The abortion data report must include the data called for in
6 the United States standard report of induced termination of pregnancy as
7 recommended by the national center for health statistics.
8 b. All abortion compliance reports must be signed by the attending physician within
9 twenty-four hours and submitted to the state department of health and human
10 services within ten business days from the date of the abortion. All abortion data
11 and complication reports must be signed by the attending physician and
12 submitted to the state department of health and human services within thirty days
13 from the date of the abortion. If a physician provides an abortion-inducing drug to
14 another for the purpose of inducing an abortion and the physician knows that the
15 individual experiences during or after the use an adverse event, the physician
16 shall provide a written report of the adverse event within thirty days of the event
17 to the state department of health and human services and the federal food and
18 drug administration via the medwatch reporting system. For purposes of this
19 section, "adverse event" is defined based upon the federal food and drug
20 administration criteria given in the medwatch reporting system. If a determination
21 of probable postfertilization age was not made, the abortion compliance report
22 must state the basis of the determination that a medical emergency existed. If the
23 probable postfertilization age was determined to be twenty or more weeks and an
24 abortion was performed, the abortion compliance report must state the basis of
25 the determination that a medical emergency existed.
26 c. A copy of the abortion report, any complication report, and any adverse event
27 report must be made a part of the medical record of the patient at the facility or
28 hospital in which the abortion was performed. In cases when post-abortion
29 complications are discovered, diagnosed, or treated by physicians not associated
30 with the facility or hospital where the abortion was performed, the state
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1 department of health and human services shall forward a copy of the report to
2 that facility or hospital to be made a part of the patient's permanent record.
3 d. The state department of health and human services is responsible for collecting
4 all abortion compliance reports, abortion data reports, complication reports, and
5 adverse event reports and collating and evaluating all data gathered from these
6 reports and shall annually publish a statistical report based on data from
7 abortions performed in the previous calendar year. All abortion compliance
8 reports received by the state department of health and human services are public
9 records. Except for disclosure to a law enforcement officer or state agency, the
10 department may not disclose an abortion compliance report without first removing
11 any individually identifiable health information and any other demographic
12 information, including race, marital status, number of previous live births, and
13 education regarding the woman upon whom the abortion was performed.
14 e. The state department of health and human services shall report to the attorney
15 general any apparent violation of this chapter.
18 14-02.1-07.1. Forms.
19 The state department of health and human services shall make available to physicians,
20 hospitals, and all abortion facilities the forms required by this chapter.
23 14-02.1-09. Humane disposal of nonviable unborn child.
24 The physician performing the abortion, if performed outside of a hospital, must see to it that
25 the unborn child is disposed of in a humane fashion under regulations established by the state
26 department of health and human services. A licensed hospital in which an abortion is performed
27 must dispose of a dead unborn child in a humane fashion in compliance with regulations
28 promulgated by the state department of health and human services.
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1 14-07.1-01. Definitions.
2 1. "Department" means the state department of health and human services.
3 2. "Domestic violence" includes physical harm, bodily injury, sexual activity compelled by
4 physical force, assault, or the infliction of fear of imminent physical harm, bodily injury,
5 sexual activity compelled by physical force, or assault, not committed in self-defense,
6 on the complaining family or household members.
7 3. "Domestic violence sexual assault organization" means a private, nonprofit
8 organization whose primary purpose is to provide emergency housing,
9 twenty-four-hour crisis lines, advocacy, supportive peer counseling, community
10 education, and referral services for victims of domestic violence and sexual assault.
11 4. "Family or household member" means a spouse, family member, former spouse,
12 parent, child, persons related by blood or marriage, persons who are in a dating
13 relationship, persons who are presently residing together or who have resided
14 together in the past, persons who have a child in common regardless of whether they
15 are or have been married or have lived together at any time, and, for the purpose of
16 the issuance of a domestic violence protection order, any other person with a sufficient
17 relationship to the abusing person as determined by the court under section
18 14-07.1-02.
19 5. "Health officer" means the state health officer of the department.
20 6. "Law enforcement officer" means a public servant authorized by law or by a
21 government agency to enforce the law and to conduct or engage in investigations of
22 violations of law.
23 7.6. "Predominant aggressor" means an individual who is the most significant, not
24 necessarily the first, aggressor.
25 8.7. "Willfully" means willfully as defined in section 12.1-02-02.
28 14-07.1-17. Duties of health officerthe department.
29 The health officerdepartment shall:
30 1. Respond to all applicants within sixty days after the deadline for receipt of
31 applications, whether or not the applicant is eligible for funds.
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1 2. Ensure that no more than ten percent of the moneys allocated to the domestic
2 violence prevention fund in any biennium is expended for departmental administration
3 of the grant program.
4 3. Distribute grants to eligible applicants in accordance with the purposes of sections
5 14-07.1-15 through 14-07.1-18.
6 SECTION 34. AMENDMENT. Subdivision f of subsection 2 of section 14-07.1-20 of the
8 f. Employees of the state department of health and human services and county
9 social services;
12 14-09-08.21. Termination of parental rights - Duty of support.
13 A termination of parental rights does not terminate the duty of either parent to support the
14 child before the child's adoption unless that duty is specially terminated by order of the court
15 after notice of a proposed termination or relinquishment is given to the department of health and
16 human services in the manner appropriate for the service of process in a civil action in this
17 state. A termination of a child support obligation under this section does not relieve a parent of
18 the duty to pay any unpaid child support.
19 SECTION 36. AMENDMENT. Subsection 1 of section 14-09-09.7 of the North Dakota
21 1. The department of health and human services shall establish child support guidelines
22 to assist courts in determining the amount a parent should be expected to contribute
23 toward the support of the child under this section. The guidelines must:
24 a. Include consideration of gross income. For purposes of the guidelines, gross
25 income does not include an employee benefit over which the employee does not
26 have significant influence or control over the nature or amount unless:
27 (1) That benefit may be liquidated; and
28 (2) Liquidation of that benefit does not result in the employee incurring an
29 income tax penalty.
30 b. Authorize an expense deduction for determining net income.
31 c. Designate other available resources to be considered.
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1 d. Specify the circumstances that should be considered in reducing support

2 contributions on the basis of hardship.
3 e. Include consideration of extended periods of time a minor child spends with the
4 child's obligor parent.
5 f. Authorize a rebuttal of the presumption provided in subsection 4 based on the
6 proportionate net income of the obligor and the obligee when the net income of
7 the obligee is at least three times higher than the net income of the obligor.
8 g. Include consideration of an obligated party's responsibility for health insurance
9 coverage or other medical support under section 14-09-08.10.
12 4. "Child support agency" means the department of health and human services in
13 execution of its duties pursuant to the state plan submitted under chapter 50-09 in
14 conformance with title IV-D of the Social Security Act [Pub. L. 93-647; 88 Stat. 2351;
15 42 U.S.C. 651 et seq.].
18 14-09-09.31. Child support exempt from process.
19 A child support obligation owed to an obligee who is a judgment debtor may not be subject
20 to execution, garnishment, attachment, or other process except to satisfy that child support
21 obligation. This section does not prohibit the child support agency from authorizing the state
22 disbursement unit to apply a payment of past-due support owed to an obligee to a child support
23 obligation owed by the same obligee or to another debt being enforced by the North Dakota
24 department of health and human services that arises out of a public assistance program.
27 14-09-12. Support - Liability of parent's estate.
28 If a parent chargeable with the support of a child dies leaving it chargeable upon the human
29 service zone and leaving an estate sufficient for its support, the department of health and
30 human services, in the name of the human service zone, may claim provision for its support
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1 from the parent's estate by civil action, and for this purpose may have the same remedies as
2 any creditor against that estate and against the heirs, devisees, and next of kin of the parent.
5 14-10-05. Assignment of children prohibited - Penalty.
6 No person, other than the parents, may assume the permanent care and custody of a child,
7 unless authorized so to do by an order or decree of a court having jurisdiction, except that a
8 parent, upon giving written notice to the department of health and human services and human
9 service zone, may place that person's own child in the home of the child's grandparent, uncle,
10 or aunt for adoption or guardianship by the person receiving the child. The child must be
11 considered abandoned if proceedings for the adoption or guardianship of the child are not
12 initiated by such relative within one year following the date of notice of placement. No parent
13 may assign or otherwise transfer the parent's rights or duties with respect to the care and
14 custody of the parent's child. Any such transfer or assignment, written or otherwise, is void. This
15 section does not affect the right of the parent to consent in writing to the legal adoption of the
16 parent's child, but such written consent does not operate to transfer any right in the child in the
17 absence of a decree by a court having jurisdiction. Any person who violates the provisions of
18 this section is guilty of a class A misdemeanor.
21 2. The department of health and human services is the support enforcement agency of
22 this state.
25 1. The department of health and human services is the state information agency under
26 this chapter.
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1 14-12.2-47.3. (703) Relationship of department of health and human services to

2 United States central authority.
3 The department of health and human services of this state is recognized as the agency
4 designated by the United States central authority to perform specific functions under the
5 convention.
8 14-12.2-47.4. (704) Initiation by department of health and human services of support
9 proceeding under convention.
10 1. In a support proceeding under the convention, the department of health and human
11 services of this state shall:
12 a. Transmit and receive applications; and
13 b. Initiate or facilitate the institution of a proceeding regarding an application in a
14 tribunal of this state.
15 2. The following support proceedings are available to an obligee under the convention:
16 a. Recognition or recognition and enforcement of a foreign support order;
17 b. Enforcement of a support order issued or recognized in this state;
18 c. Establishment of a support order if there is no existing order, including, where
19 necessary, determination of parentage of a child;
20 d. Establishment of a support order if recognition of a foreign support order is
21 refused under subdivision b, d, or i of subsection 2 of section 14-12.2-47.8;
22 e. Modification of a support order of a tribunal of this state; and
23 f. Modification of a support order of a tribunal of another state or foreign country.
24 3. The following support proceedings are available under the convention to an obligor
25 against whom there is an existing support order:
26 a. Recognition of an order suspending or limiting enforcement of an existing support
27 order of a tribunal of this state;
28 b. Modification of a support order of a tribunal of this state; and
29 c. Modification of a support order of a tribunal of another state or foreign country.
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1 4. An individual filing a direct request is not entitled to assistance from the department of
2 health and human services.
3 SECTION 46. AMENDMENT. Subdivision b of subsection 3 of section 14-12.2-47.8 of the
5 b. The department of health and human services shall take all appropriate
6 measures to request a child support order for the obligee if the application for
7 recognition and enforcement was received under section 14-12.2-47.4.
10 14-13-03. Definitions.
11 In this chapter, unless the context or subject matter otherwise requires:
12 1. "Appropriate authority in the receiving state" as used in paragraph 1 of article V of the
13 compact with reference to this state means the executive director of the department of
15 2. "Appropriate public authorities" as used in article III of the compact with reference to
16 this state means the department of health and human services, and the department
17 shall receive and act with reference to notices required by article III.
20 6. "Department" means the department of health and human services.
27 In this chapter, unless the context otherwise requires:
28 1. "Birthing hospital" means a hospital licensed under chapter 23-16 which provides
29 obstetrical services.
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1 3. "Donor" means a woman whose body produced an egg for the purposes of assisted
2 conception but does not include a woman whose body produces an egg used for the
3 purpose of conceiving a child for that woman.
4 4. "Gestational carrier" means a woman who enters into an agreement to have an
5 embryo implanted in her and bear the resulting child for intended parents, when the
6 embryo is conceived by using the egg and sperm of the intended parents.
7 5. "Married woman" includes a woman who attempted to marry by a marriage
8 solemnized in apparent compliance with law, although the attempted marriage is or
9 could be declared invalid.
10 6. "Mother" means a woman who gives birth to a child or, if pregnancy resulted from
11 assisted conception, the woman who is the donor but not the woman who is the
12 gestational carrier.
13 7. "Party" means the man with whom the relationship of father and child is sought or
14 established, the child's mother, and, for purposes of proceedings to relieve a party of
15 the relationship of father and child, the child.
16 8. "Relationship of father and child" means the legal relationship existing between a
17 father and the father's natural or adoptive child incident to which the law confers or
18 imposes rights, privileges, duties, and obligations.
19 9. "Voluntary paternity establishment service entity" means the state department of
20 health and human services and any child support agency, as that term is defined in
21 section 14-09-09.10.
24 14-19-05. Filing of acknowledgment.
25 An acknowledgment of paternity made under chapter 14-20 must be filed with the state
26 department of health on a form approved by the department, which must include the social
27 security number of the parents and any other information required by the secretary of the United
28 States department of health and human services. Upon request of the department, the state
29 department of health shall furnish a certified copy of an acknowledgment of paternity to the
30 department.
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1 SECTION 52. AMENDMENT. Subdivision d of subsection 1 of section 14-19-06 of the North

2 Dakota Century Code is amended and reenacted as follows:
3 d. Forward completed acknowledgments to the state department of health.
6 14-19-08. Powers and duties of the department.
7 The department shall:
8 1. Provide each birthing hospital and voluntary paternity establishment service entity in
9 the state:
10 a. Written materials about paternity establishment.
11 b. Forms necessary to voluntarily acknowledge paternity.
12 c. A written description of the rights and responsibilities of acknowledging paternity.
13 2. Provide training, guidance, and written instructions regarding voluntary
14 acknowledgment of paternity reasonably necessary to assist a birthing hospital or
15 voluntary paternity establishment service entity in its duties under this chapter.
16 3. In cooperation with the state department of health, secureSecure information on each
17 voluntary paternity establishment service entity's and each birthing hospital's paternity
18 acknowledgment program at least annually.
19 4. In cases involving applications for child support services made to a child support
20 agency which require paternity establishment, determine if a voluntary paternity
21 acknowledgment has been filed with the state department of health.
22 5. Assure that the same procedures governing birthing hospitals apply to voluntary
23 paternity establishment service entities, including use of the same notice provisions,
24 the same materials, the same evaluation methods, and the same training for
25 personnel.
28 3. A voluntary paternity establishment service entity shall forward completed
29 acknowledgments to the state department of health.
30 SECTION 55. AMENDMENT. Paragraph 1 of subdivision d of subsection 1 of section
31 14-20-10 of the North Dakota Century Code is amended and reenacted as follows:
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1 (1) The assertion is in a record filed with the state department of health and
2 human services;
3 SECTION 56. AMENDMENT. Subdivision a of subsection 2 of section 14-20-12 of the North
4 Dakota Century Code is amended and reenacted as follows:
5 a. States that another man is a presumed father, unless a denial of paternity signed
6 or otherwise authenticated by the presumed father is filed with the state
7 department of health and human services;
10 3. Subject to subsection 1, an acknowledgment of paternity or denial of paternity takes
11 effect on the birth of the child or the filing of the document with the state department of
12 health and human services, whichever occurs later.
15 14-20-15. (305) Effect of acknowledgment or denial of paternity.
16 1. Except as otherwise provided in sections 14-20-17 and 14-20-18, a valid
17 acknowledgment of paternity filed with the state department of health and human
18 services is equivalent to an adjudication of paternity of a child and confers upon the
19 acknowledged father all of the rights and duties of a parent and must be recognized as
20 a basis for a support order in any proceeding to establish, enforce, or modify a support
21 order.
22 2. Except as otherwise provided in sections 14-20-17 and 14-20-18, a valid denial of
23 paternity by a presumed father filed with the state department of health and human
24 services in conjunction with a valid acknowledgment of paternity is equivalent to an
25 adjudication of the nonpaternity of the presumed father and discharges the presumed
26 father from all rights and duties of a parent.
29 14-20-16. (306) No filing fee.
30 The state department of health and human services may not charge for filing an
31 acknowledgment of paternity or denial of paternity.
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3 14-20-18. (308) Challenge after expiration of period for rescission.
4 1. After the period for rescission under section 14-20-17 has expired, a signatory of an
5 acknowledgment of paternity or denial of paternity may commence a proceeding to
6 challenge the acknowledgment or denial only:
7 a. On the basis of fraud, duress, or material mistake of fact; and
8 b. Within two years after the acknowledgment or denial is filed with the state
10 2. A party challenging an acknowledgment of paternity or denial of paternity has the
11 burden of proof.
14 14-20-19. (309) Procedure for rescission or challenge.
15 1. Every signatory to an acknowledgment of paternity and any related denial of paternity
16 must be made a party to a proceeding to rescind or challenge the acknowledgment or
17 denial.
18 2. For the purpose of rescission of, or challenge to, an acknowledgment of paternity or
19 denial of paternity, a signatory submits to personal jurisdiction of this state by signing
20 the acknowledgment or denial, effective upon the filing of the document with the state
22 3. Except for good cause shown, during the pendency of a proceeding to rescind or
23 challenge an acknowledgment of paternity or denial of paternity, the court may not
24 suspend the legal responsibilities of a signatory arising from the acknowledgment,
25 including the duty to pay child support.
26 4. A proceeding to rescind or to challenge an acknowledgment of paternity or denial of
27 paternity must be conducted in the same manner as a proceeding to adjudicate
28 parentage under sections 14-20-36 through 14-20-58.
29 5. At the conclusion of a proceeding to rescind or challenge an acknowledgment of
30 paternity or denial of paternity, the court shall order the state department of health and
31 human services to amend the birth record of the child, if appropriate.
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3 1. To facilitate compliance with sections 14-20-11 through 14-20-24, the state department
4 of health and human services shall prescribe forms for the acknowledgment of
5 paternity and the denial of paternity.
8 14-20-23. (313) Release of information.
9 The state department of health and human services may release information relating to the
10 acknowledgment of paternity or denial of paternity to a signatory of the acknowledgment or
11 denial and to courts and appropriate state or federal agencies of this or another state.
14 14-20-24. (314) Adoption of rules.
15 The state department of health and human services may adopt rules to implement sections
16 14-20-11 through 14-20-23.
19 14-20-57. (636) Order adjudicating parentage.
20 1. The court shall issue an order adjudicating whether a man alleged or claiming to be
21 the father is the parent of the child.
22 2. An order adjudicating parentage must identify the child by name and date of birth.
23 3. The order must include the social security numbers of the child and the individuals
24 determined to be the child's parents.
25 4. The order may contain any other provision in the best interest of the child, including
26 payment of support, payment of expenses of the mother's pregnancy and
27 confinement, custody of the child, visitation with the child, and furnishing of bond or
28 other security for payment of support. A support order must be for a monthly payment
29 in an amount consistent with the guidelines established under section 14-09-09.7 and
30 must be subject to section 14-09-08.1. All remedies for the enforcement of support,
31 custody, and visitation orders apply. The court has continuing jurisdiction to modify an
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1 order for future support and, subject to section 14-09-09.6, custody of and visitation
2 with the child.
3 5. Except as otherwise provided in subsection 6, the court may assess filing fees,
4 reasonable attorney's fees, fees for genetic testing, other costs, and necessary travel
5 and other reasonable expenses incurred in a proceeding under sections 14-20-36
6 through 14-20-58. The court may award attorney's fees, which may be paid directly to
7 the attorney, who may enforce the order in the attorney's own name.
8 6. The court may not assess fees, costs, or expenses against the support enforcement
9 agency of this state or another state, except as provided by other law.
10 7. On request of a party and for good cause shown, the court may order that the name of
11 the child be changed.
12 8. If the order of the court is at variance with the child's birth certificate, the court shall
13 order the state department of health and human services to issue an amended birth
14 registration.
15 9. An order adjudicating parentage must be filed with the state department of health and
16 human services.
19 15-05-16. Reports - State geologist - State departmentDepartment of health and
20 human services - Department of environmental quality.
21 The state geologist, state department of health and human services, or department of
22 environmental quality, on the request of the board of university and school lands, shall visit any
23 land leased under section 15-05-09 and shall make a report of the visit to the board. The state
24 geologist, state department of health and human services, or department of environmental
25 quality may not receive a fee for making the examination and report but must be paid necessary
26 expenses incurred in connection with the examination.
29 2. The council consists of sixteen members:
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1 a. (1) Two members of the senate, one of whom must be from the majority party
2 and one of whom must be from the minority party, selected by the chairman
3 of the legislative management; and
4 (2) Two members of the house of representatives, one of whom must be from
5 the majority party and one of whom must be from the minority party, to be
6 selected by the chairman of the legislative management; and
7 (3) Two members of the department of health and human services, of which
8 one member is appointed by the state health officer;
9 b. One member selected by each of the following:
10 (1) The department of human services;
11 (2) The state board of higher education;
12 (3) The state department of health;
13 (4)(2) The North Dakota medical association;
14 (5)(3) The North Dakota hospital association;
15 (6)(4) The veterans administration hospital in Fargo;
16 (7)(5) The North Dakota center for nursing; and
17 (8)(6) The university of North Dakota center for rural health; and
18 c. Four members selected by the dean of the university of North Dakota school of
19 medicine and health sciences, one from each of the four campuses of the school
20 of medicine and health sciences with headquarters in Bismarck, Fargo, Grand
21 Forks, and Minot.
22 SECTION 68. AMENDMENT. Section 15.1-02-19 of the North Dakota Century Code is
24 15.1-02-19. Health insurance programs - Joint enrollment program.
25 The superintendent of public instruction and the department of health and human services
26 jointly shall develop a system under which families of children enrolling in the public school
27 system are provided with information regarding state and federally funded health insurance
28 programs and encouraged to apply for such coverage if determined to be eligible.
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1 3. The superintendent shall develop a plan for the coordination of services with other
2 agencies, including the department of health and human services, the state
3 department of health, the department of transportation, and law enforcement
4 agencies.
7 15.1-32-03. Interagency cooperative agreements - Development and implementation.
8 The superintendent of public instruction shall develop and implement interagency
9 agreements with the department of corrections and rehabilitation, the department of health and
10 human services, the state department of health, and other public and private entities to
11 maximize the state resources available for fulfilling the educationally related service
12 requirements of Public Law No. 94-142 [89 Stat. 773] and section 504 of the Rehabilitation Act
13 of 1973, as amended.
16 15.1-32-05. Special education - Cooperation among agencies.
17 The superintendent of public instruction, the state department of health, and the department
18 of health and human services shall cooperate in planning and coordinating early intervention
19 programs for individuals under the age of three.
22 15.1-32-19. Boarding care costs - Reimbursement of school district.
23 The superintendent of public instruction shall reimburse a student's school district of
24 residence an amount equal to eighty percent of the room and board costs paid by the district for
25 a student with disabilities who is placed in a facility that is located either within or outside of the
26 student's school district of residence in order to receive special education services. The
27 student's school district of residence is liable for any room and board costs in excess of those
28 reimbursed as provided in this section. The placement of a student with disabilities in a public or
29 private facility will be made by a school district. The placement of a student with disabilities in
30 congregate care will be made in a facility designated by the department of health and human
31 services.
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6 15.1-34-04. Boarding home fire inspection - Report.
7 The state department of health, the state fire marshal, or a designee of the state fire
8 marshal shall inspect any home for which a registration certificate is sought if requested to do
9 so by the department. The department may inspect any home for which a registration certificate
10 is sought. The entity conducting the inspection under this section shall prepare an inspection
11 report and present the report to the department.
14 1. The North Dakota early childhood education council consists of:
15 a. A chairman appointed by the governor;
16 b. The superintendent of public instruction, or the superintendent's designee;
17 c. The state health officer, or the officer's designee;
18 d. The director of the department of health and human services, or the director's
19 designee;
20 e. The North Dakota head start - state collaboration administrator, or the
21 administrator's designee;
22 f. The commissioner of higher education, or the commissioner's designee;
23 g. The commissioner of commerce, or the commissioner's designee;
24 h. The chairman of the senate education committee, or the chairman's designee;
25 i. The chairman of the house of representatives education committee, or the
26 chairman's designee; and
27 j. The following gubernatorial appointees:
28 (1) The superintendent of a school district having at least one thousand
29 students in average daily membership;
30 (2) The superintendent of a school district having fewer than one thousand
31 students in average daily membership;
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1 (3) The superintendent of a school district headquartered on a reservation or

2 including reservation land within its boundaries;
3 (4) An individual representing a non-religious-based provider of early childhood
4 education;
5 (5) An individual representing a religious-based provider of early childhood
6 education;
7 (6) An individual representing a center-based licensed child care provider;
8 (7) An individual representing a home-based licensed child care provider;
9 (8) An individual representing a reservation-based head start program;
10 (9) An elected member of a school board;
11 (10) The parent of a child not yet enrolled in elementary school;
12 (11) The parent of a child with disabilities not yet enrolled in elementary school;
13 and
14 (12) An individual representing children with disabilities.
17 18-01-03.1. Inspections - Department of health and human services - Education.
18 1. The state fire marshal and the state fire marshal's deputies may perform fire safety
19 inspections of those facilities required to be inspected under administrative rules of the
20 department of health and human services. The state fire marshal shall charge a fee
21 not to exceed fifty dollars for conducting these fire safety inspections in an amount
22 determined by administrative rules adopted by the state fire marshal. Inspection fees
23 received by the state fire marshal must be deposited into the attorney general's
24 operating fund.
25 2. The state fire marshal shall provide the department of health and human services and
26 designees of the fire marshal education regarding the fire safety requirements of
27 licensed early childhood program premises, including smoke detector and carbon
28 monoxide alarm requirements.
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1 18-01-03.2. Delegation of authority.

2 The state fire marshal may delegate to the state department of health and human services
3 or any political subdivision the authority to conduct investigations, surveys, or inspections, and
4 the authority to enforce compliance where violations are discovered, which become the
5 responsibility of the state department of health and human services or political subdivision and
6 otherwise would be the responsibility of the state fire marshal. Any delegation to the state
7 department of health and human services is limited to authority over basic care facilities. Any
8 political subdivision that meets the state fire marshal's minimum standard requirements may be
9 delegated authority under this section. A political subdivision may refuse the delegation.
15 19-01-07. Contract services.
16 Funds may be accepted by the department from cities, counties, states, federal agencies,
17 and private organizations for contract services of analytical and inspection work. Such funds
18 must be remitted by the department to the state treasurer and deposited in the operating fund of
19 the state department of health.
25 19-02.1-07. Minor violations.
26 Nothing in this chapter may be construed as requiring the state department of health or the
27 state board of pharmacy to report minor violations of this chapter for the institution of
28 proceedings under this chapter whenever the state department of health or the state board of
29 pharmacy believes that the public interest will be adequately served in the circumstances by a
30 suitable written notice or warning.
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3 5. If in package form, unless it bears a label containing:
4 a. The name and place of business of the manufacturer, packer, or distributor;
5 b. An accurate statement of the quantity of the contents in terms of weight,
6 measure, or numerical count; and
7 c. In the case of beverages that are manufactured, distributed, and sold under a
8 franchise or trademark name indicated thereon, whereby the person, firm,
9 corporation, or limited liability company owning the franchise or trademark has
10 control over the distribution, such beverages may be exempt from this
11 subsection, if a certified statement is filed with the state department of health,
12 stating the name and address of the manufacturer or distributor, and a statement
13 signed by the manufacturer or distributor that they assume all responsibility and
14 liability for the product named, which is being sold, or offered for sale, under such
15 name within the area of the state designated, which certificate must be in the
16 following form:
17 NORTH DAKOTA STATE DEPARTMENT OF HEALTH AND HUMAN SERVICES
18 BISMARCK, NORTH DAKOTA
19 BEVERAGE LABELING EXEMPTIONS CERTIFICATE
20 I, _______________________, the undersigned, an agent of and having
21 authority to sign, do hereby certify that the following information is correct:
22 Name and address of company requesting exemption
23 _________________________________________________
24 Name __________________________________________
25 Street Address ________________________________
26 City or Town __________________________________
27 State _________________________________________
28 Name of Product _______________________________
29 Brand Name ____________________________________
30 In order to be exempt from subdivisions a and b of subsection 5 of section
31 19-02.1-10 of the North Dakota Century Code, relating to misbranding of food,
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1 which requires the name and address of the real manufacturer or other persons
2 responsible for placing the product upon the market, I, the undersigned, do bind
3 the company listed above by agreeing to assume all responsibility for the product
4 named in this certificate which is being sold, or offered for sale under such name
5 and brand name within the area consisting of _________________ in the State
6 of North Dakota.
7 Note: The area must be designated by counties or other legal subdivisions of the
8 city, county, or state.
9 Firm _____________________________
10 Signed ___________________________
11 Title ____________________________
12 Address __________________________
13 Note: If signed by a person other than an officer of the company, authorization for
14 signature must accompany this form. This certificate must be acknowledged.
15 Provided, that under subdivision b reasonable variations must be permitted, and
16 exemptions as to small packages must be established, by regulations prescribed by
17 the department.
20 19-02.1-10.1. Eggs - Labeling and temperature rules.
21 The state department of health may adopt appropriate rules under chapter 28-32 to
22 establish standards for proper labeling and temperature during the retail storage and sale of
23 shell eggs. As used in this section, "eggs" means eggs in the shell which are the product of a
24 domesticated chicken.
27 2. An application provided for in subdivision b of subsection 1 becomes effective on the
28 one hundred eightieth day after the filing thereof, except that if the department finds,
29 after due notice to the applicant and giving the applicant an opportunity for a hearing,
30 that the drug is not safe or not effective for use under the conditions prescribed,
31 recommended, or suggested in the proposed labeling thereof, the state department of
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1 health shall, prior to the effective date of the application, issue an order refusing to
2 permit the application to become effective.
5 3. Practitioners must be registered to dispense any controlled substances or to conduct
6 research with controlled substances in schedules II through V if they are authorized to
7 dispense or conduct research under the laws of this state. The board need not require
8 separate registration under this chapter for practitioners engaging in research with
9 non-narcotic controlled substances in schedules II through V where the registrant is
10 already registered under this chapter in another capacity. Practitioners registered
11 under federal law to conduct research with schedule I substances may conduct
12 research with schedule I substances within this state upon furnishing the state
13 department of health evidence of that federal registration.
16 3. If the licensed addiction counselor recommends treatment, the court shall require the
17 person to participate in an addiction program licensed by the department of human
18 services as a condition of the probation. The court shall commit the person to
19 treatment through a licensed addiction program until determined suitable for discharge
20 by the court. The term of treatment may not exceed eighteen months and may include
21 an aftercare plan. During the commitment and while subject to probation, the
22 department shall supervise the person.
25 e. The department of human services for purposes regarding the utilization of
26 controlled substances by a Medicaid recipient or establishment and enforcement
27 of child support and medical support;
30 e. A designee of the department of human services;
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3 19-05.1-05. Inspection of food.
4 Upon the request made by a bona fide charitable or nonprofit organization receiving
5 perishable food under this chapter, a representative from the county health district where the
6 organization is located or the state department of health shall provide inspection of the food
7 received to determine whether the food may be used for human consumption. This chapter
8 does not restrict the authority of any appropriate agency to inspect, regulate, or ban the use of
9 perishable food.
12 19-06.1-05. Enforcement authority.
13 The state department of health shall enforce the provisions of this chapter.
16 19-17-05. Penalty.
17 Any person who violates any of the provisions of this chapter or the orders, rules, or
18 regulations promulgated by the state department of health under authority thereof, is, unless a
19 specific penalty has been provided, guilty of a class B misdemeanor.
26 SECTION 94. AMENDMENT. Subdivision a of subsection 1 of section 19-24.1-14 of the
28 a. A nonrefundable application fee, not to exceed five thousand dollars, made
29 payable to the "North Dakota State Department of Health and Human Services,
30 Medical Marijuana Program".
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3 a. A certification fee, made payable to the "North Dakota State Department of
4 Health and Human Services, Medical Marijuana Program", in the amount of
5 ninety thousand dollars for a dispensary and one hundred ten thousand dollars
6 for a manufacturing facility.
9 3. The health councildepartment shall adopt rules to allow a manufacturing facility to
10 possess no more than an additional fifty plants for the exclusive purpose of
11 department-authorized research and development related to production and
12 processing. These plants are not counted in a manufacturing facility possession
13 amount and are not subject to an additional fee.
16 e. On the grounds of a child care facility or licensed home day care, unless
17 authorized under rules adopted by the department of human services.
20 19-24.1-36. Health council - Rules.
21 1. The health councildepartment shall adopt rules as necessary for the implementation
22 and administration of this chapter, including transportation and storage of marijuana
23 and usable marijuana, advertising, packaging and labeling, standards for testing
24 facilities, inventory management, and accurate recordkeeping.
25 2. The health councildepartment may adopt rules regarding the operation and
26 governance of additional categories of registered medical marijuana establishments.
27 3. The health councildepartment shall adopt rules to establish requirements for reporting
28 incidents of individuals not authorized to possess marijuana or usable marijuana under
29 this chapter and who are found in possession of marijuana or usable marijuana. The
30 rules must identify professionals required to report, the information the reporter is
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1 required to report, and actions the reporter shall take to secure the marijuana or
2 usable marijuana.
3 4. The health councildepartment shall adopt rules to establish requirements for law
4 enforcement officials and health care professionals to report to the department
5 incidents involving overdose or adverse reaction related to the use of usable
6 marijuana.
7 SECTION 99. AMENDMENT. Section 20.1-01-26.1 of the North Dakota Century Code is
9 20.1-01-26.1. Hunting, trapping, or fishing prohibited while privileges are suspended -
10 Penalty.
11 No person may directly or indirectly hunt, trap, or fish or assist in any way in hunting,
12 trapping, or fishing while the person's privileges have been suspended by a court or by the
13 department of health and human services under section 50-09-08.6. Any person violating this
14 section is guilty of a class A misdemeanor.
17 4. Life skills and transition center patients, North Dakota youth correctional center
18 students, school for the deaf students, North Dakota vision services - school for the
19 blind students, state hospital patients, clients of regional human service centers under
20 direct therapeutic care, and residents of facilities licensed by the state department of
21 health and the department of human services may fish without a resident fishing
22 license. Patients of these institutions must be identified. The department shall issue
23 authority to each institution.
26 23-01-01. State department of healthHealth division - Officers.
27 The state department of health and human services' health division consists of a health
28 council, a state health officer, section chiefs, directors of divisions, and other designated
29 employees of the department.
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1 23-01-01.1. State departmentDepartment of health and human services to replace

2 state department of health and consolidated laboratories.
3 Wherever the termsThe legislative council shall replace, where appropriate, "North Dakota
4 state department of health", "department of health", "health department", "state department of
5 health and consolidated laboratories", "North Dakota state laboratories department", "state
6 laboratories department", "state laboratories department director", or "state laboratories
7 director", "state department of health", or any derivatives of those terms, which when used in
8 context indicate an intention to refer to those terms, wherever they appear in this code, the term
9 "state department of health" must be substituted thereforand in the North Dakota Administrative
10 Code, with "department of health and human services" or an appropriate derivative of that
11 phrase. The legislative council may replace references to the "state department of health" or
12 any derivatives of that term with "department of health and human services" in any measure
13 enacted by the sixty-seventh legislative assembly.
16 23-01-03. Powers and duties of the health council.
17 The health council shall:
18 1. Fix, subject to the provisions of section 23-01-02, the time and place of the meetings
19 of the council.
20 2. Make rules and regulations for the government of the council and its officers and
21 meetings.
22 3. Establish standards, rules, and regulations, which are found necessary for the
23 maintenance of public health, including sanitation and disease control.
24 4. Provide for the development, establishment, and enforcement of basic standards for
25 hospitals and related medical institutions which render medical and nursing care, and
26 for the construction and maintenance of such institutions, such standards to cover
27 matters pertaining to sanitation, building construction, fire protection measures,
28 nursing procedures, and preservation of medical records. No ruleregulation may be
29 adopted with respect to building construction of existing medical hospitals or related
30 medical institutions unless the ruleregulation relates to safety factors or the hospital or
31 related medical institution changes the scope of service in such a way that a different
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1 license is required from the department pursuant to rules adopted under chapter
2 23-16.
3 5. Hold hearings on all matters brought before it by applicants and licensees of medical
4 hospitals with reference to the denial, suspension, or revocation of licenses and make
5 appropriate determination as specified herein.
6 The council may direct the state health officer to do or cause to be done any or all of the things
7 which may be required in the proper performance of the various duties placed upon the state
11 1. The health councildepartment of health and human services shall adopt rules relating
12 to the storage, maintenance, and disposal of blood spots or other newborn screening
13 specimens.
16 1. The state health council, in cooperation with the North Dakota long term care
17 association, shall administer the long-term care nursing scholarship and loan
18 repayment grant program. The purpose of the program is to provide matching funds to
19 nursing facilities for the facilities to use in recruiting and retaining nurses by providing
20 scholarships to nursing facility staff and other individuals to obtain a nursing education
21 and by assisting in the repayment of student loans for licensed nurses employed in a
22 nursing facility. The statedepartment of health counciland human services shall adopt
23 rules necessary to administer the program, including rules establishing criteria
24 regarding eligibility for and distribution of program grants.
27 23-01-04. Effect of rules and regulations.
28 All rules and regulations promulgatedadopted by the health councildepartment of health and
29 human services under the powers granted by any provisions of this title are binding upon all
30 county and municipal health officers, and upon all county, municipal, and private medical
31 hospitals and upon related institutions, and have the force and effect of law.
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3 23-01-05. Health officer - Qualifications, salary, term, duties - Advisory committee.
4 The governorexecutive director of the department of health and human services shall
5 appoint a physician licensed in this state as the state health officer who must have had
6 substantive private or public administrative experience and demonstrated experience in the
7 management of people. The state health officer is entitled to receive a salary commensurate
8 with that person's training and experience. The governorexecutive director of the department of
9 health and human services shall set the salary of the state health officer within the limits of
10 legislative appropriations to the department. The state health officer is entitled to receive all
11 necessary traveling expenses incurred in the performance of official business. The state health
12 officer may not engage in any other occupation or business that may conflict with the statutory
13 duties of the state health officer and holds office for a term of four years beginning January 1,
14 1993. The state health officer is the administrative officer of the state department of health. If
15 the governor does not appoint as state health officer a physician licensed in this state, the
16 governor shall appoint at least three licensed physicians recommended by the state medical
17 association to serve as an advisory committee to the state health officer. Each member of the
18 advisory committee is entitled to receive reimbursement of expenses in performing official
19 duties in amounts provided by law for other state officers. The term of the advisory committee
20 coincides with the term of the state health officer. A committee member serves at the pleasure
21 of the governor. The duties of the state health officer are as follows:
22 1. Enforce all rules and regulations as promulgated by the health council and all rules
23 adopted by the department of health and human services.
24 2. Hold public health unit boards of health responsible for enforcement of state rules,
25 serve in an advisory capacity to public health unit boards of health, and provide for
26 coordination of health activities.
27 3. Establish and enforce minimum standards of performance of the work of the local
28 department of health.
29 4. Study health problems and plan for their solution as may be necessary.
30 5. Collect, tabulate, and publish vital statistics for each important political or health
31 administrative unit of the state and for the state as a whole.
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1 6. Promote the development of local health services and recommend the allocation of
2 health funds to local jurisdictions subject to the approval of the health council.
3 7. Collect and distribute health education material.
4 8. Maintain a central public health laboratory and where necessary, branch laboratories
5 for the standard function of diagnostic, sanitary and chemical examinations, and
6 production and procurement of therapeutic and biological preparations for the
7 prevention of disease and their distribution for public health purposes.
8 9. Establish a service for medical hospitals and related institutions to include licensing of
9 such institutions according to the standards promulgated by the health council and
10 consultation service to communities planning the construction of new hospitals and
11 related institutions.
12 10. Comply with the state merit system policies of personnel administration.
13 11. Establish a program to provide information to the surviving family of a child whose
14 cause of death is suspected to have been the sudden infant death syndrome.
15 12.11. Issue any orders relating to disease control measures deemed necessary to prevent
16 the spread of communicable disease. Disease control measures may include special
17 immunization activities and decontamination measures. Written orders issued under
18 this section shall have the same effect as a physician's standing medical order. The
19 state health officer may apply to the district court in a judicial district where a
20 communicable disease is present for an injunction canceling public events or closing
21 places of business. On application of the state health officer showing the necessity of
22 such cancellation, the court may issue an ex parte preliminary injunction, pending a
23 full hearing.
24 13.12. Make bacteriological examination of bodily secretions and excretions and of waters
25 and foods.
26 14.13. Make preparations and examinations of pathological tissues submitted by the state
27 health officer, by any county superintendent of public health, or by any physician who
28 has been regularly licensed to practice in this state.
29 15.14. Make all required analyses and preparations, and furnish the results thereof, as
30 expeditiously and promptly as possible.
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1 16.15. Cause sanitary statistics to be collected and tabulated, and cause to be ascertained by
2 research work such methods as will lead to the improvement of the sanitation of the
3 various parts of the state.
4 17.16. From time to time, cause to be issued bulletins and reports setting forth the results of
5 the sanitary and pathological work done in the laboratories embodying all useful and
6 important information resulting from the work carried on in the laboratories during the
7 year, the substance of such bulletins and reports to be incorporated in the annual
8 report of the state health officer.
9 18.17. Establish by rule a schedule of reasonable fees that may be charged for laboratory
10 analysis. No charge may be made for any analysis conducted in connection with any
11 public health incident affecting an entire region, community, or neighborhood.
12 19.18. a. Establish a review process for instances in which the department is requested to
13 conduct an epidemiological assessment of a commercial building. The
14 epidemiological assessment must include:
15 (1) A statement of whether there are known environmental causes;
16 (2) If there are known environmental causes identified, a recommendation of
17 how they can be remediated or mitigated; and
18 (3) If there are no known environmental causes identified, a statement that no
19 known causes exist.
20 b. Costs for remediation, mitigation, and consultant services are the responsibility of
21 the building owner. Proof of remediation of any identified environmental concern
22 related to the epidemiological assessment is the burden of the building owner.
25 23-01-05.1. Organ or tissue transplant assistance administration - Standing
26 appropriation.
27 The state health officerexecutive director of the department of health and human services
28 shall select a private nonprofit patient-oriented organization incorporated in this state for the
29 purpose of administering financial assistance to organ or tissue transplant patients who are
30 residents of this state. The state health officerdepartment of health and human services shall
31 adopt rules governing administration of this section. The organization selected shall administer
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1 and provide grants from available funds to alleviate demonstrated financial needs of transplant
2 patients for any costs associated with transplant operations, under guidelines based on current
3 social service eligibility requirements. There is hereby created as a special fund in the state
4 treasury an organ transplant support fund, the principal and income of which is hereby
5 appropriated to the organization selected under this section. The organization administering the
6 fund may solicit contributions from private or governmental sources and such contributions may
7 be deposited in the fund.
10 23-01-05.2. Administration of epinephrine - Liability.
11 1. The state health officerdepartment of health and human services shall adopt rules to
12 authorize a layperson to administer epinephrine to an individual who has a severe
13 allergic reaction.
14 2. An individual authorized to administer epinephrine by the state health officer may
15 obtain premeasured doses of epinephrine and the necessary paraphernalia for
16 epinephrine administration from any licensed physician or pharmacist.
17 3. An individual authorized to administer epinephrine by the state health officer, and the
18 employer of such an individual, is not civilly or criminally liable for any act or omission
19 of that individual when acting in good faith while rendering emergency treatment to an
20 individual who has a severe adverse reaction, except when the conduct amounts to
21 gross negligence.
24 23-01-05.3. Immunization data.
25 1. The state department of health and human services may establish an immunization
26 information system and may require the childhood immunizations specified in
27 subsection 1 of section 23-07-17.1 and other information be reported to the
28 department. The state department of health and human services may only require the
29 reporting of childhood immunizations and other data upon completion of the
30 immunization information reporting system. A health care provider who administers a
31 childhood immunization shall report the patient's identifying information, the
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1 immunization that is administered, and other required information to the department.

2 The report must be submitted using electronic media, and must contain the data
3 content and use the format and codes specified by the department.
4 2. If a health care provider fails to submit an immunization report required under this
5 section within four weeks of vaccination:
6 a. That health care provider may not order or receive any vaccine from the North
7 Dakota immunization program until that provider submits all reports required
8 under this section.
9 b. The state department of health and human services shall make a report to that
10 health care provider's occupational licensing entity outlining that provider's failure
11 to comply with the reporting requirements under this section.
12 3. Notwithstanding any other provision of law, a health care provider, elementary or
13 secondary school, early childhood facility, public or private postsecondary educational
14 institution, city or county board of health, district health unit, and the state health officer
15 may exchange immunization data in any manner with one another. Immunization data
16 that may be exchanged under this section is limited to the date and type of
17 immunization administered to a patient and may be exchanged regardless of the date
18 of the immunization.
21 23-01-05.4. Department to employ state forensic examiner - Qualifications - Duties.
22 The state department of health and human services may employ and establish the
23 qualifications and compensation of the state forensic examiner. The state forensic examiner
24 must be a physician who is board-certified or board-eligible in forensic pathology, who is
25 licensed to practice in this state, and who is in good standing in the profession. The state
26 forensic examiner shall:
27 1. Exercise all authority conferred upon the coroner under chapter 11-19.1 and any other
28 law;
29 2. Consult with local coroners on the performance of their duties as coroners;
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1 3. Conduct investigations into the cause of death of and perform autopsies on any
2 deceased human body whenever requested to do so by the acting local county
3 coroner or the local state's attorney;
4 4. Provide training and educational materials to local county coroners, law enforcement,
5 and any other person the state forensic examiner deems necessary;
6 5. Maintain complete records of the cause, manner, and mode of death necessary for
7 accurate health statistics and for public health purposes; and
8 6. Perform other duties assigned by the state health officer.
11 23-01-06. Biennial report - Contents.
12 The state health officerdepartment of health and human services shall submit a biennial
13 report to the governor and the secretary of state in accordance with section 54-06-04. In
14 addition to any requirements established pursuant to section 54-06-04, the report must cover
15 the following subjects:
16 1. The activities of the various divisionshealth division, the work accomplished during the
17 two years covered by the report, and an analysis of the program of each of the
18 divisionshealth division.
19 2. The expenditures of the state department of health division.
20 3. The expenditures in each county board of health or the district board of health.
21 4. Any reports relating to the hospital program as required by the health council.
24 23-01-08. Directors of divisions - Deputy - Appointment, salary, duties.
25 The state health officerexecutive director of the department of health and human services or
26 designee shall appoint directors of the various divisions of the department and shall determine
27 the salary, within the limits of legislative appropriations to the department and in conformity with
28 the state merit system, to be received by such persons. The duties of such director must be
29 those prescribed by the state health officerexecutive director of the department of health and
30 human services or designee. The state health officerexecutive director of the department of
31 health and human services or designee may appoint a deputy state health officer. A deputy
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1 state health officer who does not hold a health-related degree may not individually issue an
2 order regarding public health unless the order is cosigned by a physician who is employed by
3 the department or cosigned by the state epidemiologist. The deputy state health officer serves
4 at the pleasure of the state health officerexecutive director of the department of health and
5 human services.
8 23-01-10. Office space.
9 The state shall provide suitable office space in Bismarck for housing and maintaining the
10 state department of health and human services. Special fireproof vaults must be provided for
11 the storage of birth and death certificates.
14 23-01-11. Acceptance of funds and right to qualify for benefits under federal laws
15 authorized.
16 The state department of health and human services may:
17 1. Accept funds from cities, counties, the federal government, private organizations, and
18 individuals for infancy and maternal hygiene, for other public health work and for the
19 purpose of conducting a survey of existing medical hospitals and related institutions,
20 planning of needed hospital construction and for construction and maintenance of
21 such medical hospitals and related institutions. When approved by the governor of this
22 state, the state department of health and human services may match the same from
23 any unexpended portion of its appropriation in accordance with specifications agreed
24 to or required by congressional act. All infancy and maternal hygiene and public health
25 work must be done under the supervision of the state department of health and human
26 services.
27 2. Adopt rules necessary to enable the state to be in compliance with any federal laws in
28 order to qualify for any federal funds related to medical facilities or agencies licensed
29 by the state department of health and human services.
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1 23-01-14. State departmentDepartment of health and human services authorized to

2 transfer future accumulated fees.
3 As a continuing policy, the state department of health and human services may
4 automatically from time to time transfer unclaimed fees on deposit with the Bank of North
5 Dakota or other authorized depository to the state general fund when the unclaimed status has
6 existed for a period of at least three years.
9 23-01-15. Research studies confidential - Penalty.
10 1. All information, records of interviews, written reports, statements, notes, memoranda,
11 or other data procured by the state department of health and human services, in
12 connection with studies conducted by the state department of health and human
13 services, or carried on by the department jointly with other persons, agencies, or
14 organizations, or procured by such other persons, agencies, or organizations, for the
15 purpose of reducing the morbidity or mortality from any cause or condition of health is
16 confidential and must be used solely for the purposes of medical or scientific research.
17 2. Such information, records, reports, statements, notes, memoranda, or other data is not
18 admissible as evidence in any action of any kind in any court or before any other
19 tribunal, board, agency, or person. Such information, records, reports, statements,
20 notes, memoranda, or other data may not be exhibited nor their contents disclosed in
21 any way, in whole or in part, by any officer or representative of the state department of
22 health and human services, nor by any other person, except as may be necessary for
23 the purpose of furthering the research project to which they relate. No person
24 participating in such research project may disclose, in any manner, the information so
25 obtained except in strict conformity with such research project. No officer or employee
26 of said department may interview any patient named in any such report, nor a relative
27 of any such patient, unless the consent of the attending physician and surgeon is first
28 obtained.
29 3. The furnishing of such information to the state department of health and human
30 services or its authorized representative, or to any other cooperating agency in such
31 research project, does not subject any person, hospital, sanitarium, rest home, nursing
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1 home, or other person or agency furnishing such information, to any action for
2 damages or other relief.
5 23-01-16. Dairy products - Joint standards.
6 The state department of health and human services and the dairy department of the
7 department of agriculture shall jointly adopt a set of uniform standards in relation to all matters
8 falling within their joint jurisdiction regarding dairy products. The state department of health and
9 human services, district health units, municipal health departments or units, and the dairy
10 department shall each be permitted to accept any inspection report of the other department or
11 unit regarding the inspection of dairy products and the producers and processors of such
12 products, when such report is based substantially upon standards conforming with the milk
13 ordinance and code recommended by the United States public health service.
16 23-01-22. Department to employ waste management facility inspectors.
17 The state department of health and human services shall employ and establish the
18 qualifications, duties, and compensation of at least one full-time inspector for each commercial,
19 nonpublicly owned waste management disposal or incineration facility that accepts more than
20 twenty-five thousand tons [22679.5 kilograms] per year of hazardous waste, industrial waste,
21 nuclear waste, or ash resulting from the incineration of municipal solid waste. This section does
22 not apply to any energy conversion facility or coal mining operation that disposes of its solid
23 waste onsite. The department may require inspectors for those facilities that accept less than
24 twenty-five thousand tons [22679.5 kilograms] per year. The facility inspector shall conduct
25 regular inspections of the operating procedure and conditions of the facility and report the
26 findings to the department on a regular basis. If an inspector discovers a condition at a facility
27 that is likely to cause imminent harm to the health and safety of the public or environment, the
28 inspector shall notify the department. The department shall proceed as provided by sections
29 23-29-10 and 23-29-11.
30 The department shall assess the owner or operator of a waste management facility that
31 accepts hazardous waste, industrial waste, nuclear waste, or ash resulting from the incineration
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1 of municipal solid waste an annual fee to pay the salaries, wages, and operating expenses
2 associated with employing an inspector for the facility. The owner or operator of the facility shall
3 submit the fee to the department by July first of each year. Any fees collected must be
4 deposited in the department's operating fund in the state treasury and any expenditures from
5 the fund are subject to appropriation by the legislative assembly. If a facility begins operation
6 after July first of any year, the owner or operator of the facility shall pay to the department a
7 prorated fee for the fiscal year before the facility may begin accepting waste. Moneys in the
8 waste management facility account may be spent by the department within the limits of
9 legislative appropriation.
12 23-01-24. Health care cost and quality review program - Penalty.
13 The department of health and human services shall conduct a continuous program to
14 review and improve the quality of health care in the state. The department may contract with a
15 qualified person or organization to develop and implement the program. The department shall
16 use the program to compile relevant information about the quality of health care in this state
17 which will allow the department to evaluate the cost, quality, and outcomes of health care. The
18 department shall establish and consult a provider advisory committee composed of health care
19 providers regarding the data that is a cost-effective process for collecting and evaluating the
20 information. The state health officerdepartment may assess against a provider a penalty of one
21 hundred dollars per day for each day the provider willfully refuses to provide the department
22 with information requested for use with the program, but the penalty may not exceed one
23 thousand dollars for each request. A provider against whom a fee is assessed may appeal that
24 assessment to the state health councildepartment. If the provider fails to pay the penalty, the
25 health councildepartment may, in the county where the provider's principal place of business is
26 located, initiate a civil action against the provider to collect the penalty. As used in this section,
27 "provider" means a person who is licensed, certified, or otherwise authorized by the law of this
28 state to administer health care in the ordinary course of business or professional practice. The
29 department shall ensure that patient privacy is protected throughout the compilation and use of
30 the information. The department shall evaluate data management capabilities in the state and
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1 shall organize its capabilities to provide information about the cost of care on an individual
2 provider basis as well as a collective basis.
5 23-01-25. Commercial feed, insecticide, fungicide, rodenticide, fertilizer, and soil
6 conditioner laws - Laboratory function.
7 Notwithstanding any other provision of law, any laboratory test or analysis required under
8 chapter 4.1-34, 4.1-40, or 4.1-41 must be performed by the state department of health and
9 human services for the agriculture commissioner at no charge.
12 23-01-26. State department of healthDepartment - Indirect cost recoveries.
13 Notwithstanding section 54-44.1-15, the state department of health and human services
14 may deposit indirect cost recoveries in its operating account.
17 23-01-27. Donated dental services program.
18 The state department of health and human services shall contract with the North Dakota
19 dental association, or other appropriate and qualified organizations, to develop and administer a
20 donated dental services program through which volunteer dentists provide comprehensive
21 dental care for needy, disabled, aged, or medically compromised individuals. The volunteers will
22 treat individuals through the program and, with the exception of certain dental laboratory costs,
23 will fully donate their services and supplies. The contract must specify the responsibilities of the
24 administering organization and include:
25 1. Establishment of a network of volunteer dentists, including dental specialists, volunteer
26 dental laboratories, and other appropriate volunteer professionals to donate dental
27 services to eligible individuals;
28 2. Establishment of a system to refer eligible individuals to appropriate volunteers;
29 3. Development and implementation of a public awareness campaign to educate eligible
30 individuals about the availability of the program;
31 4. Provision of appropriate administrative and technical support to the program; and
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1 5. Submission of an annual report to the state department of health and human services
2 that:
3 a. Accounts for all program funds;
4 b. Reports the number of individuals served by the program and the number of
5 dentists and dental laboratories participating as providers in the program;
6 c. Includes any other information required by the state department of health and
7 human services; and
8 d. Performs, as required by the state department of health and human services, any
9 other duty relating to the program.
12 23-01-28. Combined purchasing with local public health units - Continuing
13 appropriation.
14 The state department of health and human services may make combined or joint purchases
15 with or on behalf of local public health units for items or services. Payments received by the
16 state department of health and human services from local public health units pursuant to a
17 combined or joint purchase must be deposited in the operating fund and are appropriated as a
18 standing and continuing appropriation to the state department of health and human services for
19 the purpose of this section.
22 23-01-29. Bone marrow donor education.
23 The state department of health and human services shall provide information and
24 educational materials to the public regarding bone marrow donation through the national
25 marrow donor program. The department shall seek assistance from the national marrow donor
26 program to establish a system to distribute materials, ensure that the materials are updated
27 periodically, and address the education and recruitment of minority populations.
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1 23-01-32. Viral hepatitis program - Vaccination - Study.

2 1. The state department of health and human services shall establish and administer a
3 viral hepatitis program with the goal of distributing to residents of the state who are at
4 an increased risk for exposure to viral hepatitis information that addresses the higher
5 incidence of hepatitis C exposure and infection among these populations, addresses
6 the dangers presented by the disease, and provides contacts for additional information
7 and referrals.
8 2. The department shall establish a list of classes of individuals by category that are at
9 increased risk for viral hepatitis exposure. The list must be consistent with
10 recommendations developed by the federal centers for disease control and
11 prevention. The department shall determine the type of information the department will
12 distribute under the program and the form and manner of distribution.
13 3. The department shall establish a vaccination and testing program, to be coordinated
14 by the department through local public health units.
17 23-01-33. Human papilloma virus - Information.
18 The state department of health and human services shall educate the public about the
19 human papilloma virus and the availability of a human papilloma virus vaccine; promote
20 immunization against the human papilloma virus; and distribute informational material regarding
21 the human papilloma virus and the human papilloma virus vaccine. The department shall
22 distribute the informational material through relevant department programs and divisions,
23 including breast and cervical cancer control programs; immunization programs; family planning
24 programs; and human immunodeficiency virus and sexually transmitted disease programs.
25 Informational materials distributed must include the recommendations of the advisory
26 committee on immunization practices of the federal centers for disease control and prevention;
27 contain information relevant to the target populations of each of the participating programs and
28 divisions distributing the informational material; and contain information regarding the
29 availability of the vaccine through the vaccines for children program operated by the department
30 under 42 U.S.C. 1396s, and the medical assistance program.
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3 23-01-34. Children with special health care needs - Program administration.
4 The state department of health and human services shall administer programs for children
5 with special health care needs as may be necessary to conform to title 5, part 2, of the federal
6 Social Security Act, as amended through July 1, 2007 [Pub. L. 74-271; 49 Stat. 620; 42 U.S.C.
7 701 et seq.], including providing services and assistance to children with special health care
8 needs and their families and developing and operating clinics for the identification, screening,
9 referral, and treatment of children with special health care needs.
12 23-01-35. Tattooing, body piercing, branding, subdermal implants, or scarification -
13 Permit - Fee - Adoption of rules - Exemptions - Injury reports.
14 1. A person may not operate a facility providing tattooing, body piercing, branding,
15 subdermal implant, or scarification services without a permit issued by the department
16 under this section. The holder of a permit shall display the permit in a conspicuous
17 place at the facility for which the permit is issued. A permit issued under this section
18 expires annually. An applicant for a permit shall submit an application for a permit to
19 the department, on a form provided by the department, with a permit fee established
20 by the department. The application must include the name and complete mailing
21 address and street address of the facility and any other information reasonably
22 required by the department for the administration of this section.
23 2. The health councildepartment of health and human services shall adopt rules to
24 regulate any person that receives compensation for engaging in the practice of
25 tattooing, body piercing, branding, subdermal implants, or scarification. The rules must
26 establish health and safety requirements and limitations with respect to the age of an
27 individual who may receive a tattoo, body piercing, or scarification and may prohibit
28 any practice that the health councildepartment of health and human services deems
29 unsafe or a threat to public health.
30 3. A facility is exempt from subsection 1 if the facility provides body piercing that is limited
31 to the piercing of the noncartilaginous perimeter or lobe of the ear and the facility does
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1 not provide tattooing, branding, scarification, or subdermal implants. A person is

2 exempt from regulation under subsection 2 if the person's practice under this section
3 is limited to piercing of the noncartilaginous perimeter or lobe of the ear. A licensed
4 health care professional acting within that professional's scope of practice and the
5 associated medical facility are exempt from this section.
6 4. If a customer of a facility regulated under this section reports to the facility an injury the
7 customer or operator of the facility believes to have resulted from the tattooing, body
8 piercing, branding, subdermal implanting, or scarification provided at the facility, the
9 operator of the facility shall provide the customer with written information on how to
10 report the alleged injury to the state department of health and human services. If a
11 licensed health care professional treats a patient for an injury the professional
12 determines, in the exercise of professional judgment, occurred as a result of a service
13 regulated under this section, the professional shall report the circumstances to the
14 state department of health and human services. A licensed health care professional is
15 immune from liability for making or not making a report under this subsection.
16 5. The fees established by the department must be based on the cost of conducting
17 routine and complaint inspections and enforcement actions and preparing and sending
18 license renewals. Fees collected under this section must be deposited in the
19 department's operating fund in the state treasury and any expenditure from the fund is
20 subject to appropriation by the legislative assembly. The department shall waive all or
21 a portion of the fee for any facility that is subject to local jurisdiction.
24 23-01-37. Survey program - Health facilities construction or renovation projects -
25 Innovation waivers.
26 1. The state department of health and human services shall conduct a life safety survey
27 process for all health facilities licensed by the division of health facilities of the state
28 department of health and human services during and at the conclusion of a
29 construction, renovation, or construction and renovation project.
30 2. The department may charge a reasonable fee for the review of plans for construction,
31 renovation, or construction and renovation projects performed under this section
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1 based on the size of the project. Revenues derived from the fees collected under this
2 subsection must be deposited in the department's operating fund in the state treasury.
3 3. The state department of health and human services shall make a determination on a
4 construction, renovation, or construction and renovation project of no more than one
5 million dollars within sixty days of receipt of a complete application.
6 4. The state department of health and human services may approve a request for a
7 waiver of a state law or rule relating to an innovative construction, renovation, or
8 construction and renovation project if the lack of compliance does not adversely affect
9 health or safety.
10 5. The department shall design and operate the program in a manner that will provide
11 that the surveyor that performs a life safety survey under this section does not violate
12 the federal requirements associated with Medicare-certified life safety surveys.
13 SECTION 131. AMENDMENT. Subdivision a of subsection 1 of section 23-01-39 of the
15 a. "Department" means the state department of health and human services.
18 23-01-40. Diabetes goals and plans - Report to legislative management.
19 1. The department of health and human services, state department of health, Indian
20 affairs commission, and public employees retirement system shall collaborate to
21 identify goals and benchmarks while also developing individual agency plans to
22 reduce the incidence of diabetes in the state, improve diabetes care, and control
23 complications associated with diabetes.
24 2. Before June first of each even-numbered year the department of health and human
25 services, state department of health, Indian affairs commission, and public employees
26 retirement system shall submit a report to the legislative management on the following:
27 a. The financial impact and reach diabetes is having on the agency, the state, and
28 localities. Items included in this assessment must include the number of lives with
29 diabetes impacted or covered by the agency, the number of lives with diabetes
30 and family members impacted by prevention and diabetes control programs
31 implemented by the agency, the financial toll or impact diabetes and diabetes
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1 complications places on the agency's programs, and the financial toll or impact
2 diabetes and diabetes complications places on the agency's programs in
3 comparison to other chronic diseases and conditions.
4 b. An assessment of the benefits of implemented programs and activities aimed at
5 controlling diabetes and preventing the disease. This assessment must document
6 the amount and source for any funding directed to the agency from the legislative
7 assembly for programs and activities aimed at reaching those with diabetes.
8 c. A description of the level of coordination existing between the agencies on
9 activities, programmatic activities, and messaging on managing, treating, or
10 preventing diabetes and diabetes complications.
11 d. The development or revision of detailed action plans for battling diabetes with a
12 range of actionable items for consideration by the legislative assembly. The plans
13 must identify proposed action steps to reduce the impact of diabetes,
14 prediabetes, and related diabetes complications. The plan must identify expected
15 outcomes of the action steps proposed in the following biennium while also
16 establishing benchmarks for controlling and preventing relevant forms of
17 diabetes.
18 e. The development of a detailed budget blueprint identifying needs, costs, and
19 resources required to implement the plan identified in subdivision d. This
20 blueprint must include a budget range for all options presented in the plan
21 identified in subdivision d for consideration by the legislative assembly.
24 23-01-41. Autism spectrum disorder database - Rulemaking - Confidentiality.
25 1. The state department of health and human services shall establish and administer an
26 autism spectrum disorder database. The database must include a record of all
27 reported cases of autism spectrum disorder in the state and any other information
28 determined relevant and appropriate by the department in order to complete
29 epidemiologic surveys of the autism spectrum disorder, enable research and analysis
30 of the autism spectrum disorder, and provide services to individuals with an autism
31 spectrum disorder.
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1 2. The state department of health and human services shall establish criteria regarding
2 who is qualified to report a case of autism spectrum disorder to the database. In
3 establishing this criteria, the department shall require that the reporter be a physician
4 or psychologist or any other licensed or certified health care professional who is
5 qualified by training and by licensure or certification to make the diagnosis of autism
6 spectrum disorder.
7 3. The database established under this section must:
8 a. Include the reported individual's diagnoses under the most recent edition of the
9 American psychiatric association's diagnostic and statistical manual of mental
10 disorders; and
11 b. Indicate whether a complete physical evaluation was performed by a licensed
12 independent practitioner as part of the diagnostic process for autism spectrum
13 disorder.
14 4. The health councildepartment of health and human services shall adopt rules to
15 provide for mandatory reporting to the autism spectrum disorder database and to
16 establish reporting requirements, including timeliness requirements. A reporter who
17 makes the diagnosis an individual is affected with autism spectrum disorder, or the
18 reporter's designee, shall report this diagnosis in the form or manner prescribed by the
19 state department of health and human services.
20 5. The state department of health and human services shall keep confidential all records
21 of the database which could be used to identify a reported individual; however, the
22 department may provide these records to other state agencies as necessary to effect
23 the purposes of this database without regard to the confidential nature of the records.
24 If the department provides confidential records of the database to a state agency, the
25 department shall notify the receiving agency of the confidential nature of the records
26 and the receiving agency shall treat these records as confidential.
27 SECTION 134. AMENDMENT. Paragraph 1 of subdivision b of subsection 1 of section
29 (1) That is approved by the United States food and drug administration for the
30 treatment of a drug overdose and is recognized by the state department of
31 health and human services for the treatment of a drug overdose; and
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3 23-01-44. Syringe or needle exchange program - Authorization.
4 1. As used in this section:
5 a. "Program" means a syringe exchange program established and operated under
6 this section.
7 b. "Qualified entity" means:
8 (1) A local health department;
9 (2) A city that operates a program within the boundaries of the city; or
10 (3) An organization that has been authorized to operate a program by the state
11 department of health and human services, the board of county
12 commissioners, or the governing body for the operation of a program within
13 the boundaries of the city.
14 2. The state department of health, in collaboration with the department of and human
15 services behavioral health division, shall design and administer a syringe exchange
16 program. The state department of health shall administer the program.
17 3. The state department of health and human services may authorize a qualified entity to
18 operate a program in a county if:
19 a. The area to be served is at risk of an increase or potential increase in prevalence
20 of viral hepatitis or human immunodeficiency virus;
21 b. A syringe exchange program is medically appropriate as part of a comprehensive
22 public health response; and
23 c. The qualified entity conducted a public hearing and submitted a report of the
24 findings and an administration plan for the program to the state health officer.
25 4. A qualified entity operating a program under this chapter shall:
26 a. Register the program annually in the manner prescribed by the state department
27 of health and human services;
28 b. Have a pharmacist, physician, or advanced practice registered nurse who is
29 licensed in the state to provide oversight for the program;
30 c. Store and dispose of all syringes and needles collected in a safe and legal
31 manner;
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1 d. Provide education and training on drug overdose response and treatment,

2 including the administration of an overdose reversal medication;
3 e. Provide education, referral, and linkage to human immunodeficiency virus, viral
4 hepatitis, and sexually transmitted disease prevention, treatment, and care
5 services;
6 f. Provide addiction treatment information and referrals to drug treatment programs,
7 including programs in the local area and programs that offer medication-assisted
8 treatment that includes a federal food and drug administration approved
9 long-acting, non-addictive medication for the treatment of opioid or alcohol use
10 disorder;
11 g. Provide syringe, needle, and injection supply distribution and collection without
12 collecting or recording personally identifiable information;
13 h. Operate in a manner consistent with public health and safety; and
14 i. Ensure the program is medically appropriate and part of a comprehensive public
15 health response.
16 5. The state department of health and human services may terminate a program for
17 failure to comply with any of the provisions in this section.
18 6. A state agency may not provide general fund moneys to a program to purchase or
19 otherwise acquire hypodermic syringes, needles, or injection supplies for a program
20 under this section.
21 7. A law enforcement officer may not stop, search, or seize an individual based on the
22 individual's participation in a program under this section. Syringes and needles
23 appropriately collected under this section are not considered drug paraphernalia as
24 provided in chapter 19-03.4 or possession of a controlled substance under section
25 19-03.1-23.
26 8. Each program shall file a semiannual report with the state department of health and
27 human services containing the following information listed on a daily basis and by
28 location, identified by the postal zip code, where the program distributed and collected
29 syringes and needles:
30 a. The number of individuals served;
31 b. The number of syringes and needles collected;
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1 c. The number of syringes and needles distributed; and

2 d. Any additional information requested by the state department of health and
3 human services.
6 23-01.2-01. Trauma system established - Duties of health council.
7 The health council, in conjunction with the state department of health and human services,
8 may establish and maintain a comprehensive trauma system for the state. The trauma system
9 may include standards for the following components:
10 1. A system plan.
11 2. Prehospital emergency medical services.
12 3. Hospitals, for which the standards must include:
13 a. Standards for designation, redesignation, and dedesignation of trauma centers.
14 b. Standards for evaluation and quality improvement programs for designated
15 trauma centers. The standards must require each trauma center to collect quality
16 improvement data and to provide specified portions to the department for use in
17 state and regional trauma quality improvement programs.
18 c. Qualifications for trauma center personnel.
19 4. A trauma registry. Data in the trauma registry is not subject to subpoena or discovery
20 or introduction into evidence in any civil action. Designated trauma centers must
21 participate in the trauma registry. A hospital not designated as a trauma center must
22 provide to the registry a minimum set of data elements for all trauma patients as
23 determined by the health council.
24 5. A trauma quality improvement program to monitor the performance of the trauma
25 system. The proceedings and records of the program are not subject to subpoena or
26 discovery or introduction into evidence in any civil action arising out of any matter that
27 is the subject of consideration by the program.
30 2. The statedepartment of health counciland human services shall adopt rules that allow
31 provisional trauma designation status for a hospital that is partially compliant with
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1 trauma designation standards. When issuing a provisional trauma designation, the

2 state health council shall allow a reasonable amount of time, determined by the
3 department, for a hospital to fully meet all trauma designation standards.
6 23-01.2-04. Medical director.
8 designee shall appoint an emergency medical services and trauma medical director to provide
9 medical oversight and consultation in the development and administration of the state
10 emergency medical services and trauma systems. The medical director must be a physician
11 licensed in the state and must be contracted and paid by the state department of health and
12 human services.
15 8. "Public health authority" means the state department of health and human services'
16 health division, department of environmental quality, a local public health unit, and any
17 authority or instrumentality of the United States, a tribal government, a state, or a
18 political subdivision of a state, a foreign nation, or a political subdivision of a foreign
19 nation, which is:
20 a. Primarily responsible for public health matters; and
21 b. Primarily engaged in activities such as injury reporting, public health surveillance,
22 and public health investigation or intervention.
25 23-01.3-08. Status of information in possession of a local public health authority.
26 Any protected health information that is created or received by a local public health
27 authority, and that is submitted or is required to be submitted to the state department of health
28 and human services' health division, is confidential and subject to the protection of, and may be
29 disclosed only as authorized by, this chapter.
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2 As used in this chapter:
3 1. "Authorized representative" means a person that has the legal authority to act on
4 behalf of the person named on a record, including a personal representative or
5 guardian.
6 2. "Certified" means a copy of the original record on file with the state department of
7 health and human services which is signed and sealed by the state registrar or deputy
8 state registrar.
9 3. "Dead body" means a lifeless human body or parts of such body or bones thereof from
10 the state of which it may reasonably be concluded that death recently occurred.
11 4. "Electronic birth registration system" means the electronic birth registration system
12 maintained by the state department of health and human services.
13 5. "Electronic death registration system" means the electronic death registration system
14 maintained by the state department of health and human services.
15 6. "Facts of death" means the demographic and personal information pertaining to an
16 individual's death.
17 7. "Fetal death" or "birth resulting in stillbirth" means death occurring before the complete
18 expulsion or extraction from its mother of a product of human conception. The death is
19 indicated by the fact that after such expulsion or extraction the fetus does not breathe
20 or show any evidence of life such as beating of the heart, pulsation of the umbilical
21 cord, or definite movement of voluntary muscles.
22 8. "Filing" means the presentation of a record, report, or other information provided for in
23 this chapter of a birth, death, fetal death, adoption, marriage, divorce, or other event
24 as specified by the state health officer for registration by the state registrar.
25 9. "Final disposition" means the entombment, burial, interment, cremation, whole-body
26 donation to a school of medicine, removal from the state, or other disposition of a dead
27 body or fetus.
28 10. "Health statistics" means data derived from records of birth, death, fetal death,
29 marriage, divorce, or other records relating to the health of the populace or the state of
30 the environment.
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1 11. "Institution" means any establishment, public or private, which provides inpatient
2 medical, surgical, or diagnostic care or treatment, or nursing, custodial, or domiciliary
3 care to two or more individuals unrelated by blood, or to which individuals are
4 committed by law.
5 12. "Live birth" means the complete expulsion or extraction from its mother of a product of
6 human conception, irrespective of the duration of pregnancy, which after such
7 expulsion or extraction, breathes or shows any other evidence of life such as beating
8 of the heart, pulsation of the umbilical cord, or definite movement of voluntary
9 muscles, whether or not the umbilical cord has been cut or the placenta is attached.
10 13. "Medical certification" means the medical information pertaining to an individual's
11 death, including the cause and manner of death.
12 14. "Miscarriage of birth" means the expulsion of a fetus from the womb, spontaneously or
13 as a result of an accident, before twenty weeks gestation.
14 15. "Personal or real property interests" means ownership or other legal rights or duties
15 concerning personal or real property.
16 16. "Physician" means an individual authorized or licensed to practice medicine or
17 osteopathy under chapter 43-17.
18 17. "Registration" means the acceptance by the state registrar and incorporation into
19 official records, reports, or other records provided for in this chapter, of birth, death,
20 fetal death, marriage, divorce, or other records as may be determined by the state
21 health officer.
22 18. "Relative" means an individual's current or surviving spouse, a parent or legal
23 guardian, a child, a grandparent, or a grandchild. The state registrar may require proof
24 of the relationship.
25 19. "Subregistrar" means a funeral practitioner or other suitable individual from a licensed
26 funeral home who is appointed by the state registrar for the purpose of issuing final
27 disposition-transit permits.
28 20. "System of health statistics tabulation and analysis" includes the tabulation, analysis,
29 and presentation or publication of statistical data derived from health statistics.
30 21. "System of vital records registration" includes the registration, collection, preservation,
31 amendment, and certification of birth, death, fetal death, marriage, divorce, or other
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1 records as may be determined necessary by the state health officer or the state health
2 officer's designee.
5 23-02.1-02. Office of statistical services.
6 There is hereby established in the state department of health and human services an office
7 of statistical services which shall install, maintain, and operate a system of health statistics
8 tabulation and analysis and a system of vital records registration throughout the state. The state
9 health officerexecutive director of the department of health and human services or designee
10 may create within the office of statistical services such working divisions as may be necessary
11 to comply with the provisions of this chapter and shall appoint the directors of such divisions in
12 accordance with the merit system laws and regulations of the state of North Dakota.
15 23-02.1-03. Director of the office of statistical services and associative duties, state
16 and deputy state registrars.
18 designee shall appoint a director of the office of statistical services, in accordance with the merit
19 system laws and regulations of the state of North Dakota, who must be the ex officio state
20 registrar of vital statistics. The deputy state registrar of vital statistics must also be appointed by
21 the state health officerexecutive director of the department of health and human services or
22 designee. The director of the office of statistical services shall administer and enforce this
23 chapter and the rules and regulations issued hereunder, and issue instructions for the efficient
24 administration of a statewide system of health statistics tabulation and analysis and a statewide
25 system of vital records registration. The director of the office of statistical services may delegate
26 such functions and duties vested in the director to the officers and employees of the office of
27 statistical services as the director deems necessary and expedient.
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1 23-02.1-04. Duties of the state department of health.

2 The state department of health is authorized todepartment of health and human services
3 may adopt, amend, and repeal rules and regulations for the purposes of carrying out the
4 provisions of this chapter, in accordance with chapter 28-32.
5 SECTION 145. AMENDMENT. Subdivision c of subsection 1 of section 23-02.1-05 of the
7 c. Prescribe, with the approval of the state department of health and human
8 services, and distribute such forms as required by this chapter and the rules and
9 regulations issued hereunder.
12 23-02.1-11. Form of records.
13 The form of the records, reports, and other information required by this chapter is subject to
14 the approval of and modification by the state department of health and human services. In order
15 to maintain uniformity in the system of vital records registration and the system of health
16 statistics tabulation and analysis, substantial efforts should be made to ensure that information
17 collected parallels that collected by other primary registration areas.
20 23-02.1-13. Birth registration.
21 1. A birth record for each live birth that occurs in this state must be filed with the state
22 registrar.
23 2. When a birth occurs in an institution, the person in charge of the institution or a
24 designated representative must use the state department of health'shealth and human
25 services' electronic birth registration system to report the birth, including all personal
26 and medical facts, to the state registrar within five days after the birth.
27 3. When a birth occurs outside an institution, the required forms prescribed by the state
28 department of health and human services must be prepared and filed with the state
29 registrar, within thirty days of the birth by one of the following in the indicated order of
30 priority:
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1 a. The physician in attendance at or immediately after the birth, or in the absence of

2 such an individual;
3 b. Any other individual in attendance at or immediately after the birth, or in the
4 absence of such an individual; or
5 c. The father, the mother, or in the absence of the father and the inability of the
6 mother, the individual in charge of the premises where the birth occurred.
7 4. If a man and the mother are or have been married or have attempted to marry each
8 other in apparent compliance with law, although the attempted marriage is or could be
9 declared invalid, and the child is born during the marriage or attempted marriage, or
10 within three hundred days after the termination of cohabitation or after the marriage or
11 attempted marriage is terminated by death, annulment, declaration of invalidity, or
12 divorce, or after a decree of separation is entered by a court, the name of the man
13 must be entered on the record as the father of the child unless the presumption of
14 paternity has been rebutted by a court decree.
15 5. If the child is not born during the marriage of the mother, or within three hundred days
16 after a marriage is terminated by death, annulment, declaration of invalidity, or divorce,
17 or after a decree of separation is entered by a court, the name of the father may not
18 be entered on the birth record unless:
19 a. After the child's birth, the father and the child's natural mother have married, or
20 attempted to marry, each other by a marriage solemnized in apparent compliance
21 with law, although the attempted marriage is or could be declared invalid, and:
22 (1) He has acknowledged his paternity of the child in writing filed with the state
23 registrar; or
24 (2) He is obligated to support the child under a written voluntary promise or by
25 court order;
26 b. After the child's birth, the child's natural mother and the father voluntarily
27 acknowledge the child's paternity on a form prescribed by the state department of
28 health and human services, signed by the child's natural mother and biological
29 father, and filed with the state registrar; or
30 c. A court or other entity of competent jurisdiction has adjudicated paternity.
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1 6. If, in accordance with subsections 4 and 5, the name of the father of the child is not
2 entered on the birth record, the child's surname must be shown on the birth record as
3 the current legal surname of the mother at the time of birth unless an affidavit or an
4 acknowledgment of paternity signed by both parents is filed with the state department
5 of health and human services.
8 23-02.1-15. Delayed registration of birth.
9 1. When the birth of an individual born in this state has not been registered, a record may
10 be filed in accordance with the regulations of the state department of health and
11 human services. Such record must be registered subject to such evidentiary
12 requirements as the state department of health and human services shall prescribe to
13 substantiate the alleged facts of birth.
14 2. Records of birth registered one year or more after the date of occurrence must be
15 marked "delayed" and show on the face of the record the date of delayed registration.
16 3. A summary statement of the evidence submitted in support of the delayed registration
17 must be endorsed on the record.
18 4. a. When an applicant does not submit the minimum documentation required in the
19 regulations for delayed registration or when the state registrar finds reason to
20 question the validity or adequacy of the record or documentary evidence, the
21 state registrar may not register the delayed record and shall advise the applicant
22 of the reasons for this action. In the event that the deficiencies are not corrected,
23 the state registrar shall advise the applicant of the right of appeal to a court of
24 competent jurisdiction for a judicial determination of the birth facts.
25 b. The state department of health and human services may by regulation provide for
26 the dismissal of an application that is more than one year old and is not being
27 actively pursued.
28 5. A report of live birth may not be registered for a deceased individual one year or more
29 after that individual's date of birth.
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1 23-02.1-16. Delayed registration of death.

2 When a death occurring in this state has not been registered within the time period
3 specified in section 23-02.1-19, a record may be filed in accordance with regulations of the state
5 1. Such records must be registered subject to such evidentiary requirements as the state
6 department of health and human services may by regulation prescribe to substantiate
7 the alleged facts of death.
8 2. Records of death registered one year or more after the date of occurrence must be
9 marked "delayed" and must show on their face the date of delayed registration.
12 2. Information in the possession of the petitioner necessary to prepare the adoption
13 report must be furnished with the petition for adoption by each petitioner for adoption
14 or petitioner's attorney. The department of health and human services or other persons
15 concerned shall supply the court with such additional information as may be necessary
16 to complete the report. The provision of such information is a prerequisite to the
17 issuance of a final decree.
20 4. If no birth record is on file for the person for whom a new birth record is to be
21 established under this section, an original birth record must be filed with the state
22 registrar in accordance with the appropriate rules and regulations promulgated by the
23 state department of health and human services. The new record is also to be prepared
24 on the standard forms in use at the time of the adoption, legitimation, or paternity
25 determination.
28 23-02.1-19. Death registration.
29 1. A death record for each death that occurs in this state must be filed with the state
30 registrar in accordance with the rules and regulations set forth by the state department
31 of health and human services using the electronic death registration system. All
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1 registration and issuing of copies of death records will be completed by the state
3 2. The funeral director shall obtain the facts of death from the next of kin or the best
4 qualified individual or source available and must file the facts of death information
5 using the electronic death registration system within three days after assuming
6 custody of the dead body. The funeral director shall obtain the medical certification of
7 death from the individual responsible for the medical certification.
8 3. The medical certification must be completed and filed using the electronic death
9 registration system within ten days after death by the physician, physician assistant, or
10 nurse practitioner in charge of the patient's care for the illness or condition which
11 resulted in death except when inquiry is required by the local health officer or coroner.
12 4. When death occurred without medical attendance or when inquiry is required by the
13 local health officer or coroner, the county coroner shall investigate the cause of death,
14 and shall obtain medical information about the individual from the individual's medical
15 records or last-known physician or physician assistant, and shall complete and file the
16 medical certification within ten days after taking charge of the case using the electronic
17 death registration system.
18 5. If the cause of death cannot be determined within ten days after death, the medical
19 certification may be filed after the prescribed period, in accordance with rules adopted
20 by the state department of health and human services. The attending physician,
21 physician assistant, nurse practitioner, or coroner shall give the funeral director in
22 custody of the body notice of the reason for the delay and final disposition may not be
23 made until authorized by the attending physician, physician assistant, nurse
24 practitioner, or coroner.
25 6. When a death is presumed to have occurred within this state but the body cannot be
26 located, a death record may be prepared by the state registrar upon receipt of findings
27 of a court of competent jurisdiction, including the facts of death and medical
28 certification required to complete the death record. The death record must be marked
29 "presumptive" and must show on the face of the death record the date of registration
30 and must identify the court and the date of the decree.
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1 7. Each death registration must include the social security number of the decedent, if the
2 information is available. A social security number included on a death record is
3 confidential and may be disclosed only to a relative or authorized representative of the
4 individual named on the record, to a person with personal or real property interests
5 that depend upon information contained in the death record, or by an order of a court
6 of competent jurisdiction.
9 23-02.1-20. Fetal death registration.
10 1. A fetal death record for each fetal death that occurs in this state after a gestation
11 period of twenty completed weeks or more must be filed with the state registrar.
12 2. When a fetal death occurs in an institution, the person in charge of the institution or a
13 designated representative shall use the state department of health'shealth and human
14 services' electronic fetal death registration system to report the fetal death, including
15 all personal and medical facts, to the state registrar within ten days after the delivery. If
16 a fetal death occurs outside of an institution, a funeral director or other individual in
17 attendance at or after delivery shall file the fetal death record.
18 3. When inquiry is required by the local health officer or coroner or in the absence of
19 medical attendance, the county coroner shall investigate the cause of fetal death, and
20 shall obtain medical information about the individual from that individual's medical
21 records or last-known physician or physician assistant and file the medical certification
22 within ten days after taking charge of the case using the electronic death registration
23 system.
24 4. If the cause of fetal death cannot be determined within ten days after death, the
25 medical certification may be filed after the prescribed period of time in accordance with
26 rules adopted by the state department of health and human services. The attending
27 physician, physician assistant, nurse practitioner, or coroner shall give the funeral
28 director in custody of the fetus the notice of the reason for the delay and final
29 disposition may not be made until authorized by the attending physician, physician
30 assistant, nurse practitioner, or coroner.
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1 5. The provision for entering the name of the father of the fetus on the fetal death record
2 and the reporting of out-of-wedlock fetal deaths concur exactly with those set forth in
3 section 23-02.1-13.
6 23-02.1-20.1. Fetal loss.
7 The state registrar may issue a certified copy of a fetal loss to an individual who
8 experiences a documented miscarriage of birth, if the individual provides to the state registrar a
9 completed fetal loss request form established by the state department of health and human
10 services which is signed by the mother or the father and a letter signed by a hospital, physician,
11 or other medical attendant documenting proof of pregnancy and fetal loss.
14 23-02.1-22. Extension of time.
15 1. The state department of health and human services may, by regulation and upon such
16 conditions as it may prescribe to assure compliance with the purposes of this chapter,
17 provide for the extension of the periods of time prescribed in sections 23-02.1-19,
18 23-02.1-20, and 23-02.1-21 for the filing of death records, fetal death records, medical
19 certification of death, and for the obtaining of final disposition-transit permits in cases
20 in which compliance with the applicable prescribed period would result in undue
21 hardship.
22 2. Regulations of the state department of health and human services may provide for the
23 issuance of a final disposition-transit permit under section 23-02.1-21 before the filing
24 of a record of death or fetal death upon conditions designed to assure compliance with
25 the purposes of this chapter in cases in which compliance with the requirement that
26 the records be filed before the issuance of the permit would result in undue hardship.
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1 23-02.1-25. Correction and amendment of vital records.

2 1. A record registered under this chapter may be amended only in accordance with this
3 chapter and regulations under this chapter adopted by the state department of health
4 and human services to protect the integrity and accuracy of vital records.
5 2. A record that is amended under this section must be marked "amended" except as
6 provided in subsection 4. The date of amendment and a summary description of the
7 evidence submitted in support of the amendment must be endorsed on or made a part
8 of the record. The state department of health and human services shall prescribe by
9 regulation the conditions under which additions or minor corrections may be made to
10 birth records within one year after the date of birth without the record being considered
11 as amended.
12 3. Upon receipt of a certified copy of a court order that is amending a birth, death, or fetal
13 death record and upon request of such individual or the individual's parent, guardian,
14 or legal representative, the state registrar shall amend the record as directed in the
15 court order; however, if the state registrar has information to believe the facts of the
16 court order are false or inaccurate, the state registrar shall provide the court and any
17 known parties with the correct information.
18 4. Upon receipt of a sworn acknowledgment of paternity of a child born out of wedlock
19 signed by both parents and upon request, the state registrar shall amend a record of
20 birth to show such paternity if paternity is not shown on the record. Upon request of
21 the parents, the surname of the child must be changed on the appropriate record to
22 the surname designated by the parents on the acknowledgment of paternity. Such
23 record may not be marked as "amended". The provisions of this subsection apply also
24 in their entirety to records of fetal death.
27 6. The state department of health and human services may grant limited access to birth
28 and death information to divisions and programs of the state department of health and
29 human services, the department of transportation, the protection and advocacy
30 project, and the department of information technology, and to the department of
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1 human services necessary for the purpose of completing their respective official
2 duties.
5 7. The state department of health and human services may issue, through electronic
6 means determined by the state department of health and human services, verifications
7 of information contained on birth or death records filed with the state registrar when
8 such information is provided and a verification is requested by a governmental agency,
9 whether foreign or domestic, in the conduct of the agency's official duties. The state
10 department of health and human services may also issue these electronic verifications
11 for a negotiated and agreed-upon fee to:
12 a. Benefit-paying parties, such as annuity companies, pension plans, and life
13 insurance companies, that demonstrate a need for such information to determine
14 whether the benefits the benefit-paying party are paying should be terminated or
15 distributed to a beneficiary;
16 b. Physicians licensed to practice in the United States who demonstrate such
17 information is needed to determine whether a patient the physician is treating has
18 been lost to care;
19 c. Attorneys licensed to practice in the United States who demonstrate that the
20 information is necessary to administer the attorneys' client's estate; or
21 d. Other entities for fraud prevention as determined by the state registrar.
24 3. Data or copies may be furnished for statistical purposes to federal, state, local, or
25 other public or private agencies, including the federal agency responsible for national
26 vital statistics, upon such terms and conditions as may be prescribed by the state
27 department of health and human services through rules and regulations adopted
28 pursuant to this chapter.
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1 23-02.1-29. Fees.
2 1. The state department of health and human services shall prescribe the fees, if any, not
3 to exceed fifteen dollars, to be paid for the following:
4 a. Each certified copy of a record.
5 b. Each certified statement of the facts of birth other than a copy of the original birth
6 record.
7 c. Each filing of a new record of birth or fetal death following adoption.
8 d. Each filing of a delayed record of birth or death except as provided for in
9 subsection 4 of section 23-02.1-18.
10 e. Each filing of an amendment to a birth or death record.
11 f. A search of the files or records when no copy is made.
12 g. A noncertified informational copy of a death or marriage record.
13 The fee for each additional copy of a death or fetal death record, requested at the
14 same time, may not exceed ten dollars.
15 2. Except as otherwise provided in subsection 3, fees collected under this section by the
16 state registrar must be deposited in the operating fund of the state department of
17 health and human services, according to procedures established by the state
18 treasurer.
19 3. The state department of health and human services shall quarterly pay fees in the
20 amount of two dollars for the issuance of each certified copy of a birth record,
21 authorized by subsection 1, into the children's trust fund created by section 50-27-01.
22 4. All fees collected in excess of the fees appropriated must be transferred to the general
23 fund of this state at the end of each biennium.
26 3. A funeral director, embalmer, or other person who removed from the place of death or
27 transports or finally disposes of a dead body or fetus, in addition to filing any record or
28 other form required by this chapter, shall keep a record which must identify the body,
29 and the information pertaining to receipt, removal, and delivery of the body as may be
30 prescribed in regulations adopted by the state department of health and human
31 services.
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3 6. a. If the deceased did not leave sufficient means to pay for expenses of final
4 disposition, including the cost of a casket, and is not survived by an individual
5 described by subsection 1 and identified for financial responsibility within the
6 human service zone's general assistance policy, within fifteen days of application
7 for services the human service zone of the county in which the deceased had
8 residence for general assistance purposes or, if residence cannot be established,
9 within fifteen days of application for assistance the human service zone of the
10 county in which the death occurs shall employ a person to arrange for and
11 supervise the final disposition. If the deceased was a resident or inmate of a
12 public institution, within fifteen days of application for assistance the human
13 service zone in which the deceased was a resident for general assistance
14 purposes immediately before entering the institution shall employ a person to
15 arrange for and supervise the final disposition.
16 b. The department of health and human services may negotiate with the interested
17 funeral directors or funeral homes regarding cremation expenses and burial
18 expenses but the total charges for burial services, including transportation of the
19 deceased to the place of burial, the grave box or vault, grave space, and grave
20 opening and closing expenses, may not be less than one thousand five hundred
21 dollars.
22 c. The department of health and human services may provide for the use of a
23 military casket or urn, if the deceased was a veteran as defined in section
24 37-01-40, unless the additional cost exceeds the negotiated expenses of this
25 section or a surviving spouse or the nearest of kin of the deceased elects a
26 nonmilitary casket.
27 d. The human service zone shall pay the charge for funeral expenses as negotiated
28 by the department of health and human services. The human service zone may
29 not decrease the human service zone payment due to a nominal amount left by
30 the deceased or contributed by kin or any other party to defray the expenses of
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1 burial or cremation. Funds adequate to allow for burial instead of cremation are
2 considered nominal under this section.
5 1. The dead body of a human being must be disposed of by the person charged with that
6 duty within eight days after the death of such person except when any of the following
7 occur:
8 a. The right to dissect the body is expressly conferred by law.
9 b. The body is being carried through this state.
10 c. The body is being removed from this state for the purpose of final disposition in
11 some other state.
12 d. A permit is obtained from the local health officer or the state department of health
13 and human services allowing a longer time during which the body need not be
14 disposed. The permit shall state the additional length of time during which the
15 body need not be disposed.
16 e. The body is being stored for an extended period of time in a vault determined
17 suitable by the state department of health and human services, but the body may
18 not be stored in a vault for a period of more than eight days during the months of
19 June through October unless a permit is obtained from the local health officer or
23 23-06-07. Regulation of final disposition - Issuance of final disposition-transit permit
24 regulated.
25 The body of any individual whose death occurs in this state may not be interred, deposited
26 in a vault or tomb, cremated, donated to a school of medicine, or otherwise disposed as
27 authorized by law, until a final disposition-transit permit has been properly issued by a
28 subregistrar. If the certificate is incorrect or incomplete, the subregistrar may not issue the
29 permit until it is corrected or completed. In the case of any death outside of this state, a final
30 disposition-transit permit issued in accordance with the law and the health regulations in force in
31 the state where the death occurred, when accompanying a body shipped through or into this
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1 state, may be accepted with the same effect as a permit from a subregistrar. If the death
2 occurred from some disease that is held to be communicable by the state department of health
3 and human services, the subregistrar shall refuse to issue a permit for the removal or other
4 disposition of the body except under the conditions prescribed by the state department of health
5 and human services and the local board of health.
8 23-06-20. Where body may be buried.
9 No dead human body may be buried in this state except in a properly registered cemetery
10 or in some other place requested by the relatives and friends of the deceased if the same is
11 authorized by the state department of health and human services and all rules and regulations
12 promulgated by the department in that connection have been complied with.
15 23-06-21. Regulation of cemeteries.
16 All persons, corporations, municipalities, associations, and organizations owning,
17 conducting, or maintaining a cemetery or plot for the burial of dead human bodies shall:
18 1. Provide for a sexton or secretary.
19 2. Cause the lot or parcel of ground used and designated as a cemetery to be platted
20 into orderly blocks and lots, alleys and streets or driveways, giving to each a distinctive
21 name or number that must be a permanent designation of its location.
22 3. File the original plat with the recorder of the county in which the cemetery or place of
23 burial is located and the copy or blueprint thereof with the sexton or secretary.
24 4. Register with the state department of health and human services the name and
25 location of the cemetery or place of burial, the name and address of the sexton, and
26 the name and address of other officers of the cemetery association, corporation, or
27 organization.
28 5. Furnish such information and reports as the state department of health and human
29 services may require including the submission of plans and specifications for review
30 and approval before constructing, erecting, or placing on the burial site for the burial or
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1 disposition of any human remains any interment structure or device constructed or

2 placed wholly or partially above the natural surface of the ground.
3 6. Keep a local register of all burials showing as to each burial the name of the
4 deceased, the date and location of burial, the date of death, and the name and
5 address of the undertaker.
8 23-06-22. Sexton - Term of office, records, duties.
9 The sexton or secretary appointed by the person, corporation, municipality, association, or
10 organization conducting a cemetery for the burial of dead human bodies shall hold office until a
11 successor is appointed and qualified. The sexton or secretary shall transfer all records to the
12 successor. The sexton or secretary shall enforce the laws of the state and the rules and
13 regulations of the state department of health and human services with respect to the burial of
14 dead human bodies within the cemetery under the sexton's or secretary's charge.
17 23-06-23. State department of healthDepartment to enforce regulation of cemeteries -
18 Injunction.
19 The state department of health and human services shall make and enforce such rules and
20 regulations as are necessary to carry out the laws relating to the regulation of cemeteries and
21 may, through injunction or other legal process, enforce compliance.
24 7. Subsection 3 does not apply to the inadvertent disturbance of a human burial site,
25 human remains, or burial goods when the state department of health and human
26 services and the state historical society have been notified of the disturbance and the
27 human remains and burial goods must be studied and reinterred pursuant to rules
28 adopted by the state department of health and human services and the state historical
29 society. Subsection 3 also does not apply to situations in which the state department
30 of health and human services and the state historical society are notified of the need
31 to disinter and move the contents of human burial sites that are recorded with the state
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1 historical society to prevent the destruction of the human burial sites by actions
2 including the construction of highways, dams, reservoirs, coal mines, power
3 generation and transmission facilities, pipelines, farming practices, and other
4 developments. Where feasible, the developments should avoid disturbance of the
5 human burial sites. In these situations the disinterred human remains and burial goods
6 must be studied and reinterred pursuant to rules adopted by the state department of
7 health and human services and the state historical society.
10 23-06-30. Abandoned cemeteries to be maintained by counties.
11 The board of county commissioners of each county may provide for the identification,
12 cataloguing, recording, and shall provide for the general maintenance and upkeep of each
13 abandoned cemetery located within such county using revenues derived from its general fund
14 levy authority. The board shall, at least once each year, proceed to have the weeds and grass
15 cut, restore gravestones to their original placement, and perform any other general
16 maintenance necessary to maintain the dignity and appearance of the grounds. For the
17 purposes of this section, a cemetery means any tract of land used as a burial plot and which is
18 filed with the recorder of the county as a public burying place. The board of county
19 commissioners of each county shall provide for the registration, with the state department of
20 health and human services, of each abandoned cemetery within such county unless such
21 cemetery has been previously registered. Such registration must take place within one year of
22 notification being made to the board, by any interested party of the existence of such
23 abandoned cemetery.
26 1. The state department of health and human services may establish or contract for the
27 establishment of a donor registry.
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1 23-07-01. State department of healthDepartment - Collection of public health

2 information.
3 The state department of health and human services shall designate the diseases or
4 conditions that must be reported. Such diseases or conditions may include contagious,
5 infectious, sexually transmitted, or chronic diseases or any illness or injury which may have a
6 significant impact on public health. The state department of health and human services shall
7 maintain a uniform statewide population-based registry system for the collection of data
8 pertaining to the incidence, prevalence, risk factors, management, survival, mortality, and
9 geographic distribution of cancer and reportable benign tumors.
12 23-07-01.1. Reporting of physical or mental disorders.
13 The state department of health and human services shall define disorders characterized by
14 lapses of consciousness, gross physical or mental impairments for the purposes of the reports
15 hereinafter referred to:
16 1. A physician or other health care provider may report immediately to the department of
17 transportation in writing, the name, date of birth, and address of every individual
18 fourteen years of age or over coming before them for examination, attendance, care,
19 or treatment if there is reasonable cause to believe that the individual due to physical
20 or mental reason is incapable of safely operating a motor vehicle or diagnosed as a
21 case of a disorder defined as characterized by lapses of consciousness, gross
22 physical or mental impairments, and the report is necessary to prevent or lessen a
23 serious and imminent threat to the health or safety of the individual or the public.
24 2. Such reports as required in this section are for the information of the director of the
25 department of transportation in determining the eligibility of any person to operate a
26 motor vehicle on the highways of this state and must be kept confidential and not
27 divulged to any person or used as evidence in any trial, except that the reports may be
28 admitted in proceedings under section 39-06-33.
29 3. The physician-patient privilege provided for by rules 501 and 503 of the North Dakota
30 Rules of Evidence may not be asserted to exclude evidence regarding the mental or
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1 physical incapacity of a person to safely operate a motor vehicle in the reports as

2 required under the provisions of this section.
3 4. Any physician or other medical professional who fails to make a report or who in good
4 faith makes a report, gives an opinion or recommendation pursuant to this section, or
5 participates in any proceeding founded upon this section is immune from any liability,
6 civil or criminal, that might otherwise be incurred, as a result of such report, except for
7 perjury.
10 23-07-02. Who to report reportable diseases.
11 Except as otherwise provided by section 23-07-02.1, the following persons or their
12 designees shall report to the state department of health and human services any reportable
13 disease coming to their knowledge:
14 1. All health care providers, including physicians, physician assistants, nurse
15 practitioners, nurses, dentists, medical examiners or coroners, pharmacists,
16 emergency medical service providers, and local health officers.
17 2. The director, principal manager, or chief executive officer of:
18 a. Health care institutions, including hospitals, medical centers, clinics, long-term
19 care facilities, assisted living facilities, or other institutional facilities;
20 b. Medical or diagnostic laboratories;
21 c. Blood bank collection or storage centers;
22 d. Public and private elementary and secondary schools;
23 e. Public and private universities and colleges;
24 f. Health or correctional institutions operated or regulated by municipal, county or
25 multicounty, state, or federal governments;
26 g. Funeral establishments and mortuaries; and
27 h. Child care facilities or camps.
28 3. The state veterinarian, if the disease may be transmitted directly or indirectly to or
29 between humans and animals.
30 4. A person having knowledge that a person or persons are suspected of having a
31 reportable disease may notify the department and provide all information known to the
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1 person reporting concerning the reportable disease or condition of the person or

2 persons.
3 If the person reporting is the attending physician or the physician's designee, the physician or
4 the physician's designee shall report not less than twice a week, in the form and manner
5 directed by the state department of health and human services, the condition of the person
6 afflicted and the state of the disease. A person making a report in good faith is immune from
7 liability for any damages which may be caused by that act.
10 23-07-02.1. Reports of human immunodeficiency virus infection - Penalty.
11 Every attending physician treating an individual known by the physician to have a diagnosis
12 of human immunodeficiency virus infection, acquired immune deficiency syndrome, or human
13 immunodeficiency virus-related illness, including death from human immunodeficiency virus
14 infection, shall make a report on that individual to the state department of health and human
15 services. A person treating an individual known to have human immunodeficiency virus infection
16 in a hospital, a clinic, a sanitarium, the physical custody of the department of corrections and
17 rehabilitation, a regional or local correctional facility or juvenile detention center, the North
18 Dakota youth correctional center, or other private or public institution shall make a report on that
19 individual to the facility administrator or the facility administrator's designee. Further disclosure
20 of information on any individual known to have human immunodeficiency virus infection may
21 only be provided to medical personnel providing direct care to the individual or as otherwise
22 authorized by law. The designated official shall, if satisfied that the report is valid, make a report
23 to the department on each individual having a diagnosis of human immunodeficiency virus
24 infection, acquired immune deficiency syndrome, or human immunodeficiency virus-related
25 illness, including death from human immunodeficiency virus infection, unless the diagnosed
26 individual's attending physician has made such a report. The reports required under this section
27 must contain the name, date of birth, sex, and address of the individual reported on and the
28 name and address of the physician or designated official making the report. Failure by a facility
29 to designate an official to whom reports must be made is an infraction. Any person who in good
30 faith complies with this section is immune from civil and criminal liability for any action taken in
31 compliance with this section.
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3 23-07-02.2. Confidentiality of reports.
4 A report required by section 23-07-02.1 and held by the state department of health and
5 human services is confidential information. The information may not be disclosed, shared with
6 any agency or institution, or made public, upon subpoena, search warrant, discovery
7 proceedings, or otherwise, except that:
8 1. Disclosure may be made of medical or epidemiological information for statistical
9 purposes in a manner such that no individual person can be identified;
10 2. Disclosure may be made of medical or epidemiological information to the extent
11 necessary to enforce section 23-07-02.1 and this section and related rules concerning
12 the treatment, control, and investigation of human immunodeficiency virus infection by
13 public health officials; or
14 3. Disclosure may be made of medical or epidemiological information to medical
15 personnel to the extent necessary to protect the health or life of any individual.
16 No officer or employee of the state department of health and human services may be examined
17 in any judicial, executive, legislative, or other proceeding regarding the existence or content of
18 any individual's report retained by the department under section 23-07-02.1.
21 3. The temporary order may be issued and is effective without regard to chapter 28-32
22 for a period of ninety days, unless earlier revoked by the state health officer.
23 Emergency rulemaking must be initiated under chapter 28-32 within ninety days of the
24 order or the order expires. The temporary order and any emergency rulemaking under
25 this section are effective without the necessity of approval from the health
26 councildepartment of health and human services.
29 23-07-03. Report of cases of sexually transmitted disease.
30 The superintendent of a hospital, dispensary, or charitable or penal institution, in which
31 there is a case of sexually transmitted disease, or the superintendent's designee, shall report
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1 such case to the nearest health officer having jurisdiction. The report must be made in the form
2 and manner directed by the state department of health and human services.
5 23-07-05. Local health officers to report reportable disease to state department of
7 At such time as may be required by the state department of health and human services,
8 each local health officer shall submit to such department, on blanks furnished by the department
9 for that purpose, a summarized report of the reportable diseases reported to the health officer
10 during the week. When no cases have been reported during the week, the report must be made
11 with the notation "No cases reported".
14 2. The results of any positive or reactive test must be reported to the state department of
15 health and human services in the manner prescribed by the department and to the
16 individual tested. Subsection 1 does not require the testing of an individual before
17 sentencing or the testing of an individual held in a jail or correctional facility awaiting
18 transfer to the state penitentiary.
21 23-07-07.6. Report of testing result of imprisoned individuals.
22 Notwithstanding any other provision of law, the state department of health and human
23 services or any other agency shall release the results of any testing for any reportable disease
24 performed on an individual convicted of a crime who is imprisoned if the request is made by any
25 individual and the individual provides written proof from the administrator of the facility with
26 control over the individual imprisoned which states that the individual has had a significant
27 exposure as defined in section 23-07.3-01.
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1 23-07-15. Removal of person afflicted with contagious or infectious disease -

2 Removal of person who died of such disease - Prohibited.
3 No person, unless the person has a permit from the local board of health or state
4 department of health and human services, may remove or cause to be removed from without
5 this state into this state, or from one building to another within this state, or from or to any
6 railroad car or motor vehicle, any person afflicted with a contagious or infectious disease, or the
7 body of any person who died of any such disease.
10 23-07-17.1. Inoculation required before admission to school.
11 1. A child may not be admitted to any public, private, or parochial school, or day care
12 center, child care facility, head start program, or nursery school operating in this state
13 or be supervised through home-based instruction unless the child's parent or guardian
14 presents to the institution authorities a certification from a licensed physician or
15 authorized representative of the state department of health and human services that
16 the child has received age-appropriate immunization against diphtheria, pertussis,
17 tetanus, measles, rubella (German measles), mumps, hepatitis B, haemophilus
18 influenza type b (Hib), varicella (chickenpox), poliomyelitis, pneumococcal disease,
19 meningococcal disease, rotovirus, and hepatitis A. In the case of a child receiving
20 home-based instruction, the child's parent or legal guardian shall file the certification
21 with the public school district in which the child resides.
22 2. A child may enter an institution upon submitting written proof from a licensed physician
23 or authorized representative of the state department of health and human services
24 stating that the child has started receiving the required immunization or has a written
25 consent by the child's parent or guardian for a local health service or department to
26 administer the needed immunization without charge or has complied with the
27 requirements for certificate of exemption as provided for in subsection 3.
28 3. Any minor child, through the child's parent or guardian, may submit to the institution
29 authorities either a certificate from a licensed physician stating that the physical
30 condition of the child is such that immunization would endanger the life or health of the
31 child or a certificate signed by the child's parent or guardian whose religious,
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1 philosophical, or moral beliefs are opposed to such immunization. The minor child is
2 then exempt from the provisions of this section.
3 4. The enforcement of subsections 1, 2, and 3 is the responsibility of the designated
4 institution authority.
5 5. The immunizations required, and the procedure for their administration, as prescribed
6 by the state department of health and human services, must conform to recognized
7 standard medical practices in the state. The state department of health and human
8 services shall administer the provisions of this section and shall promulgate rules and
9 regulations in the manner prescribed by chapter 28-32 for the purpose of
10 administering this section.
11 6. When, in the opinion of the health officer, danger of an epidemic exists from any of the
12 communicable diseases for which immunization is required under this section, the
13 exemptions from immunization against such disease may not be recognized and
14 children not immunized must be excluded from an institution listed in subsection 1
15 until, in the opinion of the health officer, the danger of the epidemic is over. The
16 designated institution authority shall notify those parents or guardians taking legal
17 exception to the immunization requirements that their children are excluded from
18 school during an epidemic as determined by the state department of health and
19 human services.
20 7. When, in the opinion of the health officer, extenuating circumstances make it difficult or
21 impossible to comply with immunization requirements, the health officer may authorize
22 children who are not immunized to be admitted to an institution listed in subsection 1
23 until the health officer determines that the extenuating circumstances no longer exist.
24 Extenuating circumstances include a shortage of vaccine and other temporary
25 circumstances.
28 23-07-21. Penalties.
29 Except as otherwise provided in this section, a person is guilty of an infraction:
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1 1. Who violates or fails to obey any provision of this chapter, any lawful rule made by the
2 state department of health and human services, or any order issued by any state,
3 district, county, or municipal health officer;
4 2. Who violates any quarantine law or regulation, or who leaves a quarantined area
5 without being discharged; or
6 3. Who, knowing that the person is infected with a sexually transmitted disease, willfully
7 exposes another person to infection.
8 Any person required to make a report under section 23-07-02.1 who releases or makes public
9 confidential information or otherwise breaches the confidentiality requirements of section
10 23-07-02.2 is guilty of a class C felony.
13 2. "Department" means the state department of health and human services, including
14 local public health units.
17 23-07.1-04. State health officer - Designee - Responsibility.
18 The state health officer or designee is responsible for the inpatient and outpatient care of
19 persons afflicted or suspected of being afflicted with tuberculosis. If the state health officer
20 determines that suspected or actual tuberculous patients may be adequately cared for on an
21 inpatient basis by contract with general hospitals or other appropriate facilities, authority for
22 contracting with such facilities is granted to the state health officerdepartment of health and
23 human services. In addition, the state health officerdepartment of health and human services is
24 authorized to establish and maintain the necessary outpatient clinics for diagnostic workup and
25 evaluation on all suspected or actual tuberculous patients in the state. The state health
26 officerdepartment of health and human services shall pay the contract fee to general hospitals
27 or other appropriate facilities and provide funds to the outpatient evaluation clinics from funds to
28 be appropriated for this purpose by the legislative assembly. The state's claim on patient
29 benefits as provided in section 23-07.1-03 applies insofar as applicable to tuberculous patients
30 in general hospitals and for services rendered in outpatient clinics. The state health officer or a
31 designee has the power to:
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1 1. Do any act necessary and proper in the performance of the functions imposed upon
2 the state health officer by the provisions of this chapter.
3 2. Issue orders and compel obedience thereto.
4 3. Administer oaths.
7 23-07.1-14. Care of tubercular patients - Acceptance of federal funds - General
8 hospital.
9 The state health officer, or a designee, is hereby authorized todepartment may contract with
10 public or private agencies for the care of persons having tuberculosis. The state health
11 officerdepartment is hereby authorized to accept any federal funds or to enter into any federal
12 programs on behalf of persons having tuberculosis in North Dakota. The state health
13 officerdepartment may also utilize general hospitals or other appropriate facilities in the
14 placement of recalcitrant persons having tuberculosis.
17 23-07.2-02. Blood disorder assistance program.
18 The state health officerdepartment of health and human services shall establish a program
19 of financial assistance to persons suffering from hemophilia and other related congenital
20 bleeding disorders. The program shall assist those persons to purchase the blood derivatives
21 and supplies necessary for home care.
24 23-07.2-03. Recovery from other sources.
25 The state health officerdepartment of health and human services may enter into
26 agreements with third parties, including any insurer or private sources, for recovery of payments
27 for blood products and supplies used in home care by persons participating in the program.
30 23-07.2-04. Rulemaking authority.
31 The state health officerdepartment of health and human services shall:
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1 1. Establish a reasonable cost for blood products and supplies used in home care as a
2 basis of reimbursement under this chapter.
3 2. Determine when reimbursement may not be made under this chapter for any blood
4 products or supplies which are not purchased in compliance with regulations
5 promulgated pursuant to this chapter. Reimbursement may not be made under this
6 chapter for any portion of the costs of blood products or supplies which are payable
7 under any other state or federal program or under any grant, contract, or any other
8 contractual arrangement.
9 3. Define what constitutes "home care".
10 4. Define what constitutes "income", "net worth", and "patient eligibility" for assistance.
11 5. Provide guidelines to determine individual liability.
12 6. Adopt all rules necessary to implement subsections 1 through 5 pursuant to chapter
13 28-32.
16 4. Upon issuance of any order under subsection 2 or 3, the state health officer or a
17 designee of the state health officer shall promptly, personally, and confidentially notify
18 the person who is the subject of the order, stating the grounds and provisions of the
19 order and the right to contest the order, the right to be present at a judicial hearing in
20 the district court serving the county in which the person resides to review the order,
21 and the right to be represented by counsel during the hearing. If the person who is the
22 subject of the order refuses to comply with the order and refuses to cooperate
23 voluntarily with the state health officer or a designee of the state health officer, the
24 state health officer or designee may petition the district court serving the county in
25 which the person resides for an order of compliance. The state health officer or
26 designee shall request the state's attorney in the county in which the person resides to
27 file the petition in the district court. If an order of compliance is requested, the court
28 shall hear the matter within ten days after the request. Notice of the place, date, and
29 time of the court hearing must be made by personal service or, if the person is not
30 available, must be mailed to the person who is the subject of the order by certified mail
31 at the person's last-known address. Proof of mailing by the state health officer or
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1 designee is sufficient notice under this section. The burden of proof is on the state
2 health officer or designee to show by clear and convincing evidence that the specified
3 grounds exist for the issuance of the order and for the need for compliance and that
4 the terms and conditions imposed in the order are no more restrictive than necessary
5 to protect the public health. Upon conclusion of the hearing, the court shall issue
6 appropriate orders affirming, modifying, or dismissing the order. If the court dismisses
7 the order, the fact that the order was issued must be expunged from the records of the
8 state department of health and human services. If the court affirms or modifies the
9 order and the person subject to the order is infected with the human immunodeficiency
10 virus, the court shall require the person to disclose the names and addresses, if
11 known, of persons with whom the person has had contact that poses an
12 epidemiologically demonstrated risk of transmission of the human immunodeficiency
13 virus. Failure to comply with court-ordered disclosure constitutes contempt of court.
16 3. Any order issued by the district court under subsection 2 is subject to review in a court
17 hearing. Prompt, personal, and confidential notice of the place, date, and time of the
18 court hearing and of the person's right to be present at the hearing and the right to
19 representation by counsel during the hearing must be given to the person who is the
20 subject of the court order. The hearing must be conducted by the court within
21 forty-eight hours after the order is issued. The burden of proof is on the state health
22 officer or designee to show by clear and convincing evidence that grounds exist for the
23 order issued by the court under subsection 2 and that the terms and conditions
24 imposed in the order are no more restrictive than necessary to protect the public
25 health. Upon conclusion of the hearing, the court shall issue appropriate orders
26 affirming, modifying, or dismissing the order. If the court dismisses the order, the fact
27 that the order was issued must be expunged from the records of the state department
28 of health and human services. If the court affirms or modifies the order and the person
29 subject to the order is infected with the human immunodeficiency virus, the court shall
30 require the person to disclose the names and addresses, if known, of persons with
31 whom the person subject to the order has had contact that poses an epidemiologically
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1 demonstrated risk of transmission of the human immunodeficiency virus. Failure to

2 comply with court-ordered disclosure constitutes contempt of court.
5 23-07.6-04. Place of confinement.
6 A respondent must be confined in a place designated in the written directive until the health
7 officer who issued the written directive determines that the respondent no longer poses a
8 substantial threat to the public health or until a court of competent jurisdiction orders the release
9 of the respondent. The state department of health and human services or the local board may
10 establish and maintain places of confinement.
13 3. The laboratory shall send a copy of the test results to the physicians designated in the
14 court order, who shall then release the test results to the defendant or alleged juvenile
15 offender and each requesting victim as designated in the court order. The court order
16 must be served on the physicians before any test. The laboratory also shall send a
17 copy of test results that indicate exposure to or infection by acquired
18 immunodeficiency syndrome virus, acquired immunodeficiency syndrome-related
19 conditions, or other sexually transmitted diseases to the state department of health
20 and human services.
26 23-09-02. State department of healthDepartment to enforce provisions of chapter.
27 The department shall enforce the provisions of this chapter. Under no circumstances may
28 any other state agency adopt rules that relate in any way to the provisions of this chapter.
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3 23-09.1-02. Bed and breakfast facilities - Powers of state department of health.
4 The department shall establish by rule the procedures for licensing, qualifying, classifying,
5 inspecting, and regulating persons providing bed and breakfast facilities in private homes,
6 including rules affecting the health and safety of the facility and the persons using the facility. No
7 political subdivision, including a home rule city or county, may impose health and safety,
8 licensure, or inspection requirements that exceed the requirements of this chapter or rules
9 adopted by the department.
18 23-09.3-01.1. Moratorium on expansion of basic care bed capacity.
19 1. Basic care beds may not be added to the state's licensed bed capacity during the
20 period between August 1, 2019, and July 31, 2021, except if:
21 a. A nursing facility converts nursing facility beds to basic care;
22 b. An entity licenses bed capacity transferred as basic care bed capacity under
23 section 23-16-01.1;
24 c. An entity demonstrates to the state department of health and the department of
25 human services that basic care services are not readily available within a
26 designated area of the state or that existing basic care beds within a fifty-mile
27 [80.47-kilometer] radius have been occupied at ninety percent or more for the
28 previous twelve months. In determining whether basic care services will be
29 readily available if an additional license is issued, preference may be given to an
30 entity that agrees to any participation program established by the department of
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1 human services for individuals eligible for services under the medical assistance
2 program under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.]; or
3 d. The state department of health and the department of human services grant
4 approval of new basic care beds to an entity. The approved entity shall license
5 the beds within forty-eight months from the date of approval.
6 2. Transfers of basic care beds from one basic care facility to another entity is permitted.
7 Transferred basic care beds must become licensed within seventy-two months of
8 transfer. The entity receiving the transferred beds or any new facility may seek to
9 participate in the basic care assistance program. If the entity can demonstrate that
10 individuals can be cared for at a more independent level and that this service will delay
11 entry into the nursing facility, the entity may be approved for basic care assistance
12 funds.
13 3. If an Indian tribe acquires basic care beds, the tribal facility must meet state licensing
14 requirements for those beds within seventy-two months of acquisition. A tribal facility
15 may seek to participate in the basic care assistance program. Basic care assistance
16 payments may only be made to a tribal facility that agrees to participate and adhere to
17 all federal and state requirements of the basic care assistance program including
18 participation, screening, ratesetting, and licensing requirements.
21 23-09.3-05.1. Application for license - License fee.
22 Applicants for a license shall file applications under oath with the state department of health
23 upon forms prescribed. An application for a license for facilities not owned by the state or its
24 political subdivisions must be accompanied by a fee of ten dollars per bed. License fees
25 collected pursuant to this section must be deposited in the state department of health services
26 operating fund in the state treasury and any expenditure from the fund is subject to
27 appropriation by the legislative assembly.
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3 9. The state department of health and human services or a local regulating authority may
4 conduct an investigation upon complaint of an illness or environmental health
5 complaint.
11 11. "Public place" means an area which the public enters. Some examples of public
12 places are publicly owned buildings, vehicles, or offices; bars; bingo facilities;
13 gambling and gaming facilities as defined in section 12.1-28-01; child care and adult
14 day care facilities subject to licensure by the department of health and human
15 services, including those operated in private homes; convention facilities; educational
16 facilities, both public and private; facilities primarily used for exhibiting a motion
17 picture, stage, drama, lecture, musical recital, or other similar performance; financial
18 institutions; health care facilities; hotels and motels, including all rooms that are rented
19 to guests; laundromats; any common areas in apartment buildings, condominiums,
20 mobile home parks, retirement facilities, nursing homes, and other multiple-unit
21 residential facilities; private and semi-private nursing home rooms; museums, libraries,
22 galleries, and aquariums; polling places; professional offices; public transportation
23 facilities, including buses, trains, airplanes and similar aircraft, taxicabs and similar
24 vehicles such as towncars and limousines when used for public transportation, and
25 ticket, boarding, and waiting areas of public transit facilities, including bus and train
26 stations and airports; reception areas; restaurants; retail food production and
27 marketing establishments; retail service establishments; retail stores, including
28 tobacco and hookah establishments; rooms, chambers, places of meeting or public
29 assembly, including school buildings; shopping malls; sports arenas; theaters; and
30 waiting rooms.
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3 a. Private residences, except those residences used as a child care, adult day care,
4 or health care facility subject to licensure by the department of health and human
5 services.
8 1. State agencies with statutory jurisdiction over a state-owned building or office shall
9 enforce section 23-12-10. These agencies include the fire marshal department, state
10 department of health, department of and human services, legislative council, and
11 office of management and budget.
14 2. The owner, operator, manager, or other person in control of a public place or place of
15 employment where smoking is prohibited by this chapter may request from the state
16 department of health and human services the signs necessary to comply with the
17 signage requirements of subsection 1.
20 2. The state department of health and human services shall establish guidelines for
21 employers concerning workplace breastfeeding and infant friendly designations.
24 23-16-01. Licensure of medical hospitals and state hospitals.
25 After July 1, 1947, no person, partnership, association, corporation, limited liability
26 company, county or municipal corporation, or agency thereof, which maintains and operates
27 organized facilities for the diagnosis, treatment, or care of two or more nonrelated persons
28 suffering from illness, injury, or deformity or where obstetrical or other care is rendered over a
29 period exceeding twenty-four hours, may be established, conducted, or maintained in the state
30 of North Dakota without obtaining annually a license therefor in the manner hereinafter provided
31 in sections 23-16-02 and 23-16-03. Chiropractic hospitals, sanatoriums, and hospitals such as
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1 those for unmarried mothers maintained and operated by the department of health and human
2 services are not required to obtain a license under this chapter.
3 In the case of emergency or transfer beds attached to and forming a part of a licensed
4 medical doctor's office, the state department of health and human services has the right of
5 inspection, but no license may be required under the provisions of this chapter when the
6 number of such beds does not exceed four.
9 6. A nursing facility, upon prior written notice to the state department of health and
10 human services, may delicense a maximum of twenty-five percent of its licensed
11 nursing facility bed capacity and have the delicensed nursing facility held for a period
12 of forty-eight months. The total delicensed nursing facility bed capacity that may be
13 held for a nursing facility at no time may be greater than fifty percent of the number of
14 currently licensed beds in the nursing facility. Delicensed nursing facility bed capacity
15 in excess of fifty percent of the nursing facility's licensed capacity may not be held and
16 is not eligible for the provisions of subsection 7. Delicensed bed capacity not sold or
17 relicensed at the conclusion of the forty-eight-month holding period ceases to exist.
20 23-16-03. Application for license - License fee.
21 Applicants for license shall file applications under oath with the state department of health
22 and human services upon forms prescribed. Applications must be signed by the owner, or in the
23 case of a corporation by two of its officers, or in the case of a county or municipal unit by the
24 head of the governmental department having jurisdiction over it. Applications must set forth the
25 full name and address of the owner of the institution for which license is sought, the names of
26 the persons in control thereof, and such additional information as the state department of health
27 and human services may require, including affirmative evidence of ability to comply with such
28 minimum standards, rules, and regulations as may be lawfully prescribed pursuant to this
29 section. An application for a license for facilities not owned by the state or its political
30 subdivisions must be accompanied by the following fees:
31 1. For each licensed acute care bed, ten dollars.
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1 2. For each licensed skill care bed, ten dollars.

2 License fees collected pursuant to this section must be deposited in the state department of
3 health and human services services operating fund in the state treasury and any expenditure
4 from the fund is subject to appropriation by the legislative assembly.
7 23-16-04. Licenses.
8 Licenses issued hereunder expire one year after date of issuance or upon such uniform
9 dates annually, as the department of health counciland human services may prescribe by rule.
10 Licenses must be issued only for the premises and persons named in the application and are
11 not transferable or assignable. Licenses must be posted in a conspicuous place on the licensed
12 premises.
15 23-16-05. Inspections, consultations, and approval of plans.
16 The state department of health and human services shall make or cause to be made such
17 inspections as may be prescribed by regulation. The health council may prescribe by
18 regulations that any licensee or prospective applicant desiring to make a substantial alteration
19 or addition to its facilities or to construct new facilities shall, before commencing such alteration,
20 addition, or new construction, submit plans and specifications therefor to the state department
21 of health and human services for preliminary inspection, recommendation, and approval.
24 23-16-06. Authority to issue, deny, suspend, or revoke licenses.
25 The state department of health and human services shall issue licenses for the operation of
26 institutions subject to this chapter which are found to comply with the provisions of this chapter
27 and such regulations as are lawfully promulgated by the health councilrules adopted by the
28 department. The state health officer with the approval of the health council may, after a hearing,
29 suspend or revoke licenses issued hereunder on any of the following grounds:
30 1. Violation of any of the provisions of this chapter or the rules and regulations
31 promulgated pursuant thereto.
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1 2. Permitting, aiding, or abetting the commission of any unlawful act.

2 3. Conduct or practices detrimental to the health or safety of patients and employees of
3 said institutions; provided that this provision may not be construed to have any
4 reference to practices authorized by law; and provided further that no license may be
5 suspended or revoked for any trivial violation.
6 No application for a license may be denied, or any licenses suspended or revoked, except after
7 a hearing before the health council held pursuant to written notice to the applicant or licensee,
8 served by registered or certified mail, which notice must concisely state the grounds for such
9 denial or for such proposed suspension or revocation and must fix the time and place of hearing
10 which may not be less than thirty days after the date of the mailing of such notice. After such
11 hearing, the council shall make an order, either denying the application for license or granting
12 the same, or suspending or revoking such license, or dismissing the proceedings to suspend or
13 revoke as the merits of the case warrant. The council shall send a copy of its order to the
14 applicant or licensee by registered or certified mail, which must contain its findings and
15 conclusions, and such order, except an order of dismissal, becomes final thirty days after the
16 date of mailing unless the applicant or licensee appeals therefrom in the manner provided by
17 section 23-16-10.
20 23-16-08. Offering or advertising to dispose of infants prohibited.
21 No hospital providing maternity care may in any way offer to dispose of any child or
22 advertise that it will give children for adoption or hold itself out, directly or indirectly, as being
23 able to dispose of children, however, such hospitals may inform an unmarried mother of
24 child-placing agencies licensed by the department of health and human services.
27 23-16-09. Information confidential.
28 Information other than reports relating to vital statistics received by the state department of
29 health and human services through inspection or otherwise, authorized under this chapter are
30 confidential and may not be disclosed publicly except in a proceeding involving the question of
31 license. No agent of the state department of health and human services or of any board of
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1 health, may disclose individually identifiable health information of such an institution obtained in
2 the course of a survey or inspection except in a judicial or administrative proceeding in
3 response to an order of a court or administrative tribunal.
6 2. In addition to any criminal sanctions that may be imposed pursuant to law, any person
7 maintaining or operating a nursing facility licensed by the department who is found
8 guilty of knowingly violating any provision of this title or any rules adopted under this
9 title, or any person maintaining or operating a nursing facility found to have
10 deficiencies during a survey of the nursing facility, may be assessed a civil penalty not
11 to exceed one thousand dollars for each violation and for each day the violation
12 continues plus interest and any costs incurred by the department to enforce this
13 penalty. This civil penalty may be imposed by a court in a civil proceeding or by the
14 state health officer through an administrative hearing under chapter 28-32. If a civil
15 penalty levied by the department after an administrative hearing is not paid within thirty
16 days after a final determination that a civil penalty is owed, unless the determination of
17 a civil penalty is appealed to a district court, the civil penalty and any costs incurred by
18 the department to enforce the penalty may be withheld from payments due to the
19 person or nursing facility from the department of health and human services. Any
20 funds received as penalties must be applied to protect residents of the nursing facility,
21 to relocate residents, to maintain operation of the nursing facility, and to reimburse
22 residents for loss of personal funds.
25 23-16-12. Injunction.
26 The state department of health and human services, in accordance with the laws of the
27 state governing injunctions and other process, may maintain an action in the name of the state
28 against any person, partnership, association, corporation, or limited liability company for
29 establishing, conducting, managing, or operating any hospital within the meaning of the chapter
30 without first having a license therefor as herein provided or without first obtaining from the state
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1 department of health and human services written approval of plans and specifications for major
2 alterations of, additions to, or construction of health facilities.
8 23-17-08. Establishment of advisory committee.
9 The chiropractic board of examiners shall request the governor to appoint an advisory
10 committee consisting of the executive director of the department of health and human services,
11 one chiropractic hospital superintendent, and one person interested in chiropractic hospitals.
12 One member is to serve for three years, one for two, and one is to serve for one year from the
13 date of their appointment or until their successors are duly appointed. Following this first
14 appointment, the term of office must be for three years. This advisory committee shall act in an
15 advisory capacity to the chiropractic board of examiners in dealing with matters pertaining to
16 particular problems of chiropractic hospitals and sanatoriums and other related institutions.
22 23-17.3-08. Rules - State department of health.
23 The department shall adopt necessary rules relating to the home health agencies licensed
24 pursuant to section 23-17.3-02, including rules governing:
25 1. Qualifications of professional and ancillary personnel in order to furnish adequately
26 home health services.
27 2. Standards for the organization and quality of patient care.
28 3. Procedures for maintaining records.
29 4. Provision for contractual arrangements for professional and ancillary health services.
30 5. Procedures for application, issuance, and renewal of license.
31 6. Procedures for denial, suspension, or revocation of license.
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1 7. Inspections of licensed home health agencies.

4 23-17.3-10. Information confidential.
5 Information received under this chapter by the state department of health, through
6 inspection or otherwise, is confidential and may not be disclosed except:
7 1. In a proceeding involving the question of license;
8 2. In a judicial proceeding, upon a court order; or
9 3. To a health or social services agency with specific responsibility for a patient's care.
15 23-21-16. Removal and reinterment by cemetery authority.
16 After the completion of notice, and after the expiration of the period of six months specified
17 in the notice, any cemetery authority may cause the removal of all human remains interred in
18 the cemetery or portion from which the remains have been ordered removed, and may reinter
19 such remains in any other place in this state where interments are permitted, without further
20 notice to any person claiming any interest in the cemetery, or portion affected, or in the remains
21 interred therein. Whenever any remains are removed from any cemetery or portion of a
22 cemetery pursuant to this chapter by a cemetery authority, such remains must be reinterred as
23 near as possible to the cemetery from which such remains were taken. The remains of each
24 person reinterred must be placed in a separate and suitable receptacle and decently and
25 respectfully interred under rules and regulations adopted by the cemetery authority making the
26 removal and the state department of health and human services.
29 23-21.1-02.1. License to operate a perpetual care cemetery - Fee.
30 No organization may operate as a perpetual care cemetery unless licensed on forms
31 provided by the state department of health and human services by the recorder of the county
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1 within which the cemetery is located, unless the board of county commissioners designates a
2 different official. The license must be renewed by or before July first of each year. Prior to
3 issuance or renewal of a license, the recorder, or designated official, shall determine if the
4 applicant is in full compliance with the provisions of this chapter. When applying for a license
5 renewal, the applicant shall report to the recorder, or designated official, the number of spaces
6 sold, the gross amount of receipts from the sale of spaces, and the amount of money
7 transferred to the perpetual care trust fund during the organization's previous fiscal year. The
8 license fee must be five dollars per year, except that any perpetual care cemetery which has
9 sold less than ten spaces during the previous fiscal year may not be required to pay a license
10 fee.
13 1. Any organization subject to this chapter which is organized or commences business in
14 this state and desires to operate as a perpetual care cemetery, before selling or
15 disposing of any interment space or lots, shall establish a minimum perpetual care and
16 maintenance guarantee fund of twenty-five thousand dollars in cash, except that the
17 minimum perpetual care and maintenance guarantee fund for organizations in
18 operation on July 1, 1963, must be five thousand dollars. The perpetual care and
19 maintenance guarantee fund must be permanently set aside in trust to be
20 administered under the jurisdiction of the district court of the county wherein the
21 cemetery is located. The district court shall have jurisdiction over the approval of
22 trustees, reports and accounting of trustees, amount of surety bond required, and
23 investment of funds as provided by chapters 59-09, 59-10, 59-11, 59-12, 59-13, 59-14,
24 59-15, 59-16, 59-17, 59-18, and 59-19 relating to the administration of trust estates.
25 Only the income from such fund may be used for the care and maintenance of the
26 cemetery for which it was established. All such organizations shall submit at least
27 annually, to the district court, such reports as are required. The clerks of each of the
28 district courts shall transmit copies of all reports, and rules and regulations enacted by
29 the organization, to the state department of health and human services and the
30 commissioner of financial institutions.
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3 23-23-03. Enforcement by health officer - Seizure - Inspection - Injunction.
4 It is the duty of the state health officer to enforce the provisions of this chapter, and for that
5 purpose the investigators, inspectors, representatives, and agents of the state department of
6 health and human services shall have the full power and authority of peace officers in this state,
7 and shall have the power and authority to administer oaths, to enter upon premises at all times
8 for the purpose of making inspections, to seize evidence, to interrogate all persons, and to
9 require the production of books, papers, documents, or other evidence. The state health officer
10 may institute, in its own name, proceedings to enjoin and restrain violations of this chapter,
11 regardless of whether the defendant has been convicted of violation of the penal provisions
12 thereof, and may not be required to pay any costs or filing fees or furnish any bond in
13 connection therewith.
16 23-27-01. License required - Licensing of emergency medical services operations -
17 Exception - Waiver.
18 1. The state department of health and human services shall license emergency medical
19 services operations and may designate their service areas. The department shall limit
20 the issuance of a license for any new emergency medical services operation based on
21 the needs of the service area. A license for an emergency medical services operation
22 is nontransferable.
23 2. Emergency medical services may not be advertised, offered, or provided to the public
24 except by an emergency medical services operator that provides the emergency
25 medical services through emergency medical services personnel.
26 3. Except as otherwise provided under subsection 4, an emergency medical services
27 operator must be separately licensed for each of the operator's emergency medical
28 services operations and an operation that is headquartered from a separate location
29 must be considered a separate operation. Under this subsection, an operation with a
30 single headquarters site may dispatch vehicles and emergency medical services
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1 personnel from more than one location if calls requesting services are received and
2 orders for vehicle dispatch are made at the single headquarters site.
3 4. Notwithstanding subsection 3, an operator of an emergency medical services
4 operation may operate one or more substation ambulance services operations under a
5 single license if:
6 a. The headquarters ambulance services operation is not a substation ambulance
7 services operation of another emergency medical services operation;
8 b. The substation ambulance services operation area borders the headquarters
9 ambulance services operation area or borders another substation of the
10 headquarters ambulance services operation;
11 c. The headquarters ambulance services operation and the substation ambulance
12 services operation are dispatched by the same entity; and
13 d. The operator of the emergency medical services operation pays a license fee for
14 each of its substation ambulance services operations.
15 5. The provisions of this chapter do not apply to an operator from another state which is
16 headquartered at a location outside of this state and transports patients across state
17 lines, but the operator may not treat patients within this state or pick up patients within
18 this state for transportation to locations within this state, except as provided by rule.
19 6. The statedepartment of health counciland human services shall adopt rules for special
20 licenses and waiver provisions for an operator of an emergency medical services
21 operation intended for industrial sites not available to the general public.
27 23-27-03. License fees.
28 The fee for an emergency medical services operation license to operate an emergency
29 medical services operation or a substation ambulance services operation must be set by the
30 state health council at a sum of not more than twenty-five dollars annually, as may be required
31 to defray the costs of administration of the licensing program. This operation license fee does
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1 not apply to licensure or certification of emergency medical services personnel. All license fees
2 must be paid to the state department of health and human services and deposited with the state
3 treasurer and credited to the state general fund.
6 1. An emergency medical services operation within this state may not operate unless the
7 operation is licensed in accordance with this chapter and rules adopted by the
8 statedepartment of health counciland human services. The rules must include:
9 a. Time when operator's services must be available.
10 b. Type of motor vehicle operator's license needed for drivers of ground vehicles.
11 c. Training standards for operation personnel.
12 d. Equipment and ground vehicle standards.
13 e. Annual license fees.
14 f. Number of personnel required for each run.
15 g. The scope of practice for uncertified drivers, certified personnel, and emergency
16 medical services professionals.
17 h. Performance standards, which may include response time standards.
18 i. Other requirements as may be found necessary to carry out the intent of this
19 chapter.
22 23-27-04.2. Emergency medical services - State assistance.
23 The state department of health and human services shall assist in the training of emergency
24 medical services personnel of certain emergency medical services operations as determined by
25 the department and financially shall assist certain emergency medical services operations as
26 determined by the department in obtaining equipment. Assistance provided under this section
27 must be within the limits of legislative appropriation. The department shall adopt criteria for
28 eligibility for assistance in the training of emergency medical services personnel of various
29 types of emergency medical services operations. To qualify for financial assistance for
30 equipment an emergency medical services operation shall certify, in the manner required by the
31 department, that the operation has fifty percent of the amount of funds necessary for identified
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1 equipment acquisitions. The department shall adopt a schedule of eligibility for financial
2 assistance for equipment. The schedule must provide for a direct relationship between the
3 amount of funds certified and the number of responses during the preceding calendar year for
4 the purpose of rendering medical care, transportation, or both, to individuals who were sick or
5 incapacitated. The schedule must require that as the number of responses increases, a greater
6 amount of funds certified is required. The schedule must classify responses and the financial
7 assistance available for various classifications. The department may establish minimum and
8 maximum amounts of financial assistance to be provided to an emergency medical services
9 operation under this section. If applications for financial assistance exceed the amount of
10 allocated and available funds, the department may prorate the funds among the applicants in
11 accordance with criteria adopted by the department. No more than one-half of the funds
12 appropriated by the legislative assembly each biennium and allocated for training assistance
13 may be distributed in the first year of the biennium.
16 23-27-04.3. Emergency medical services personnel training, testing, certification,
17 licensure, and quality review - Penalty.
18 The statedepartment of health counciland human services shall adopt rules prescribing
19 minimum training, testing, certification, licensure, and quality review standards for emergency
20 medical services personnel, instructors, and training institutions. Rules adopted must include a
21 definition of minimum applicable standards, a definition of emergency medical services
22 personnel, provide for a mechanism for certifying or licensing persons who have met the
23 required standards, provide a mechanism to review and improve the quality of care rendered by
24 emergency medical services personnel, and define minimum standards for emergency medical
25 services training institutions. Licensing as an emergency medical services training institution is
26 optional. It is a class B misdemeanor for an individual to willfully misrepresent that individual's
27 certification or licensing status as emergency medical services personnel. Quality review and
28 improvement information, data, records, and proceedings are not subject to subpoena or
29 discovery or introduction into evidence in any civil action.
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1 23-27-04.7. County reporting - Use of property tax levies.

2 The board of county commissioners of every county in this state shall conduct an annual
3 review of the emergency medical services coverage within that county and shall submit an
4 annual report to the state health officer in a format approved by the state department of health
5 and human services. A taxing district that levies a special emergency medical services or
6 ambulance service levy shall allocate all of the special tax levy revenue collected in a particular
7 township to the ambulance service that serves the largest area within that township.
10 6. The statedepartment of health counciland human services shall adopt rules
11 establishing air ambulance service provider requirements that must address transport
12 plans, including auto launch protocol and auto launch cancellation protocol;
13 transporting to the nearest appropriate medical facility; medical necessity; and
14 informed consent. As necessary, the statedepartment of health counciland human
15 services shall adopt rules relating to quality of care standards and other appropriate
16 requirements regarding air ambulance service providers.
19 23-34-02. Peer review records - Confidentiality.
20 1. Peer review records are confidential and may be used by a peer review organization
21 and the organization members only for conducting a professional peer review.
22 2. A health care organization may release reports, data compilations, analyses, and
23 summaries, which are prepared by a peer review organization and which identify or
24 analyze trends in medical errors to the state department of health and human
25 services, the North Dakota hospital association, and the North Dakota hospital
26 foundation.
27 3. The state department of health and human services, the North Dakota hospital
28 association, and the North Dakota hospital foundation may release any information
29 provided under subsection 2 to the public.
30 4. This section does not prohibit access of the state department of health and human
31 services to peer review records to determine compliance with requirements of federal
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1 or state law for the survey and certification of a health care facility or for trauma center
2 designation and as authorized under any rules issued under section 23-01.2-01 or
3 23-01-11 to enable the state to be in compliance with any federal laws to qualify for
4 any federal funds related to medical facilities or agencies licensed by the state
8 23-34-02.1. Peer review organization reports - Admissibility.
9 Any report, data, data compilation, analyses, or summary that is generated by a peer review
10 organization and made available to the state department of health and human services or the
11 public by the state department of health and human services, the North Dakota hospital
12 association, or the North Dakota hospital foundation, may not be introduced into evidence, for
13 any purpose, in any civil or administrative proceeding.
19 23-35-02. Public health units.
20 All land in the state must be in a public health unit before January 1, 2001. The health
21 councildepartment of health and human services may issue rules defining the core functions a
22 public health unit shall undertake.
28 23-38.1-01. Cardiac ready community grant program.
29 The state department of health and human services shall establish a cardiac ready
30 community grant program. The primary purpose of the program is to support bystander,
31 emergency responder, and community private public partnerships for strengthening
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1 community-based capacity for cardiac and stroke emergency response and risk reduction
2 programs throughout the state. The program must build on and may not duplicate existing
3 programs. The department shall award grants on a competitive basis based on criteria
4 established by an advisory committee. To facilitate volume purchasing savings, the department
5 may procure vendor rates and purchases, and grant the acquired elements to community
6 programs.
9 1. The state department of health and human services shall establish a cardiac ready
10 community grant program advisory committee with members appointed by the state
11 health officerexecutive director of the department of health and human services or
12 designee. The advisory committee shall advise the department of health and human
13 services in the development of the cardiac ready community grant program and the
14 membership must include a representative of the department of health and human
15 services, one cardiac ready community member, one representative of the emergency
16 medical services association, one representative of the American heart association,
17 one representative of the cardiac task force, one representative of the stroke task
18 force, one representative of the emergency services advisory committee, one survivor
19 advocate, and the state department of health and human services emergency medical
20 services and trauma medical director.
23 3. The state department of health and human services, with the advisory committee's
24 involvement, shall provide assistance to:
25 a. Evaluate programs;
26 b. Promote public awareness of core program elements;
27 c. Facilitate the coordination of program components with the local level;
28 d. Involve state agencies, law enforcement, and local government in the
29 administration and management of the program; and
30 e. Assist the department in screening and implementing the grants.
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3 23-38.1-03. Gifts, grants, and donations - Continuing appropriation.
4 The state department of health and human services may accept any gifts, grants, or
5 donations, whether conditional or unconditional. The department or local grantees may contract
6 public or private entities and may expend any available moneys to obtain matching funds for the
7 purposes of this chapter. All moneys received by the state department of health and human
8 services as gifts, grants, or donations under this section are appropriated on a continuing basis
9 to the department's operations fund for the purpose of funding the grant program.
15 23-39-06. Injury reports.
16 If a customer of a tanning facility reports a sunburn injury to that facility resulting from the
17 use of its tanning device, the owner shall provide the customer with written information on how
18 to report the alleged injury to the state department of health and human services. If a health
19 care provider treats a patient for a sunburn injury and determines, in the exercise of
20 professional judgment, that the injury occurred as a result of using a tanning device at a tanning
21 facility, the health care provider shall report the circumstances of the injury to the state
22 department of health and human services. A health care provider making or not making a report
23 in good faith pursuant to this section is immune from liability for making or not making a report.
26 23-39-07. Enforcement - Rules - Penalty.
27 The department shall enforce this chapter. The state health council and shall adopt rules
28 necessary to implement this chapter. The department may deny issuance of a permit to an
29 applicant or suspend or revoke any permit issued under this chapter if the applicant or
30 permitholder, or an employee of the applicant or permitholder, violates this chapter or any rule
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1 adopted to implement this chapter. Violation of this chapter or any rule adopted to implement
2 this chapter is a class B misdemeanor.
6 In this chapter unless the context or subject matter otherwise requires:
8 2. "Human service zone" means a county or consolidated group of counties
9 administering human services within a designated area in accordance with an
10 agreement or plan approved by the department of human services.
11 3. "Human services" means:
12 a. A service or assistance provided to an individual or an individual's family in need
13 of services or assistance, including child welfare services, economic assistance
14 programs, medical service programs, and aging service programs, to assist the
15 individual or the individual's family in achieving and maintaining basic
16 self-sufficiency, including physical health, mental health, education, welfare, food
17 and nutrition, and housing.
18 b. A service or assistance provided, administered, or supervised by the department
19 of human services in accordance with chapter 50-06.
20 c. Licensing duties as administered or supervised by the department of human
21 services or delegated by the department of human services to a human service
22 zone.
25 1. Cooperate with the department in administering this chapter in its human service zone,
26 subject to rules adopted by the state health councildepartment.
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1 23-43-02. Designation of comprehensive stroke center, primary stroke centers, and

2 acute stroke-ready hospitals.
3 1. The state department of health and human services shall identify hospitals that meet
4 the criteria as a comprehensive stroke center, primary stroke center, or acute
5 stroke-ready hospital. In order to receive a designation under this section, a hospital
6 shall apply to the state department of health and human services and shall
7 demonstrate to the satisfaction of the department the hospital meets the applicable
8 criteria.
9 2. In order to qualify for designation as a comprehensive stroke center, an accredited
10 acute care hospital must be certified as a comprehensive stroke center by a
11 department-approved, nationally recognized guidelines-based organization, which
12 provides comprehensive stroke center hospital certification for stroke care. As a
13 condition of retaining designation as a comprehensive stroke center, an acute care
14 hospital shall maintain its certification.
15 3. In order to qualify for designation as a primary stroke center, an accredited acute care
16 hospital must be certified as a primary stroke center by a department-approved,
17 nationally recognized guidelines-based organization, which provides primary stroke
18 center certification for stroke care. As a condition of retaining designation as a primary
19 stroke center, an acute care hospital shall maintain its certification.
20 4. In order to qualify for designation as an acute stroke-ready hospital, an accredited
21 acute care hospital must be certified as an acute stroke-ready hospital by
22 department-approved, nationally recognized guidelines-based criteria. As a condition
23 of retaining designation as an acute stroke-ready hospital, an acute care hospital shall
24 maintain its certification.
25 5. Through agreement, a comprehensive stroke center and primary stroke center may
26 coordinate with an acute stroke-ready hospital to provide appropriate access to care
27 for acute stroke patients. The coordinating stroke care agreement must be in writing
28 and include, at a minimum:
29 a. The transfer agreement for the transport and acceptance of a stroke patient seen
30 by the acute stroke-ready hospital for stroke treatment therapies the stroke
31 center or primary care center is not capable of providing; and
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1 b. Communication criteria and protocol with the acute stroke-ready hospital.

2 6. If the department determines the hospital is not in compliance with the requirements
3 set for designation level, after notice and a hearing, the state department of health and
4 human services may suspend or revoke a hospital's state designation as a
5 comprehensive stroke center, primary stroke center, or acute stroke-ready hospital.
6 7. Any facility that is not designated, must have a predetermined plan for the triage of
7 acute stroke patients. The plan must be filed annually with the state department of
8 health and human services, division of emergency medical services and trauma.
11 23-43-03. Emergency medical services operations - Assessment and transportation
12 of stroke patients to a comprehensive stroke center, primary stroke center, or acute
13 stroke-ready hospital.
14 1. Before June first of each year the state department of health and human services shall
15 send the list of comprehensive stroke centers, primary stroke centers, and acute
16 stroke-ready hospitals to the medical director of each licensed emergency medical
17 services operation in this state. The state department of health and human services
18 shall maintain a copy of the list and shall post a list of comprehensive stroke centers,
19 primary stroke centers, and acute stroke-ready hospitals to the state department of
20 health'sand human services' website.
21 2. The state department of health and human services shall adopt and distribute a
22 nationally recognized, standardized stroke triage assessment tool. The department
23 shall post this stroke triage assessment tool on the department's website and provide
24 a copy of the assessment tool to each licensed emergency medical services
25 operation. Each licensed emergency medical services operation shall use a stroke
26 triage assessment tool that is substantially similar to the sample stroke triage
27 assessment tool provided by the state department of health and human services.
28 3. Each emergency medical services operation in the state shall establish prehospital
29 care protocols related to the assessment, treatment, and transport of a stroke patient
30 by a licensed emergency medical services operation. Such protocols must include
31 plans for the triage and transport of an acute stroke patient to the closest
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1 comprehensive or primary stroke center or when appropriate to an acute stroke-ready

2 hospital, within a specified time frame of onset of symptoms.
3 4. As part of current training requirements, each emergency medical services operation
4 in the state shall establish protocols to assure licensed emergency medical services
5 providers and 911 dispatch personnel receive regular training on the assessment and
6 treatment of stroke patients.
7 5. An emergency medical services operation shall comply with this chapter.
8 6. All data reported under this chapter must be made available to the state department of
9 health and human services and to all other government agencies, or contractors of
10 government agencies, which have responsibility for the management and
11 administration of emergency medical services throughout the state.
12 7. This chapter may not be construed to require disclosure of any confidential information
13 or other data in violation of the federal Health Insurance Portability and Accountability
14 Act of 1996 [Pub. L. 104-191; 110 Stat. 1936; 29 U.S.C. 1181 et seq.].
17 23-43-04. Continuous improvement of quality of care for individuals with stroke -
18 Recommendations - Report to legislative management.
19 1. The state department of health and human services shall establish and implement a
20 plan for achieving continuous quality improvement in the quality of care provided
21 under the state comprehensive stroke system for stroke response and treatment. In
22 implementing this plan, the state department of health and human services shall:
23 a. Maintain a statewide stroke database that compiles information and statistics on
24 stroke care which align with nationally recognized stroke consensus metrics. The
25 state department of health and human services shall utilize a nationally
26 recognized data set platform with confidentiality standards no less secure than
27 the stroke registry data platform. The state department of health and human
28 services shall coordinate with national voluntary health organizations involved in
29 stroke quality improvement to avoid duplication and redundancy.
30 b. Require comprehensive stroke centers and primary stroke centers and
31 encourage acute stroke-ready hospitals and emergency medical services
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1 operations to report data consistent with nationally recognized guidelines on the

2 treatment of individuals with confirmed stroke within the state.
3 c. Encourage sharing of information and data among health care providers on ways
4 to improve the quality of care of stroke patients in this state.
5 d. Facilitate the communication and analysis of health information and data among
6 the health care professionals providing care for individuals with stroke.
7 e. Require the application of evidence-based treatment guidelines regarding the
8 transitioning of patients to community-based followup care in hospital outpatient,
9 physician office, and ambulatory clinic settings for ongoing care after hospital
10 discharge following acute treatment for stroke.
11 2. The state department of health and human services shall establish a data oversight
12 process and implement a plan for achieving continuous quality improvement in the
13 quality of care provided under the state comprehensive stroke system for stroke
14 response and treatment which must:
15 a. Analyze data generated by the stroke registry on stroke response and treatment;
16 b. Identify potential interventions to improve stroke care in geographic areas or
17 regions of the state; and
18 c. Provide recommendations to the state department of health and human services,
19 emergency medical services advisory council, and legislative assembly for the
20 improvement of stroke care and delivery in the state.
21 3. Data reported under this section must be made available to the state department of
22 health and human services and to other government agencies, or contractors of
23 government agencies, which have responsibility for the management and
24 administration of emergency medical services throughout the state.
25 4. Before June first of each even-numbered year, the state department of health and
26 human services shall provide a report to the legislative management regarding
27 progress made toward the recommendations provided in this chapter and any
28 recommendations for future legislation.
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1 23-43-05. Stroke system of care task force.

2 1. The state department of health and human services shall establish a stroke system of
3 care task force to address matters of triage, treatment, and transport of possible acute
4 stroke patients. The stroke system of care task force must include representation from
5 the state department of health and human services, the emergency medical services
6 advisory council, the university of North Dakota's center for rural health, the American
7 stroke association or similar entity, comprehensive stroke centers, primary stroke
8 centers, rural hospitals, physicians, and emergency medical services operations.
9 2. The task force shall implement the regulations necessary to establish an effective
10 stroke system of care in the state, with a focus on serving rural areas. The regulations
11 must include protocols for the assessment, stabilization, and appropriate routing of
12 stroke patients by emergency medical services operations, and for coordination and
13 communication between hospitals, comprehensive stroke centers, primary stroke
14 centers, and other support services necessary to assure all residents have access to
15 effective and efficient stroke care.
16 3. The stroke system of care task force shall make recommendations to the state
17 department of health and human services and health council. Upon receiving such
18 recommendations, the department of health counciland human services may adopt
19 rules implementing the recommendations.
20 4. As used in this subsection, "telemedicine services" means the use of interactive audio,
21 video, and other electronic media used for the purpose of diagnosis, consultation, or
22 treatment of acute stroke. The stroke system of care task force shall recommend
23 eligible essential health care services for acute stroke care provided through
24 telemedicine services.
27 23-43-06. General provisions.
28 1. This chapter is not a medical practice guideline and may not be used to restrict the
29 authority of a hospital to provide services for which the hospital received a license
30 under state law. Patients must be treated individually based on the needs and
31 circumstances of each patient.
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1 2. A person may not advertise to the public, by way of any medium, that a hospital is a
2 comprehensive stroke center, primary stroke center, or acute stroke ready hospital
3 unless the hospital is designated as such by the state department of health and
4 human services.
5 3. The department of health counciland human services may adopt rules to implement
6 this chapter.
12 2. The health councildepartment shall adopt rules to regulate and register an individual
13 who receives compensation for engaging in the provision of nursing or nursing-related
14 services to an individual in a health care facility or other setting. The rules do not apply
15 to a licensed health care professional practicing within the scope of that profession, an
16 unlicensed assistive person under chapter 43-12.1, or a volunteer in the course of
17 providing services without pay. In developing the rules, the health councildepartment
18 shall consult with the state board of nursing and other key stakeholders.
21 2. The method a health care professional uses to provide the information under
22 subsection 1 may include verbally or in writing or by providing the patient with a
23 publication prepared by the state department of health and human services under
24 section 23-45-02.
27 1. By January 1, 2012, the stateThe department of health and human services shall
28 prepare a pamphlet that includes information regarding the following:
29 a. The medical processes involved in the collection of umbilical cord blood.
30 b. The medical risks of umbilical cord blood collection to the mother and her
31 newborn child.
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1 c. The current and potential future medical uses, risks, and benefits of umbilical
2 cord blood collection to a mother, her newborn child, and the mother's biological
3 family.
4 d. The current and potential future medical uses, risks, and benefits of umbilical
5 cord blood collection to individuals who are not biologically related to a mother or
6 her newborn child.
7 e. Any costs that may be incurred by a patient who chooses to make an umbilical
8 cord blood donation.
9 f. Options for ownership and future use of the donated material.
10 g. The average cost of public and private umbilical cord blood banking.
13 23-46-02. Emergency medical services advisory council.
14 The state department of health and human services shall establish an emergency medical
15 services advisory council. The council must include at least three representatives appointed by
16 an emergency medical services organization, one individual to represent basic life support and
17 one individual to represent advanced life support, both appointed by the state health
18 officerexecutive director of the department of health and human services or designee, and other
19 members designated by the state health officerexecutive director of the department of health
20 and human services or designee, not to exceed a total of fourteen members. The department of
21 health and human services and state health officer shall consider the recommendations of the
22 council on the plan for integrated emergency medical services in the state, development of
23 emergency medical services funding areas, development of the emergency medical services
24 funding areas application process and budget criteria, and other issues relating to emergency
25 medical services as determined by the executive director of the department of health and
26 human services or state health officer. Council members are entitled to reimbursement for
27 expenses in the manner provided in section 44-08-04. The department of health and human
28 services shall establish by policy the length of terms and the method for rotation of membership.
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1 23-46-03. Emergency medical services funding areas.

2 The state department of health and human services shall establish and update biennially a
3 plan for integrated emergency medical services in this state. The plan must identify ambulance
4 operations areas, emergency medical services funding areas that require state financial
5 assistance to operate a minimally reasonable level of emergency medical services, and a
6 minimum reasonable cost for an emergency medical services operation. The department shall
7 designate emergency medical services funding areas based on criteria adopted by rule of the
8 department of health council and published in the North Dakota Administrative Codeand human
9 services.
12 23-46-04. State financial assistance for emergency medical services - Confidential
13 information - Annual allocation.
14 Emergency medical services operations that request financial assistance from the state
15 must provide requested fiscal information to the state department of health and human services
16 for use in financial assistance determinations. All information provided to the department under
17 this section is confidential. The state department of health and human services shall determine
18 annually the allocation amount of state financial assistance for each emergency medical
19 services funding area based on the department's determination of the minimum annual funding
20 necessary to operate the emergency medical services operation or service designated to
21 operate in the ambulance funding area, based on the financial needs unique to each
22 emergency medical services funding area.
28 23-47-02. Acute cardiovascular emergency medical system - Duties of state
29 department of health.
30 1. Following consultation with and receipt of a recommendation of the acute
31 cardiovascular emergency medical system of care advisory committee, the
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1 department shall establish and maintain a comprehensive emergency cardiovascular

2 medical system for the state. The system must include standards for the following
3 components:
4 a. A system plan.
5 b. Prehospital emergency medical services.
6 c. Hospitals, for which the standards must include:
7 (1) Standards for designation, redesignation, and dedesignation of receiving
8 and referring centers.
9 (2) Standards for evaluation and quality improvement programs for designated
10 centers.
11 (3) Recognition of a hospital as a STEMI receiving center or as a STEMI
12 referring center. In making such recognition, the standards must include
13 consideration of whether the hospital is:
14 (a) Accredited as a mission: lifeline STEMI receiving center or mission:
15 lifeline STEMI referring center by the society of cardiovascular patient
16 care and the American heart association accreditation process; or
17 (b) Accredited by a department-approved, nationally recognized
18 organization that provides mission: lifeline STEMI receiving center
19 and mission: lifeline STEMI referring center accreditation or a
20 substantive equivalent.
21 d. System registries, for which the components must include a plan for achieving
22 continuous quality improvement in the quality of care provided under the
23 statewide system, including for STEMI response and treatment.
24 (1) In implementing this plan, the department shall maintain a statewide STEMI
25 heart attack database that aggregates information and statistics on heart
26 attack care. The department shall utilize the ACTION registry-get with the
27 guidelines data platform, or other equivalent platform.
28 (2) To the extent possible, the department shall coordinate with national
29 voluntary health organizations involved in STEMI heart attack quality
30 improvement to avoid duplication and redundancy.
31 (3) Designated receiving centers shall participate in the registry.
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1 2. The proceedings and records of the program are not subject to subpoena, discovery,
2 or introduction into evidence in any civil action arising out of any matter that is the
3 subject of consideration by the program.
6 1. The state health officerexecutive director of the department of health and human
7 services or designee shall appoint the members of the acute cardiovascular
8 emergency medical system of care advisory committee. The state health officer, or the
9 officer's designee, is an ex officio member of the advisory committee. The state health
10 officerexecutive director of the department of health and human services or designee
11 shall appoint to the committee members who represent referring and receiving
12 hospitals, physicians who treat patients, and members who represent emergency
13 medical services operations that provide services in rural and urban areas of the state.
14 Members of the acute cardiovascular emergency medical system of care advisory
15 committee serve at the pleasure of the state health officerexecutive director of the
19 23-50-01. Drug fatalities review panel.
20 1. The forensic pathology department of the university of North Dakota school of
21 medicine and health sciences shall appoint individuals to serve as members on the
22 drug fatalities review panel. To encompass disciplines needed for evaluation and
23 balance of members' viewpoints, panel membership must include representation from
24 multiple disciplines and services. Membership may include a forensic pathologist, a
25 pharmacist with knowledge in pharmacogenomics, representatives of rural and urban
26 healthcare facilities, a licensed addiction counselor, a physician, and representatives
27 of nonregulatory divisions of the state department of health and department of human
28 services.
29 2. The state department of health and human services and the university of North Dakota
30 school of medicine and health sciences shall provide for or arrange for administrative
31 services to assist the panel in performing official duties, including collection and
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1 management of case review files, the maintenance of records, data collection and
2 analysis, and the issuance of a state report on drug-related fatalities. The department
3 and the university of North Dakota school of medicine and health sciences are
4 responsible for the confidentiality and security of data on the sharing site on which the
5 documents are stored.
8 4. Maintain, in conjunction with the state department of health and human services, a
9 laboratory to carry out the necessary tests and examinations for purposes of this title,
10 and establish a fee schedule for the tests and examinations;
13 7. "Supervising officer" means the executive director of the department of health and
14 human services or the superintendent of public instruction, as the case may be.
17 25-01-01.1. State council on developmental disabilities.
18 1. There must be maintained in the department of health and human services a state
19 council on developmental disabilities consisting of one:
20 a. One representative of each of the following departments, divisions, institutions,
21 and organizations designated by the head of such agency or organization:
22 1. (1) Office of superintendent of public instruction.
23 2. North Dakota department of human services.
24 3. State department of health.
25 4. Life skills and transition center.
26 5. (2) Job service North Dakota.
27 b. Three representatives of the department of health and human services to include
28 at least:
29 (1) One representative from the life skills and transition center designated by its
30 superintendent; and
31 (2) One representative from the department's health division.
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1 2. The council shall, at a minimum, include representation that conforms to federal law
2 requirements regarding state councils on developmental disabilities. All members of
3 the council must be appointed by the governor. The council shall select its own officers
4 who shall serve for a term of two years commencing on October first of each year.
5 Meetings must be held at least twice a year or at the call of the chairman or upon
6 notice in writing signed by not less than three members of the council. A simple
7 majority of the council constitutes a quorum and may act upon any matter coming
8 before the council. Members of the council are entitled to reimbursement in the same
9 manner and at the same rate provided by law for other state officials.
10 3. The council shall assist in the development of the state plan for developmental
11 disabilities, monitor and evaluate the implementation of such state plan, and review
12 and comment on all state plans in the state which relate to programs affecting
13 individuals with developmental disabilities. The council may take any action
14 reasonably necessary to secure and administer any money made available to state
15 councils on developmental disabilities through the Developmentally Disabled and Bill
16 of Rights Act [Pub. L. 95-602; 92 Stat. 2955; 42 U.S.C. 6000 et seq.]. The council, if
17 approved by the governor, shall appoint a full-time director who shall assist the
18 council. The director must be classified under the state personnel merit system. The
19 council shall also perform studies and surveys of the needs of individuals with
20 developmental disabilities in North Dakota and shall facilitate coordination of the
21 activities of all state departments, divisions, agencies, and institutions having
22 responsibilities in the field of developmental disabilities.
28 25-01.2-18. Authority to adopt rules.
29 The director of the state department of health and human services may adopt, in
30 accordance with chapter 28-32, any rules necessary to implement this chapter. The
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1 superintendent of public instruction may adopt rules to implement this chapter in schools. The
2 rules adopted may not restrict or limit the rights guaranteed by this chapter.
5 25-02-01. State hospital for the mentally ill - Location - Title - Administration and
6 control.
7 An institution for the care of the mentally ill must be maintained at the city of Jamestown
8 and must be known as the state hospital. The department of health and human services shall
9 administer and control the state hospital.
12 25-02-01.1. Maintenance of state hospital accreditation - Governing body
13 membership - Rulemaking authority.
14 1. The department of health and human services shall seek appropriations and
15 resources sufficient to ensure maintenance of the state hospital's accreditation by the
16 joint commission and certification by the centers for Medicare and Medicaid services
17 or by similar accrediting and certifying organizations and agencies possessing hospital
18 standards recognized by the health care industry and accepted by the department.
19 2. The department, in consultation with the state hospital, shall create a state hospital
20 governing body and shall by rules describe the powers and duties of the governing
21 body. The department shall compensate members not employed by the department in
22 the amount of one hundred dollars per day and reimburse members for expenses
23 incurred in attending meetings in the amounts provided by sections 44-08-04 and
24 54-06-09.
25 3. The governing body must be composed of the executive director of the department of
26 health and human services; the director of the division of behavioral health of the
27 department, who shall serve as chairman of the governing body; the state hospital
28 superintendent; the state hospital medical director; a representative of the
29 department's fiscal administration division; a behavioral health consumer selected by
30 the mental health association; and a legislator selected by the legislative
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1 management. The governing body may include other persons as appointed by the
2 governing body.
5 25-02-03. Object of state hospital.
6 The state hospital is an institution for mental diseases serving specialized populations of the
7 mentally ill, including persons suffering from drug addiction or alcoholism. The state hospital is
8 one component of the North Dakota mental health delivery system and serves as a resource to
9 community-based treatment programs. The state hospital shall, pursuant to rules adopted by
10 the department of health and human services, receive and care for all mentally ill persons,
11 including persons suffering from drug addiction or alcoholism, residing within this state in
12 accordance with this title, and shall furnish to those mentally ill persons all needed food, shelter,
13 treatment, and support that may tend to restore their mental health or to alleviate their illness or
14 suffering.
20 25-03.1-34.1. Exchange of individuals with a substance use disorder.
21 The director of the department of health and human services, a county, a city, or a local law
22 enforcement agency may enter into reciprocal agreements with the appropriate authorities of
23 any other state regarding the mutual exchange, return, and transportation of individuals with a
24 mental illness or substance use disorder who are treated or confined in hospitals of one state
25 for treatment of a substance use disorder or mental illness but who have legal residence in
26 another state.
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1 2. "Executive director" means the executive director of the department of health and
2 human services or the executive director's designee.
5 25-03.3-07. Appointment of guardian ad litem.
6 At any stage of a proceeding under this chapter, on application of any individual or on its
7 own motion, the court may appoint a guardian ad litem for a minor or an individual with an
8 intellectual disability who is a respondent or witness or otherwise involved in the proceeding, if
9 the minor or an individual with an intellectual disability has no parent, guardian, or custodian
10 appearing on behalf of the minor or the individual with an intellectual disability or the interests of
11 those persons conflict with those of the minor or an individual with an intellectual disability. The
12 department of health and human services shall pay the expense of the guardian ad litem fee as
13 established by the court.
16 25-03.3-08. Sexually dangerous individual - Procedure on petition - Detention.
17 1. Upon the filing of a petition pursuant to this chapter, the court shall determine whether
18 to issue an order for detention of the respondent named in the petition. The petition
19 may be heard ex parte. The court shall issue an order for detention if there is cause to
20 believe that the respondent is a sexually dangerous individual. If the court issues an
21 order for detention, the order must direct that the respondent be taken into custody
22 and transferred to an appropriate treatment facility or local correctional facility to be
23 held for subsequent hearing pursuant to this chapter. Under this section, the
24 department of health and human services shall pay for any expense incurred in the
25 detention or evaluation of the respondent.
26 2. If the state's attorney knows or believes the respondent named in the petition is an
27 individual with an intellectual disability, the state's attorney shall notify the court in the
28 petition and shall advise the court of the name of the legal guardian of the respondent
29 or, if none is known, the court may appoint a guardian ad litem for the respondent.
30 Before service of the notice required in section 25-03.3-10, the court shall appoint an
31 attorney for the respondent. An individual with an intellectual disability may be
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1 detained in a correctional facility before the probable cause hearing only when no
2 other secure facility is accessible, and then only under close supervision.
5 25-03.3-12. Sexually dangerous individual - Evaluation.
6 The evaluation must be conducted by one or more experts chosen by the executive
7 director. Whenever a respondent is subject to an evaluation pursuant to this chapter, the
8 respondent may retain an expert to perform an evaluation or testify on the respondent's behalf.
9 When the respondent is an adult with an intellectual disability and a guardian or guardian
10 ad litem has not been appointed for the respondent, the court shall appoint an expert to perform
11 an evaluation on behalf of the respondent. In the case of a respondent who is indigent, the court
12 shall appoint a qualified expert to perform an examination or participate in the commitment
13 proceeding on the respondent's behalf. The department of health and human services shall
14 compensate any qualified expert appointed by the court on behalf of an indigent respondent in a
15 reasonable amount based on time and expenses. An expert retained on behalf of the
16 respondent must have reasonable access to the respondent for the purpose of the examination
17 and to all relevant medical, psychological, and court records and reports.
20 25-03.3-17. Postcommitment proceeding, discharge, and further disposition.
21 1. A committed individual must remain in the care, custody, and control of the executive
22 director until, in the opinion of the executive director, the individual is safe to be at
23 large.
24 2. Each committed individual must have an examination of that individual's mental
25 condition at least once a year. A report regarding the examination must be provided to
26 the court that committed the individual. At the time of the annual examination, the
27 committed individual has the right to have an expert examine the individual, and, upon
28 the request of an indigent committed individual, the court shall appoint a qualified
29 expert to examine the committed individual and report to the court. The department of
30 health and human services shall compensate a qualified expert appointed by the court
31 in a reasonable amount based on time and expenses. That expert must have
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1 reasonable access to the committed individual and to all records relating to the
2 committed individual, including confidential records.
3 3. If a committed individual has been committed to an out-of-state facility by the
4 executive director for purposes of treatment, an expert from that state may be
5 appointed by the court as a qualified expert for an indigent committed individual for
6 any postcommitment proceeding.
7 4. After any report pursuant to this section is provided to the court, the court may order
8 further examination and investigation of the committed individual as the court
9 considers necessary. The court may set the matter for a hearing. At the hearing, the
10 committed individual is entitled to be present and to the benefit of the protections
11 afforded at the commitment proceeding. The state's attorney shall represent the state
12 at the hearing. After the hearing, the court shall determine whether the committed
13 individual is to be discharged or to be retained as a sexually dangerous individual in
14 the care, custody, and control of the executive director.
15 5. The executive director may only discharge a sexually dangerous individual from
16 commitment pursuant to a court order. The executive director may petition the
17 committing court at any time for the discharge of the committed individual. The
18 executive director shall give the state's attorney notice of any petition for discharge the
19 executive director files with the court. Before the petition is granted, the state's
20 attorney has the right to be heard by the court on the petition. The state's attorney may
21 waive this right.
22 6. If the executive director moves a committed individual from a placement in the
23 community to a placement in a secure treatment facility that is more restrictive, the
24 committed individual may challenge the move at a hearing to be held within thirty days
25 after the move in accordance with procedures established by the department of health
29 3. At the hearing on the petition for discharge, the committed individual is entitled to be
30 present and to the benefit of the protections afforded at the commitment proceeding.
31 The state's attorney shall represent the state and may have the committed individual
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1 evaluated by experts chosen by the state. The committed individual is entitled to have
2 an expert of the committed individual's choice conduct an evaluation. The court shall
3 appoint a qualified expert if the committed individual is indigent and requests an
4 appointment. The department of health and human services shall compensate a
5 qualified expert appointed by the court in a reasonable amount based on time and
6 expenses. That expert must have reasonable access to the committed individual and
7 to all records relating to the committed individual, including confidential records.
10 25-03.3-21. Recovery of expense.
11 The department of health and human services, to the extent it has expended sums or
12 provided services pursuant to this title, may seek civil recovery from the property of the
13 respondent or committed individual. The department of health and human services must
14 commence the action within six years after the department paid the sums or provided the
15 services to the respondent or committed individual. After notice and hearing, the court may
16 order an individual to reimburse the department of health and human services for all or part of
17 the expenditures made for that individual pursuant to this chapter. In establishing the amount of
18 reimbursement ordered under this section, the court shall consider the ability of the respondent
19 or committed individual to pay.
22 25-03.3-22. Rules.
23 The department of health and human services may adopt rules under chapter 28-32 to
24 implement this chapter, but the rules may not restrict or limit the rights guaranteed by this
25 chapter.
28 25-04-01. Life skills and transition center - Name - Administration and control.
29 A facility for individuals with developmental disabilities must be maintained at or near the
30 city of Grafton in Walsh County. The facility must also be available for an individual who is
31 determined to be an individual who may benefit from the facility's services. The facility must be
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1 known and designated as the life skills and transition center. The department of health and
2 human services has administrative authority and control of the life skills and transition center.
5 25-04-02. Purpose of life skills and transition center.
6 1. The life skills and transition center must be maintained for the relief, instruction, care,
7 and custody of individuals with developmental disabilities or other individuals who may
8 benefit from the services offered at the center. For this purpose the department of
9 health and human services may introduce and establish such trades and manual
10 industries as in its judgment will best prepare the residents for future self-support.
11 2. The department may provide onsite and offsite additional services and effectuate its
12 powers and duties to best serve individuals with developmental disabilities and other
13 individuals who may benefit from those activities. The services provided and the duties
14 effectuated need not be accredited by the accreditation council on services for people
15 with developmental disabilities or certified by the health care financing administration,
16 or any other similar accrediting or certifying organization, if the service or duty is not
17 provided to individuals with developmental disabilities or if such accrediting or
18 certifying organization does not accredit or certify the service or duty.
21 25-04-02.1. Accreditation of life skills and transition center.
22 The department of health and human services shall request appropriations and resources
23 sufficient to ensure maintenance of the life skills and transition center's accreditation by the
24 accreditation council on services for people with developmental disabilities and certification by
25 the health care financing administration and, if deemed necessary, by similar accrediting and
26 certifying organizations and agencies possessing standards applicable to an individual with a
27 developmental disability and disciplines needed to provide quality services to individuals
28 served.
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1 25-04-04. Who may receive benefits of life skills and transition center.
2 Subject to this chapter and to any rules adopted by the department of health and human
3 services, the benefits of the life skills and transition center may be received by:
4 1. Individuals with developmental disabilities and other individuals who may benefit from
5 services provided at the life skills and transition center who, in the opinion of the
6 superintendent of the life skills and transition center are of suitable age and capacity to
7 receive instruction in the center and whose deficiencies prevent them from receiving
8 proper training and instruction in the public schools;
10 services provided at the life skills and transition center who cannot be properly cared
11 for in their homes or other available facilities; or
13 onsite and offsite services provided or duties effectuated by the life skills and transition
14 center.
15 Residents and nonresidents of this state may receive the benefits of the life skills and transition
16 center. Priority, however, must be given to residents of this state and first priority must be given
17 to individuals with developmental disabilities.
20 25-04-05. Qualifications for admission to state facility - Screening required prior to
21 admission or readmission - Educational or related services without charge for persons
22 twenty-one years of age and under.
23 1. The superintendent may admit a person to the life skills and transition center when all
24 of the following conditions have been met:
25 a. Application for admission has been made on behalf of the person by a parent or
26 guardian or the person or agency having legal custody, or by the person seeking
27 admission, in accordance with procedures established by the department of
29 b. A comprehensive evaluation of the person has been made within three months of
30 the date of application, a report of which has been filed with the superintendent
31 and which, together with such other information or reviews as the department of
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1 health and human services may require, indicates to the superintendent's

2 satisfaction that the person is eligible for admission to the life skills and transition
3 center.
4 c. The person may be admitted without exceeding the resident capacity of the
5 facility as specified in the professional standards adopted by the department of
7 2. No person may be admitted or readmitted to the life skills and transition center unless
8 that person has undergone a screening process at the life skills and transition center
9 to determine whether the admission or readmission is appropriate. Length of stay
10 criteria may be established under rules as the department of health and human
11 services may adopt. Any person who is suspected of being able to benefit from the
12 services offered at the center may be screened to ascertain whether or not that person
13 is actually a proper case for care, treatment, and training at the life skills and transition
14 center. If in the opinion of the superintendent the person screened under this
15 subsection is a proper subject for institutional care, treatment, and training at the life
16 skills and transition center, that person may remain as a voluntary resident at the
17 center at the discretion of the superintendent if all other conditions for admission
18 required by this section are met.
19 3. Notwithstanding any other provision of this chapter, no handicapped patient,
20 twenty-one years of age or under, or the estate or the parent of such patient, may be
21 charged for educational or related services provided at the life skills and transition
22 center. Except as provided in subsection 4, the department of health and human
23 services has prior claim on all benefits accruing to such patients for medical and
24 medically related services under entitlement from the federal government, medical or
25 hospital insurance contracts, workforce safety and insurance, or medical care and
26 disability programs. For purposes of this subsection, "related services" means
27 transportation and such developmental, corrective, and other supportive services, as
28 determined by the department of public instruction, as are required to assist a
29 handicapped patient to benefit from special education. The cost of related services
30 other than medical and medically related services must be paid by the life skills and
31 transition center, the school district of residence of the handicapped child, and other
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1 appropriate state agencies and political subdivisions of this state. The department of
2 public instruction, the department of health and human services, the school district of
3 residence, and other appropriate state agencies and political subdivisions, as
4 determined by the department of public instruction, shall determine and agree to that
5 portion of related services, other than medical and medically related services, for
6 which each agency and political subdivision is liable. The department of public
7 instruction may adopt rules necessary to implement this section.
8 4. Parents of an individual with a developmental disability, who is twenty-one years of
9 age or under, are not required to file, assist in filing, agree to filing, or assign an
10 insurance claim when filing the claim would pose a realistic threat that the parents
11 would suffer a financial loss not incurred by similarly situated parents of children with
12 disabilities. Financial losses do not include incidental costs such as the time needed to
13 file or assist in filing an insurance claim or the postage needed to mail the claim.
14 Financial losses include:
15 a. A decrease in available lifetime coverage or any other benefit under an insurance
16 policy.
17 b. An increase in premiums or the discontinuation of a policy.
18 c. An out-of-pocket expense such as the payment of a deductible amount incurred
19 in filing a claim unless the life skills and transition center pays or waives the
20 out-of-pocket expense.
23 1. The superintendent shall have the right of temporary transfer of any resident of the life
24 skills and transition center to an appropriate hospital or other specialized facility when
25 in the superintendent's opinion the immediate health and safety of the resident
26 requires the transfer. The superintendent shall also have the right and responsibility of
27 indefinite transfer of a resident from one state facility for individuals with
28 developmental disabilities to another when the best interest of the resident will be
29 served thereby, or when the transfer is required in conformity with the policies of the
30 department of health and human services; provided, however, that no transfer may be
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1 effected until all reasonable efforts have been made to consult with the resident's
2 parent or guardian of the person.
5 3. The person is admitted on indefinite transfer to a hospital, school, or other facility, or a
6 protective service under the jurisdiction of another state, or another agency or
7 department of this state; provided, however, that if such admission be by contractual
8 arrangement made by the department of health and human services, the person must
9 be placed on nonresident release status, but not discharged.
12 25-04-08.1. Notification before discharge.
13 Before discharge the superintendent shall consult with the parent or guardian of the person
14 to be discharged, or with the court that ordered the commitment, and shall notify the director of
15 the county social service board or human service zone of the county in which it is proposed that
16 such person will assume residence and also shall notify the executive director of the
20 25-04-11. Disposition of person who is not a legal resident.
21 If a person who has no legal residence in this state is subject to admission to the life skills
22 and transition center or other appropriate state facility, by order of a court of competent
23 jurisdiction, such person must be sent, at the expense of the county or human service zone, to
24 the life skills and transition center in the same manner as a resident of this state who is found to
25 be in need of services offered at the life skills and transition center, and the superintendent of
26 the life skills and transition center shall then arrange for the transportation of such person to the
27 place where the person belongs. The department of health and human services shall ascertain
28 the place where such person belongs when the same conveniently can be done.
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1 25-04-14. Expenses chargeable against patient or patient's estate - Filing claims.

2 Expenses for care and treatment of each patient at the life skills and transition center must,
3 if practicable, be in accordance with the cost of providing care and treatment for the different
4 degrees or conditions of mental and physical health and charges may be adjusted in
5 accordance with the patient's ability to pay which must include an estimate of potential future
6 receipts, including amounts from estates. The supervising department shall recover from the
7 patient or from a discharged patient expenses chargeable for care and treatment. If any patient
8 is receiving social security benefits or is a veteran or a dependent of a veteran who has
9 received, is receiving, or is entitled to receive compensation or pension from the veterans'
10 administration, the expenses are a current claim against the patient and may be recovered
11 monthly by the supervising department except that any amount required by the payer of the
12 benefits to be paid directly to the patient must, upon approval of the department of health and
13 human services, be credited to the patient's personal account from any money thus received.
16 2. No real property belonging to the estate may be sold during the lifetime of the patient
17 except for the maintenance and support of the patient's dependents, unless it is shown
18 that the sale of the property will not result in undue hardship to those dependents, and
19 it may be sold only upon the order of the district court having jurisdiction of the estate,
20 with the consent of the department of health and human services.
23 5. As used in this chapter, "supervising department" means the department of health and
24 human services.
27 25-11-02. Compact administrator - Powers.
28 Pursuant to said compact, the executive director of the department of health and human
29 services must be the compact administrator and who, acting jointly with like officers of other
30 party states, may adopt rules to carry out more effectively the terms of the compact. The
31 compact administrator shall cooperate with all departments, agencies, and officers of and in the
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1 government of this state and its subdivisions in facilitating the proper administration of the
2 compact or any supplementary agreement or agreements entered into by this state thereunder.
5 25-14-02. StateDepartment of health officerand human services shall administer
6 compact.
7 The statedepartment of health officer is hereby authorized toand human services may
8 negotiate and enter into contracts on behalf of the state pursuant to article III of the compact
9 and may perform such contracts; provided that no funds, personnel, facilities, equipment,
10 supplies, or materials shall be pledged, committed, or used on account of any such contract
11 unless legally available therefor.
17 25-16-07. Records of treatment or care center confidential.
18 Except as otherwise authorized by law, an agent of the department of human services or
19 the superintendent of the life skills and transition center or the licensee or their agents or
20 employees may not disclose the contents of the individual records of a treatment or care center
21 for individuals with a developmental disability, nor of the reports received from those records,
22 except:
23 1. In a judicial proceeding when ordered by the presiding judge;
24 2. To a law enforcement official for a law enforcement purpose or any other legally
25 constituted boards or agencies serving the interests of the residents for treatment,
26 payment, or health care operations, to arrange, facilitate, or coordinate service to any
27 such person;
28 3. To the parents or legal guardians of the resident;
29 4. To a physician to aid in the treatment of an individual within the fourth degree of
30 consanguinity of a deceased resident, if the disclosure is limited to genetic health
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1 information that has a direct bearing on the health of the relative, the relative's child, or
2 the relative's decision to have a child; or
3 5. To an individual who is within the fourth degree of consanguinity of a deceased
4 resident, if the disclosure is limited to information about a resident needed to establish
5 a family's genealogy.
8 25-16-12. Efforts to obtain private and governmental grants.
9 The department of human services and the duly licensed treatment or care centers for
10 individuals with a developmental disability may exert all possible efforts to obtain grants, both
11 private and governmental, for the care, custody, treatment, training, and education of individuals
12 with a developmental disability.
18 25-16.2-01. Work activity center - Definition.
19 As used in this chapter "work activity center" means a facility, licensed by the department of
20 health and human services, which is located in the state and operated by a nonprofit
21 corporation organized for the primary purpose of employing and providing rehabilitative
22 activities for individuals with physical disabilities, developmental disabilities, or chronic mental
23 illnesses.
26 25-17-00.1. Definitions.
27 As used in this chapter, unless the context otherwise requires:
28 1. "Confirmatory-diagnostic testing" means testing to prove or disprove the presence of a
29 specific metabolic disease or genetic disease.
30 2. "Confirmatory-diagnostic testing laboratory" means a laboratory performing
31 confirmatory-diagnostic testing.
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2 4. "Licensed clinician" means a currently licensed physician, physician assistant, or
3 advanced practice registered nurse.
4 5. "Low-protein modified food product" means a food product that is specially formulated
5 to have less than one gram of protein per serving and is intended to be used under the
6 direction of a licensed clinician for the dietary treatment of a metabolic disease. The
7 term does not include a natural food that is naturally low in protein.
8 6. "Medical food" means a food that is intended for the dietary treatment of a disease or
9 condition for which nutritional requirements are established by medical evaluation and
10 is formulated to be consumed or administered under the direction of a licensed
11 clinician.
12 7. "Metabolic disease" and "genetic disease" mean a disease as designated by rule of
13 the state health councildepartment for which early identification and timely intervention
14 will lead to a significant reduction in mortality, morbidity, and associated disabilities.
15 8. "Newborn screening program" means a program facilitating access to appropriate
16 testing, followup, diagnosis, intervention, management, evaluation, and education
17 regarding metabolic diseases and genetic diseases identified in newborns.
18 9. "Out-of-range screening result" means a screening result that is outside of the
19 expected range of testing results established for a particular disease.
20 10. "Responsible clinician" means the licensed clinician, midwife, naturopath, or birth
21 attendant attending a newborn.
22 11. "Screening" means initial testing of a newborn for the possible presence of metabolic
23 disease or genetic disease.
24 12. "Screening laboratory" means the laboratory the department selects to perform
25 screening.
28 25-17-01. Newborn screening education programs and tests.
29 The state department of health shall:
30 1. Develop and implement a metabolic disease and genetic disease educational program
31 among licensed clinicians, hospital staffs, public health nurses, and the citizens of this
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1 state. This educational program must include information about the nature of the
2 diseases and about screening for the early detection of these diseases so that proper
3 measures may be taken to reduce mortality, morbidity, and associated disabilities.
4 2. Provide, on a statewide basis, a newborn screening program.
5 3. Coordinate with or refer individuals to public and private health care service providers
6 for long-term followup services for metabolic diseases and genetic diseases.
7 4. Select a screening laboratory.
8 5. Store, maintain, and dispose of blood spots used for screening.
11 25-17-02. Rulemaking requirement.
12 The state health councildepartment shall adopt rules necessary to implement this chapter.
15 25-17-03. Treatment for positive diagnosis - Registry of cases.
16 The state department of health shall:
17 1. Notify responsible clinicians regarding cases with out-of-range screening results or
18 positive confirmatory-diagnostic testing results in order to facilitate access to
19 appropriate treatment. If the responsible clinician is not a licensed clinician, the
20 responsible clinician shall refer the patient to a licensed clinician for appropriate
21 followup care.
22 2. Refer every diagnosed case of a metabolic disease or genetic disease to a licensed
23 clinician for necessary treatment.
24 3. Maintain a registry of cases of metabolic diseases and genetic diseases.
25 4. Provide medical food at no cost to males under age twenty-six and females under age
26 forty-five who are diagnosed with phenylketonuria or maple syrup urine disease,
27 regardless of income. If treatment services under this subsection are provided to an
28 individual by the department, the department may seek reimbursement from any
29 government program that provides coverage to that individual for the treatment
30 services provided by the department.
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1 5. Offer for sale at cost medical food to females age forty-five and over and to males age
2 twenty-six and over who are diagnosed with phenylketonuria or maple syrup urine
3 disease, regardless of income. These individuals are responsible for payment to the
4 department for the cost of medical food.
5 6. Provide low-protein modified food products, if medically necessary as determined by a
6 qualified health care provider, to females under age forty-five and males under age
7 twenty-six who are receiving medical assistance and are diagnosed with
8 phenylketonuria or maple syrup urine disease.
11 25-17-06. Pulse oximetry screening for critical congenital heart defects - Exception.
12 Before discharge of a newborn child born in a hospital with a birthing center, the newborn
13 child must receive a pulse oximetry screening for critical congenital heart defects. The
14 screening requirement of this section does not apply if the parents or guardians of a newborn
15 child object to the screening. The state department of health shall provide medical staff and
16 facilities that provide birthing services with notice regarding this screening requirement. For
17 purposes of this chapter, pulse oximetry screening is not a test under section 25-17-05 and a
18 congenital heart defect detected by screening under this section is not a metabolic disease or
19 genetic disease as those terms are used under this chapter.
23 SECTION 313. AMENDMENT. Subdivision b of subsection 1 of section 26.1-02-28 of the
25 b. "Department" means the department of health and human services and any
26 designee of the department.
27 SECTION 314. AMENDMENT. Subdivision b of subsection 9 of section 26.1-26.4-02 of the
29 b. An agent acting on behalf of the federal government or the department of health
30 and human services, but only to the extent that the agent is providing services to
31 the federal government or the department of health and human services.
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3 2. a. The benefits must be provided for each of the following services: inpatient
4 treatment, treatment by partial hospitalization, residential treatment, and
5 outpatient treatment.
6 b. In the case of benefits provided for inpatient treatment, the benefits must be
7 provided for a minimum of forty-five days of services covered under this section
8 and section 26.1-36-08 in any calendar year if provided by a hospital as defined
9 under section 52-01-01 and rules of the state department of health and human
10 services pursuant thereto offering treatment for the prevention or cure of mental
11 disorder or other related illness. An insurance provider may require an
12 individualized treatment plan from the inpatient treatment service provider which
13 indicates that the course of treatment is the most appropriate and least restrictive
14 form of treatment available in the community.
15 c. In the case of benefits provided for partial hospitalization, the benefits must be
16 provided for a minimum of one hundred twenty days of services covered under
17 this section and section 26.1-36-08 in any calendar year. Partial hospitalization
18 must be provided by a hospital as defined under section 52-01-01 and rules of
19 the state department of health and human services pursuant thereto or by a
20 regional human service center licensed under section 50-06-05.2, offering
21 treatment for the prevention or cure of mental disorder or other related illness.
22 For services provided in regional human service centers, charges must be
23 reasonably similar to the charges for care provided by hospitals as defined in this
24 subsection.
25 d. In the case of benefits provided for residential treatment, the benefits must be
26 provided for a minimum of one hundred twenty days of services covered under
27 this section in any calendar year. Residential treatment services must be
28 provided by a hospital as defined under section 52-01-01 and rules of the state
29 department of health and human services; by a regional human service center
30 licensed under section 50-06-05.2 offering treatment for the prevention or cure of
31 mental disorder or other related illness; or by a residential treatment program. For
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1 services provided in a regional human service center, charges must be

2 reasonably similar to the charges for care provided by a hospital as defined in
3 this subsection.
4 e. Any individual receiving residential treatment services who requires residential
5 treatment service beyond the minimum of one hundred twenty days may trade
6 unused inpatient treatment benefits provided for under subdivision b. For the
7 purpose of computing the period for which benefits are payable, each day of
8 inpatient treatment is equivalent to two days of treatment by a residential
9 treatment program; provided, however, that no more than twenty-three days of
10 the inpatient treatment benefits required by this section may be traded for
11 residential treatment services.
12 f. (1) In the case of benefits provided for outpatient treatment, the benefits must
13 be provided for a minimum of thirty hours for services covered under this
14 section in any calendar year if the treatment services are provided within the
15 scope of licensure by a nurse who holds advanced licensure with a scope of
16 practice within mental health or if the diagnosis, evaluation, and treatment
17 services are provided within the scope of licensure by a licensed physician,
18 a licensed psychologist who is eligible for listing on the national register of
19 health service providers in psychology, a licensed professional clinical
20 counselor who is qualified in the clinical mental health counseling specialty
21 in this state, or a licensed independent clinical social worker.
22 (2) A person who is qualified for third-party payment by the board of social work
23 examiners on August 1, 1997, is exempt from paragraph 1.
24 (3) Upon the request of an insurance company, a nonprofit health service
25 corporation, or a health maintenance organization, the North Dakota board
26 of social work examiners shall provide to the requesting entity information to
27 certify that a licensed certified social worker meets the qualifications
28 required under this section.
29 (4) The insurance company, nonprofit health service corporation, or health
30 maintenance organization may not establish a deductible or a copayment
31 for the first five hours in any calendar year, and may not establish a
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1 copayment greater than twenty percent for the remaining hours. The
2 deductible limitation of this paragraph does not apply to a high-deductible
3 health plan used to establish a health savings account pursuant to and as
4 defined in section 223 of the Internal Revenue Code [26 U.S.C. 223].
5 (5) If the services are provided by a provider outside a preferred provider
6 network without a referral from within the network, the insurance company,
7 nonprofit health service corporation, or health maintenance organization
8 may establish a copayment greater than twenty percent for only those hours
9 after the first five hours in any calendar year.
10 g. "Partial hospitalization" means continuous treatment for at least three hours, but
11 not more than twelve hours, in any twenty-four-hour period and includes the
12 medically necessary treatment services provided by licensed professionals under
13 the supervision of a licensed physician.
14 h. "Residential treatment" has the same meaning as provided in section 25-03.2-01,
15 but only applies to individuals under twenty-one years of age.
16 SECTION 316. AMENDMENT. Subsection 4 of section 26.1-36-09.7 of the North Dakota
18 4. This section does not require medical benefits coverage for low-protein modified food
19 products or medical food for an individual to the extent those benefits are available to
20 that individual under a state department of health or department ofand human services
21 program.
22 SECTION 317. AMENDMENT. Subdivision b of subsection 1 of section 26.1-36-09.10 of
23 the North Dakota Century Code is amended and reenacted as follows:
24 b. "Prehospital emergency medical services" means a service or its personnel either
25 licensed under chapter 23-27 or certified by the state department of health and
26 human services.
29 1. Any provision in any individual or group accident and health insurance policy,
30 employee welfare benefit plan, or nonprofit health service contract issued by any
31 insurance company, group health plan as defined in section 607(1) of the Employee
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1 Retirement Income Security Act of 1974 [Pub. L. 99-272; 100 Stat. 281; 29 U.S.C.
2 1167(1)], or nonprofit health service corporation denying or prohibiting the insured,
3 participant, beneficiary, or subscriber from assigning to the department of health and
4 human services any rights to medical benefits coverage to which the insured,
5 participant, beneficiary, or subscriber is entitled under the policy, plan, or contract is
6 void. An individual or group insurance company or nonprofit health service corporation
7 shall recognize the assignment of medical benefits coverage completed by the
8 insured, participant, beneficiary, or subscriber, notwithstanding any provision
9 contained in the policy or contract to the contrary.
10 SECTION 319. AMENDMENT. Subsection 2 of section 26.1-36-12.2 of the North Dakota
12 2. Notwithstanding the provisions of subsection 1, the department of health and human
13 services may exclude, from participation in the medical assistance program
14 administered under chapter 50-24.1 and title XIX of the Social Security Act
15 [Pub. L. 89-97; 79 Stat. 343; 42 U.S.C. 1396 et seq.], as amended, any provider of
16 pharmacy services who does not agree to comply with state and federal requirements
17 governing the program, or who, after so agreeing, fails to comply with those
18 requirements.
21 26.1-36-30. Individual or group accident and health insurer or nonprofit health service
22 corporation responsibility - Release of information to department of health and human
23 services.
24 1. Any individual or group accident and health insurer or nonprofit health service
25 corporation, upon request of the department of health and human services, shall
26 provide any information contained in its records pertaining to an individual who is an
27 applicant for or recipient of medical assistance under chapter 50-24.1, and who is
28 covered under an accident and health insurance policy or a health service contract
29 issued by the insurer or nonprofit health service corporation or the medical benefits
30 paid by or claims paid to the insured or subscriber under a policy or contract. The
31 insurer or nonprofit health service corporation shall make the requested records or
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1 information available upon receipt of a certification by the department of health and

2 human services that the individual is an applicant for or recipient of medical assistance
3 under chapter 50-24.1, or is a person who is legally responsible for the applicant or
4 recipient.
5 2. The information required to be made available pursuant to this section is limited to
6 information necessary to determine whether benefits under the policy or contract have
7 been or should have been claimed and paid pursuant to an accident and health
8 insurance policy or health service contract with respect to items of medical care and
9 services received by a particular individual for which medical assistance coverage
10 would otherwise be available.
11 3. The department of health and human services shall, in consultation with the
12 commissioner, establish guidelines:
13 a. For the method of requesting and furnishing appropriate information, the time in
14 which the information is to be provided, and method of reimbursing insurance
15 companies and nonprofit health service corporations for necessary costs incurred
16 in furnishing the requested information.
17 b. To assure that information relating to an individual certified to be an applicant for
18 or recipient of medical assistance under chapter 50-24.1, furnished to an insurer
19 or subscriber pursuant to this section, is used only for the purpose of identifying
20 the records or information requested in such manner so as not to violate section
21 50-06-15.
24 1. Regardless of whether a resident of this state has or is eligible for health insurance
25 coverage under a health insurance policy, health service contract, or evidence of
26 coverage by or through an employer or under a plan sponsored by the state or federal
27 government, the resident is not required to obtain or maintain a policy of individual
28 health coverage except as may be required by a court or by the department of health
29 and human services through a court or administrative proceeding.
30 SECTION 322. AMENDMENT. Subsection 2 of section 26.1-36.5-03 of the North Dakota
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1 2. If a parent fails to provide health coverage for any child, enroll the child under family
2 coverage upon application by the child's other parent or by the department of health
3 and human services;
4 SECTION 323. AMENDMENT. Subsection 2 of section 26.1-36.5-04 of the North Dakota
6 2. Permit the custodial parent, the provider of health care, with the custodial parent's
7 approval, or the department of health and human services, as the custodial parent's
8 assignee, to submit claims for covered services without the approval of the
9 noncustodial parent; and
12 26.1-45-13. Qualified service providers.
13 Any insurance company providing long-term care coverage for home and community-based
14 services shall pay a provider meeting qualified service provider standards a daily payment
15 allowance as defined in the policy or certificate. "Qualified service provider" means a human
16 service zone or independent contractor that agrees to meet standards for personal attendant
17 care service as established by the department of health and human services.
20 26.1-47-01. Definitions.
21 As used in this chapter, unless the context indicates otherwise:
22 1. "Air ambulance" means a specially equipped aircraft licensed by the state department
23 of health and human services for transporting patients.
24 2. "Air ambulance provider" means a publicly or privately owned organization that is
25 licensed or applies for licensure by the state department of health and human services
26 to provide transportation and care of patients by air ambulance.
27 3. "Commissioner" means the insurance commissioner of the state of North Dakota.
28 4. "Covered person" means any person on whose behalf the health care insurer is
29 obligated to pay for or provide health care services.
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1 5. "Health benefit plan" means the health insurance policy or subscriber agreement
2 between the covered person or the policyholder and the health care insurer which
3 defines the services covered.
4 6. "Health care insurer" includes an insurance company as defined in section 26.1-02-01,
5 a health service corporation as defined in section 26.1-17-01, a health maintenance
6 organization as defined in section 26.1-18.1-01, and a fraternal benefit society as
7 defined in section 26.1-15.1-02.
8 7. "Health care provider" means licensed providers of health care services in this state.
9 8. "Health care services" means services rendered or products sold by a health care
10 provider within the scope of the provider's license. The term includes hospital, medical,
11 surgical, dental, vision, chiropractic, and pharmaceutical services or products.
12 9. "In-network payment" means a full and final payment for air ambulance services
13 pursuant to a network plan.
14 10. "Network" means a group of preferred providers providing services under a network
15 plan.
16 11. "Network plan" means a health benefit plan that requires a covered person to use, or
17 creates incentives, including financial incentives, for a covered person to use health
18 care providers managed by, owned by, under contract with, or employed by the health
19 care insurer.
20 12. "Out-of-network" means a provider that is not providing the service under a network
21 plan.
22 13. "Preferred provider" means a duly licensed health care provider or group of providers
23 who have contracted with the health care insurer, under this chapter, to provide health
24 care services to covered persons under a health benefit plan.
25 14. "Preferred provider arrangement" means a contract between the health care insurer
26 and one or more health care providers which complies with all the requirements of this
27 chapter.
28 Definitions. (Contingent effective date - See note) As used in this chapter, unless the
29 context indicates otherwise:
30 1. "Air ambulance" means a specially equipped aircraft licensed by the state department
31 of health and human services for transporting patients.
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1 2. "Air ambulance provider" means a publicly or privately owned organization that is

2 licensed or applies for licensure by the state department of health and human services
3 to provide transportation and care of patients by air ambulance.
4 3. "Authorized representative" means:
5 a. A person to which a covered person has given express written consent to
6 represent the covered person;
7 b. A person authorized by law to provide substituted consent for a covered person;
8 or
9 c. If a covered person is unable to provide consent, the covered person's treating
10 health care professional or a family member of the covered person.
11 4. "Balance billing" means the practice of an air ambulance provider billing for the
12 difference between the air ambulance provider's charge and the health care insurer's
13 allowed amount.
14 5. "Commissioner" means the insurance commissioner of the state of North Dakota.
15 6. "Covered person" means an individual on whose behalf the health care insurer is
16 obligated to pay for or provide health care services.
17 7. "Facility" means an institution or other immobile health care setting providing physical,
18 mental, or behavioral health care services.
19 8. "Health benefit plan" means the health insurance policy or subscriber agreement
20 between the covered person or the policyholder and the health care insurer which
21 defines the services covered.
22 9. "Health care insurer" includes an insurance company as defined in section 26.1-02-01,
23 a health service corporation as defined in section 26.1-17-01, a health maintenance
24 organization as defined in section 26.1-18.1-01, and a fraternal benefit society as
25 defined in section 26.1-15.1-02.
26 10. "Health care provider" means licensed providers of health care services in this state.
27 11. "Health care services" means services rendered or products sold by a health care
28 provider within the scope of the provider's license. The term includes hospital, medical,
29 surgical, dental, vision, chiropractic, and pharmaceutical services or products.
30 12. "Network" means a group of preferred providers providing services under a network
31 plan.
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1 13. "Network plan" means a health benefit plan that requires a covered person to use, or
2 creates incentives, including financial incentives, for a covered person to use health
3 care providers managed by, owned by, under contract with, or employed by the health
4 care insurer.
5 14. "Out-of-network" means a provider that is not providing the service under a network
6 plan.
7 15. "Preferred provider" means a duly licensed health care provider or group of providers
8 who have contracted with the health care insurer, under this chapter, to provide health
9 care services to covered persons under a health benefit plan.
10 16. "Preferred provider arrangement" means a contract between the health care insurer
11 and one or more health care providers which complies with all the requirements of this
12 chapter.
13 17. "Prior authorization" means confirmation by the covered person's health care insurer
14 that the air ambulance services sought to be provided by the air ambulance provider
15 meet the criteria for coverage under the covered person's health benefit plan as
16 defined by the provisions of the covered person's health benefit plan.
19 26.1-47-10. Preferred provider arrangements - Requirements for accessing air
20 ambulance providers. (Contingent effective date - See note)
21 1. In addition to the other preferred provider arrangement requirements under this
22 chapter, a preferred provider arrangement must require the health care insurer and
23 health care provider comply with this section.
24 2. Except as otherwise provided under this section, before a health care provider
25 arranges for air ambulance services for an individual the health care provider knows to
26 be a covered person, the health care provider shall request a prior authorization from
27 the covered person's health care insurer for the air ambulance services to be provided
28 to the covered person. If the health care provider is unable to request or obtain prior
29 authorization from the covered person's health care insurer:
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1 a. The health care provider shall provide the covered person or the covered
2 person's authorized representative an out-of-network services written disclosure
3 stating the following:
4 (1) Certain air ambulance providers may be called upon to render care to the
5 covered person during the course of treatment;
6 (2) These air ambulance providers might not have contracts with the covered
7 person's health care insurer and are, therefore, considered to be out of
8 network;
9 (3) If these air ambulance providers do not have contracts with the covered
10 person's health care insurer, the air ambulance services will be provided on
11 an out-of-network basis;
12 (4) A description of the range of the charges for the out-of-network air
13 ambulance services for which the covered person may be responsible;
14 (5) A notification the covered person or the covered person's authorized
15 representative may agree to accept and pay the charges for the
16 out-of-network air ambulance services, contact the covered person's health
17 care insurer for additional assistance, or rely on other rights and remedies
18 that may be available under state or federal law; and
19 (6) A statement indicating the covered person or the covered person's
20 authorized representative may obtain a list of air ambulance providers from
21 the covered person's health care insurer which are preferred providers and
22 the covered person or the covered person's representative may request
23 those participating air ambulance providers be accessed by the health care
24 provider.
25 b. Before air ambulance services are accessed for the covered person, the health
26 care provider shall provide the covered person or the covered person's
27 authorized representative the written disclosure, as outlined by subdivision a and
28 obtain the covered person's or the covered person's authorized representative's
29 signature on the disclosure document acknowledging the covered person or the
30 covered person's authorized representative received the disclosure document
31 before the air ambulance services were accessed. If the health care provider is
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1 unable to provide the written disclosure or obtain the signature required under
2 this subdivision, the health care provider shall document the reason, which may
3 include the health and safety of the patient. The health care provider
4 documentation satisfies the requirement under this subdivision.
5 3. This section does not:
6 a. Preclude a covered person from agreeing to accept and pay the charges for the
7 out-of-network services and not access the covered person's health care
8 insurer's out-of-network air ambulance billing process described under this
9 section.
10 b. Preclude a covered person from agreeing to accept and pay the bill received
11 from the out-of-network air ambulance provider or from not accessing the air
12 ambulance provider mediation process described under this section.
13 c. Regulate an out-of-network air ambulance provider's ability to charge certain fees
14 for services or to charge any amount of fee for services provided to a covered
15 person by the out-of-network air ambulance provider.
16 4. A health care insurer shall develop a program for payment of out-of-network air
17 ambulance bills submitted under this section. A health benefit plan may not be issued
18 in this state without the terms of the health benefit plan including the provisions of the
19 health care insurer's program for payment of out-of-network air ambulance bills.
20 a. A health care insurer may elect to pay out-of-network air ambulance provider bills
21 as submitted, or the health care insurer may elect to use the out-of-network air
22 ambulance provider mediation process described in subsection 5.
23 b. This section does not preclude a health care insurer and an out-of-network facility
24 air ambulance provider from agreeing to a separate payment arrangement.
25 5. A health care insurer shall establish an air ambulance provider mediation process for
26 payment of out-of-network air ambulance provider bills. A health benefit plan may not
27 be issued in this state if the terms of the health benefit plan do not include the
28 provisions of the health care insurer's air ambulance provider mediation process for
29 payment of out-of-network air ambulance provider bills.
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1 a. A health care insurer's air ambulance provider mediation process must be

2 established in accordance with mediation standards recognized by the
3 department by rule.
4 b. If the health care insurer and the out-of-network air ambulance provider agree to
5 a separate payment arrangement or if the covered person agrees to accept and
6 pay the out-of-network air ambulance provider's charges for the out-of-network
7 services, compliance with the air ambulance provider mediation process is not
8 required.
9 c. A health care insurer shall maintain records on all requests for mediation and
10 completed mediation under this subsection for one year and, upon request of the
11 commissioner, submit a report to the commissioner in the format specified by the
12 commissioner.
13 6. The rights and remedies provided under this section to covered persons are in
14 addition to and may not preempt any other rights and remedies available to covered
15 persons under state or federal law.
16 7. The department shall enforce this section and shall report a violation of this section by
17 a facility to the state department of health and human services.
18 8. This section does not apply to a policy or certificate of insurance, whether written on a
19 group or individual basis, which provides coverage limited to:
20 a. A specified disease, a specified accident, or accident-only coverage;
21 b. Credit;
22 c. Dental;
23 d. Disability;
24 e. Hospital;
25 f. Long-term care insurance as defined by chapter 26.1-45;
26 g. Vision care or any other limited supplemental benefit;
27 h. A Medicare supplement policy of insurance, as defined by the commissioner by
28 rule or coverage under a plan through Medicare;
29 i. Medicaid;
30 j. The federal employees health benefits program and any coverage issued as a
31 supplement to that coverage;
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1 k. Coverage issued as supplemental to liability insurance, workers' compensation,

2 or similar insurance; or
3 l. Automobile medical payment insurance.
4 9. The commissioner may adopt rules to implement this section.
7 26.1-54-01. American health benefit exchange.
8 To ensure that an American health benefit exchange is created in the state, the
9 commissioner and the department of health and human services shall:
10 1. Plan for the implementation of an American health benefit exchange for the state that
11 facilitates the purchase of qualified health benefit plans; provides for the establishment
12 of a small business health options program that is designed to assist qualified small
13 employers in facilitating the enrollment of their employees in qualified health benefit
14 plans offered in the small group market; implements eligibility determination and
15 enrollment of individuals in the state's medical assistance program and the state's
16 children's health insurance program; provides simplification; provides coordination
17 among medical assistance, the children's health insurance program, and the state
18 health insurance exchange; and meets the requirements of the Patient Protection and
19 Affordable Care Act of 2010 [Pub. L. 111-148] as amended by the Health Care and
20 Education Reconciliation Act of 2010 [Pub. L. 111-152]. The legislative assembly may
21 consider establishing one exchange that will provide services to both qualified
22 individuals and qualified small employers;
23 2. Subject to section 3 of chapter 225 of the 2011 Session Laws, take all actions
24 necessary to ensure that the exchange is determined, not later than January 1, 2013,
25 by the federal government to be ready to operate not later than January 1, 2014, and
26 that the exchange is operating on or after January 1, 2014;
27 3. Subject to section 3 of chapter 225 of the 2011 Session Laws, consider whether to
28 seek federal grant funds for the planning and implementation of the exchange and
29 administer all funds appropriated or made available for the purpose of carrying out the
30 provisions of this chapter;
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1 4. Subject to section 3 of chapter 225 of the 2011 Session Laws, contract with outside
2 entities as necessary to provide services necessary to implement the exchange; and
3 5. Collaborate with the information technology department as necessary and appropriate
4 in completing the responsibilities set forth in this section.
7 26.1-54-02. Rules.
8 The commissioner and the department of health and human services may adopt rules
9 necessary or desirable to carry out the provisions of this chapter.
12 26.1-54-03. Cooperation of state agencies.
13 State agencies shall cooperate with the commissioner and the department of health and
14 human services to ensure the success of the exchange.
17 26.1-54-04. Records.
18 Notwithstanding any provision of this code making records confidential, the commissioner
19 or the commissioner's designee and the department of health and human services may receive
20 from and provide to federal and state agencies information gathered in the administration of the
21 exchange, including social security numbers, if the disclosure is necessary for the
22 commissioner, the department of health and human services, or the receiving entity to perform
23 its duties and responsibilities.
26 27-20-11. Venue.
27 A proceeding under this chapter may be commenced in the county in which the child
28 resides. A proceeding under section 27-20-30.1 must be commenced in the county within the
29 administrative human service zone, as determined by the department of health and human
30 services. If delinquent or unruly conduct is alleged, the proceeding may be commenced in the
31 county in which the acts constituting the alleged delinquent or unruly conduct occurred. If
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1 deprivation is alleged, the proceeding may be brought in the county in which the child is present
2 when it is commenced, the county in which the child has resided the majority of the thirty days
3 prior to the date of the alleged deprivation, or the county where the alleged deprivation has
4 occurred. The court shall determine the appropriate venue for a deprivation action based upon
5 the best interests of the child.
6 SECTION 332. AMENDMENT. Subdivision c of subsection 7 of section 27-20-20.1 of the
8 c. "Department" means the department of health and human services or its
9 designee, including any county social service board.
12 27-20-30.1. Disposition of child needing continued foster care services.
13 1. For purposes of this section, "child" means an individual between the ages of eighteen
14 and twenty-one years who is in need of continued foster care services.
15 2. A petition to commence an action under this section must contain information as
16 required by supreme court rule along with an affidavit either prepared by the
17 administrative human service zone, as determined by the department of health and
18 human services, or prepared by an agency or tribal council of a recognized Indian
19 reservation in North Dakota.
20 3. The court shall issue a summons in accordance with section 27-20-22 upon the filing
21 of a petition and affidavit.
22 4. If a child is in need of continued foster care services as determined by the human
23 service zone and the department of health and human services and as set forth in a
24 continued foster care agreement, the court shall make the following judicial
25 determination:
26 a. That the child is not deprived, delinquent, or unruly but is in need of continued
27 foster care services;
28 b. That the child will remain in or will return to foster care pursuant to the child's
29 continued foster care agreement;
30 c. That the child's continued foster care agreement has been willfully entered
31 between:
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1 (1) The human service zone and the department of health and human services
2 or its agent, the child, and the foster care provider; or
3 (2) An agency or tribal council of a recognized Indian reservation in North
4 Dakota if the child is not subject to the jurisdiction of the state of North
5 Dakota, the child, and the foster care provider;
6 d. That it is in the best interest of the child to remain in or return to foster care;
7 e. That reasonable efforts were made in accordance with subsection 7 of section
8 27-20-32.2;
9 f. That the child has attained the age of eighteen or older but does not exceed the
10 age of twenty-one years;
11 g. That the child has satisfied the education, employment, or disability requirements
12 under the Fostering Connections to Success and Increasing Adoptions Act of
13 2008 [Pub. L. 110-351] and as set forth by the department of health and human
14 services;
15 h. That the administrative human service zone, as determined by the department, or
16 that an agency or tribal council of a recognized Indian reservation in North
17 Dakota, shall continue foster care case management, unless otherwise agreed to
18 or required by the department;
19 i. That the administrative human service zone or an agency or tribal council of a
20 recognized Indian reservation in North Dakota must have care and placement
21 responsibility of the child;
22 j. That permanency hearing must be as set forth in section 27-20-36; and
23 k. That there are no grounds to file a petition to terminate parental rights under
24 chapter 27-20.
25 5. Pursuant to rule 16 of the North Dakota Rules of Juvenile Procedure, a court may
26 modify or vacate the judicial determination made under subsection 4.
29 7. At least ten days before the petition is heard, the clerk of district court or juvenile court
30 shall provide a copy of the petition and summons, if any, to the human service zone
31 and the department of health and human services.
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3 1. Except as provided in this section, all files and records of the juvenile court, whether in
4 the office of the clerk of district court or juvenile court, of a proceeding under this
5 chapter are closed to the public. Juvenile court files and records are open to
6 inspection only by:
7 a. The judge and staff of the juvenile court.
8 b. The parties to the proceeding or their counsel or the guardian ad litem of any
9 party.
10 c. A public or private agency or institution providing supervision or having custody of
11 the child under order of the juvenile court, which must be given a copy of the
12 findings and order of disposition when it receives custody of the child.
13 d. Any court and its probation and other officials or professional staff and the
14 attorney for the defendant for use in preparing a presentence report in a criminal
15 case in which the defendant is convicted and who, prior to the criminal case, had
16 been a party to the proceeding in juvenile court.
17 e. The professional staff of the uniform crime victims compensation program when
18 necessary for the discharge of their duties pursuant to chapter 54-23.4.
19 f. A staff member of the division of children and family services of the department of
20 health and human services or a law enforcement officer when necessary for the
21 performance of that person's duties under section 50-11.1-06.2 or the National
22 Child Protection Act of 1993 [Pub. L. 103-209; 107 Stat. 2490; 42 U.S.C. 5119 et
23 seq.].
24 g. An employee or agent of the department of health and human services when
25 necessary for performance of that individual's duty under chapter 50-11 or
26 50-11.1 to investigate the background of an individual living or working in the
27 facility, home, or residence for which licensure is sought.
28 h. A criminal justice agency if the juvenile is required to register under section
29 12.1-32-15.
30 i. The staff of a children's advocacy center if the juvenile or a victim of the juvenile
31 has been referred for or has received services at the children's advocacy center.
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1 j. A victim of the delinquent child or the victim's guardian. All records including
2 medical, educational, and school information must be redacted before inspection.
3 For purposes of this subdivision, only records pertaining to the specific offense
4 between the victim and the delinquent child may be inspected.
7 2. Upon the final destruction of a file or record, the proceeding must be treated as if it
8 never occurred. The juvenile court shall notify each agency named in the file or record
9 of the destruction. All index references, except those which may be made by the
10 attorney general and the directors of the department of transportation, the department
11 of health and human services, the department of corrections and rehabilitation, the
12 commission on legal counsel for indigents and its public defender offices, law
13 enforcement agencies, and human service zones, must be deleted. Each agency,
14 except the attorney general and the directors of the department of transportation, the
15 department of health and human services, the department of corrections and
16 rehabilitation, the commission on legal counsel for indigents and its public defender
17 offices, law enforcement agencies, and human service zones, upon notification of the
18 destruction of a file or record, shall destroy all files, records, and references to the
19 child's apprehension, detention, and referral to the juvenile court and any record of
20 disposition made by the juvenile court. The attorney general, the department of health
21 and human services, the department of corrections and rehabilitation, the commission
22 on legal counsel for indigents and its public defender offices, law enforcement
23 agencies, and human service zones may not keep a juvenile file or record longer than
24 is required by the records retention policy of that official, department, or agency. Upon
25 inquiry in any matter the child, the court, and representatives of agencies, except the
26 attorney general and the directors of the department of transportation, the department
27 of health and human services, the department of corrections and rehabilitation, law
28 enforcement agencies, and human service zones, shall properly reply that no record
29 exists with respect to the child.
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1 27-21-09. Cooperation with other agencies and departments of the state - Right to
2 inspect facilities of state institutions - Right to examine children.
3 The division of juvenile services shall cooperate with and receive the cooperation of the
4 department of health and human services, the department of public instruction, the department
5 of career and technical education, the juvenile courts, the state department of health, and such
6 other agencies and departments of the state as may be necessary to carry out the objectives of
7 this chapter. The division of juvenile services may inspect at all reasonable times the facilities of
8 those institutions within the state it is authorized to utilize under this chapter, and may examine
9 any child it has placed in the care of such institution, and may contract with public and private
10 agencies to provide services for them or to retain from them required services to meet the
11 purpose and objective of this chapter.
12 SECTION 338. AMENDMENT. Subdivision d of subsection 2 of section 27-21-12 of the
14 d. The department of health and human services or a human service zone.
17 28-21-05.2. Department of health and human services may issue executions for child
18 support arrearages.
19 1. Notwithstanding section 28-21-05, if the judgment debtor is listed on the arrears
20 registry as defined in section 14-09-09.10, or if the judgment debtor meets criteria
21 established by the secretary of the United States department of health and human
22 services that apply when a financial institution is doing business in two or more states,
23 the department of health and human services may issue an execution, against the
24 property of the judgment debtor, to the sheriff of any county in which the property may
25 be found.
26 2. A writ of execution issued by the department of health and human services must be
27 issued as provided in section 28-21-06, except the past-due support need not be
28 docketed and the writ may be issued in a form prescribed by the department of health
29 and human services. A writ issued under this section must be accompanied by a copy
30 of the payment records maintained under section 50-09-02.1 which has been certified
31 under section 14-08.1-08.
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1 3. A writ issued by the department of health and human services is returnable to the
2 department.
5 30-16-04. Descent and distribution of real property subject to homestead estate.
6 The real property subjected to the homestead estate descends, subject to the full
7 satisfaction of that estate, exempt from decedent's debts except claims in favor of the county for
8 county general assistance, the department of health and human services for general
9 assistance, and also for claims of the state of North Dakota for repayment of old-age assistance
10 and aid to the permanently and totally disabled and as otherwise provided in section 47-18-04,
11 and must be distributed in the manner in which real property not subjected to a homestead
12 estate is distributed or as directed in the decedent's will. The real property constituting the
13 homestead of a decedent, or any part thereof, may not descend or be distributed to any person
14 other than the surviving spouse and decedent's heirs in the direct descending line as prescribed
15 in title 30.1 until all the decedent's debts are fully paid.
19 As used in sections 32-03-48 through 32-03-50, unless the context otherwise requires:
20 1. "Critical incident" means any event encountered by emergency service personnel
21 within the scope of their employment which causes them to experience unusually
22 strong emotional reactions that have the potential to interfere with their ability to
23 perform their jobs or that may interfere with their personal lives.
24 2. "Critical incident stress debriefing" means the process of resolving the effects of
25 critical incidents on emergency service personnel through a structured meeting with
26 both psychological and educational components according to the model approved by
27 the state department of health and human services.
28 3. "Critical incident stress management team" means those volunteers who are
29 recognized by the state department of health and human services as members of an
30 organized group that provides critical incident stress debriefing services on behalf of
31 the state.
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1 4. "Emergency service personnel" means individuals who provide emergency services to

2 persons requiring medical aid, firefighting services, law enforcement assistance, or
3 other emergency assistance. The term includes law enforcement officers, firefighters,
4 rescue personnel, ambulance personnel, quick response personnel, emergency
5 service dispatchers, nurses, physicians, and other emergency care providers.
6 5. "Peer support personnel" means those members of a critical incident stress
7 management team who are emergency service personnel and who have completed
8 appropriate training approved by the state department of health and human services.
11 32-37-05. Fees paid by petitioner - Filing copy of judgment.
12 The petitioner, upon the filing of the petition, must pay to the clerk of the district court a filing
13 fee as prescribed in subsection 1 of section 27-05.2-03. The cost of the publication of the notice
14 required by this chapter shall be paid by the petitioner. In the event that said judgment shall
15 establish the date and place of birth of the petitioner, the clerk of the court shall certify a copy of
16 such judgment and file the same with the division of vital statistics, state department of health
17 and human services, Bismarck, North Dakota.
20 (3) An individual, firm, corporation, limited liability company, or association
21 licensed or certified by the department of health and human services to
22 provide employment related services, to the extent the employment-related
23 services are being provided for the clientele identified by the department in
24 the issuance of the license or certificate.
30 2. Upon request by the person confiscating the animal, the board, the state department
31 of health and human services, the game and fish department, any county sheriff's
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1 office, city police department, or other peace officer may provide assistance in any
2 action to seize, impound, confiscate, or quarantine any animal suspected of being held
3 or possessed in violation of this title.
7 In this chapter, unless the context otherwise requires:
8 1. "Disaster relief organization" means an entity that provides emergency or disaster
9 relief services that include health or veterinary services provided by volunteer health
10 practitioners and which:
11 a. Is designated or recognized as a provider of those services pursuant to a disaster
12 response and recovery plan adopted by an agency of the federal government,
13 the state department of health and human services, or the state board of animal
14 health; or
15 b. Regularly plans and conducts its activities in coordination with an agency of the
16 federal government, the state department of health and human services, or the
17 state board of animal health.
18 2. "Emergency" means an event or condition that is a disaster or an emergency as
19 defined under chapter 37-17.1 and any event, condition, or incident for which the
20 deployment of volunteer health practitioners is determined to be necessary by the
21 state health officer, a local board of health, or the state veterinarian.
22 3. "Emergency declaration" means a declaration or proclamation of disaster or
23 emergency issued by the governor.
24 4. "Emergency management assistance compact" means the interstate compact
25 approved by Congress by Public Law No. 104-321 [110 Stat. 3877].
26 5. "Entity" means a person other than an individual.
27 6. "Health facility" means an entity licensed under the laws of this or another state to
28 provide health or veterinary services.
29 7. "Health practitioner" means an individual licensed under the laws of this or another
30 state to provide health or veterinary services and any other individual performing
31 nonmedical support disaster or emergency responsibilities or duties at any place in
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1 this state subject to the order or control of, or pursuant to a request of, the state
2 department of health and human services or a local public health unit and deployed
3 through the emergency system for advance registration of volunteer health
4 professionals.
5 8. "Health services" means the provision of treatment, care, advice or guidance, or other
6 services, or supplies related to the health or death of individuals or human
7 populations, to the extent necessary to respond to an emergency, including:
8 a. The following, concerning the physical or mental condition or functional status of
9 an individual or affecting the structure or function of the body:
10 (1) Preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative
11 care; and
12 (2) Counseling, assessment, procedures, or other services;
13 b. Sale or dispensing of a drug, a device, equipment, or another item to an
14 individual in accordance with a prescription; and
15 c. Funeral, cremation, cemetery, or other mortuary services.
16 9. "Host entity" means an entity operating in this state which uses volunteer health
17 practitioners to respond to an emergency.
18 10. "License" means authorization by a state to engage in health or veterinary services
19 that are unlawful without the authorization. The term includes authorization under the
20 laws of this state to an individual to provide health or veterinary services based upon a
21 national certification issued by a public or private entity.
22 11. "Scope of practice" means the extent of the authorization to provide health or
23 veterinary services granted to a health practitioner by a license issued to the
24 practitioner in the state in which the principal part of the practitioner's services are
25 rendered, including any conditions imposed by the licensing authority.
26 12. "Veterinary services" means the provision of treatment, care, advice or guidance, or
27 other services, or supplies related to the health or death of an animal or animal
28 populations, to the extent necessary to respond to an emergency, including:
29 a. Diagnosing, treating, or preventing an animal disease, injury, or other physical or
30 mental condition by prescribing, administering, or dispensing vaccine, medicine,
31 surgery, or therapy;
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1 b. Using a procedure for reproductive management; and

2 c. Monitoring and treating animal populations for diseases that have spread or
3 demonstrate the potential to spread to humans.
4 13. "Volunteer health practitioner" means a health practitioner who provides health or
5 veterinary services, whether or not the practitioner receives compensation for those
6 services. The term does not include a practitioner who receives compensation
7 pursuant to a pre-existing employment relationship with a host entity or affiliate which
8 requires the practitioner to provide health services in this state, unless the practitioner
9 is not a resident of this state and is employed by a disaster relief organization
10 providing services in this state during an emergency.
13 37-17.4-03. Regulation of services during emergencies.
14 1. During an emergency, the state department of health and human services or the state
15 board of animal health may limit, restrict, or otherwise regulate:
16 a. The duration of practice by volunteer health practitioners;
17 b. The geographical areas in which volunteer health practitioners may practice;
18 c. The types of volunteer health practitioners who may practice; and
19 d. Any other matters necessary to coordinate effectively the provision of health or
20 veterinary services during the emergency.
21 2. An order issued under subsection 1 may take effect immediately, without prior notice
22 or comment, and is not a rule within the meaning of chapter 28-32.
23 3. A host entity that uses volunteer health practitioners to provide health or veterinary
24 services in this state shall:
25 a. Consult and coordinate its activities with the state department of health and
26 human services or the state board of animal health to the extent practicable to
27 provide for the efficient and effective use of volunteer health practitioners; and
28 b. Comply with any laws other than this chapter relating to the management of
29 emergency health or veterinary services, including chapters 23-27 and 43-29.
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1 37-17.4-04. Volunteer health practitioner registration systems.

2 1. In the case of a volunteer health practitioner whose principal practice is located in this
3 state and who is licensed by a North Dakota professional board or agency, the
4 volunteer health practitioner registration system is the emergency system for advance
5 registration of volunteer health professionals and is maintained by the state
6 department of health and human services and is known as the public health
7 emergency volunteer medical reserve corps.
8 2. In the case of a volunteer health practitioner who is not covered under subsection 1,
9 the volunteer health practitioner registration system is the system established under
10 subsection 1 or a system that qualifies under this subsection. To qualify as a volunteer
11 health practitioner registration system under this subsection, a system must:
12 a. Accept applications for the registration of volunteer health practitioners before or
13 during an emergency;
14 b. Include information about the licensure and good standing of health practitioners
15 which is accessible by authorized persons;
16 c. Be capable of confirming the accuracy of information concerning whether a
17 health practitioner is licensed and in good standing before health services or
18 veterinary services are provided under this chapter; and
19 d. Meet one of the following conditions:
20 (1) Be an emergency system for advance registration of volunteer health-care
21 practitioners established by a state and funded through the United States
22 department of health and human services under section 319I of the Public
23 Health Services Act [42 U.S.C. 247d-7b];
24 (2) Be a local unit consisting of trained and equipped emergency response,
25 public health, and medical personnel formed pursuant to section 2801 of the
26 Public Health Services Act [42 U.S.C. 300hh]; or
27 (3) Be operated by a:
28 (a) Disaster relief organization;
29 (b) Licensing board;
30 (c) National or regional association of licensing boards or health
31 practitioners;
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1 (d) Health facility that provides comprehensive inpatient and outpatient

2 health care services, including a tertiary care and teaching hospital; or
3 (e) Governmental entity.
4 3. During an emergency, the state department of health and human services, a person
5 authorized to act on behalf of the state department of health and human services, or a
6 host entity may confirm whether volunteer health practitioners utilized in this state are
7 registered with a registration system that complies with subsection 1 or 2.
8 Confirmation is limited to obtaining identities of the practitioners from the system and
9 determining whether the system indicates that the practitioners are licensed and in
10 good standing.
11 4. Upon request of a person in this state authorized under subsection 3, or a similarly
12 authorized person in another state, a registration system located in this state shall
13 notify the person of the identities of volunteer health practitioners and whether the
14 practitioners are licensed and in good standing.
15 5. A host entity is not required to use the services of a volunteer health practitioner even
16 if the practitioner is registered with a registration system that indicates that the
17 practitioner is licensed and in good standing.
20 3. The state department of health and human services or the state board of animal health
21 may modify or restrict the health or veterinary services that volunteer health
22 practitioners may provide pursuant to this chapter. An order under this subsection may
23 take effect immediately, without prior notice or comment, and is not a rule within the
24 meaning of chapter 28-32.
27 37-17.4-09. Regulatory authority.
28 The department of health counciland human services may adopt rules to implement this
29 chapter. In doing so, the health councildepartment shall consult with and consider rules adopted
30 by similarly empowered agencies in other states to promote uniformity of application of this
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1 chapter and make the emergency response systems in the various states reasonably
2 compatible.
6 In this title, unless the context or subject matter otherwise requires:
7 1. "Appropriate licensed addiction treatment program" means an addiction treatment
8 program conducted by an addiction facility licensed by the department of health and
9 human services or conducted by a licensed individual specifically trained in addiction
10 treatment.
11 2. "Authorized emergency vehicles":
12 a. "Class A" authorized emergency vehicles means:
13 (1) Vehicles of a governmentally owned fire department.
14 (2) Vehicles when operated by or under the control of a police officer having
15 authority to enforce the provisions of this title or by a salaried employee of a
16 municipal police department within the municipality or by a sheriff or deputy
17 sheriff not including special deputy sheriffs, or by the director of the
18 department of corrections and rehabilitation and the director's authorized
19 agents who have successfully completed training in the operation of class A
20 authorized emergency vehicles.
21 (3) Vehicles clearly identifiable as property of the department of corrections and
22 rehabilitation when operated or under the control of the director of the
23 department of corrections and rehabilitation.
24 (4) Ambulances and other vehicles authorized by licensure granted under
25 chapter 23-27.
26 (5) Vehicles operated by or under the control of the director, district deputy
27 director, or a district deputy game warden of the game and fish department.
28 (6) Vehicles owned or leased by the United States and used for law
29 enforcement purposes.
30 (7) Vehicles designated for the use of the adjutant general or assistant adjutant
31 general in cases of emergency.
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1 (8) Vehicles operated by or under the control of the director of the parks and
2 recreation department.
3 (9) Vehicles operated by or under the control of a licensed railroad police officer
4 and used for law enforcement purposes.
5 (10) Vehicles operated by or under the control of the state forester.
6 (11) Vehicles operated by or under the control of the bureau of criminal
7 investigation and used for law enforcement purposes.
8 (12) Vehicles operated by or under the state department of health and human
9 services in cases of emergencies.
10 b. "Class B" authorized emergency vehicles means wreckers and such other
11 emergency vehicles as are authorized by the local authorities.
12 c. "Class C" authorized emergency vehicles means:
13 (1) Vehicles used by the state division of homeland security or local division of
14 emergency management organizations.
15 (2) Vehicles used by volunteer firefighters while performing their assigned
16 disaster and emergency responsibilities.
17 (3) Vehicles, other than ambulances, used by emergency medical services
18 personnel.
19 3. "Bicycle" means every device propelled solely by human power upon which any
20 person may ride, having two tandem wheels either of which is more than twenty
21 inches [50.8 centimeters] in diameter.
22 4. "Bus" means every motor vehicle designed for carrying more than ten passengers and
23 used for the transportation of persons, and every motor vehicle, other than a taxicab,
24 designed and used for the transportation of persons for compensation. Provided,
25 every motor vehicle designed for carrying not more than fifteen persons and used for a
26 ridesharing arrangement, as defined in section 8-02-07, is not a "bus".
27 5. "Business district" means the territory contiguous to a highway when fifty percent or
28 more of the frontage thereon for a distance of three hundred feet [91.44 meters] or
29 more is occupied by buildings in use for business.
30 6. "Camping trailer" means a vehicular portable unit mounted on wheels and constructed
31 with collapsible partial side walls that fold for towing by another vehicle and unfold at
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1 the campsite to provide temporary living quarters for recreational, camping, or travel
2 use.
3 7. "Cancellation" means a license is annulled and terminated because of an error or
4 defect or because the licensee is no longer entitled to the operator's license, but the
5 cancellation of a license is without prejudice and application for a new license may be
6 made at any time after the cancellation.
7 8. "Child restraint system" means a specifically designed device, built-in seating system,
8 or belt-positioning booster that meets the federal motor vehicle safety standards and is
9 permanently affixed to a motor vehicle, is affixed to the vehicle by a safety belt or
10 universal attachment system, or is combined with a federally compliant safety belt
11 system.
12 9. "Commercial freighting" means the carriage of things other than passengers, for hire,
13 except that such term does not include:
14 a. The carriage of things other than passengers within the limits of the same city;
15 b. Carriage by local dray lines of baggage or goods to or from a railroad station from
16 or to places in such city or in the immediate vicinity thereof, in this state, and not
17 to exceed two miles [3.22 kilometers] from the corporate or recognized limits of
18 said city; or
19 c. Hauling done by farmers for their neighbors in transporting agricultural products
20 to or from market.
21 10. "Commercial passenger transportation" means the carriage of passengers for hire,
22 except that the term does not include:
23 a. The carriage of passengers within the limits of a city.
24 b. The carriage by local buslines of passengers to or from a railroad station from or
25 to places within any city or within two miles [3.22 kilometers] of the limits of the
26 city.
27 c. The carriage of passengers under a ridesharing arrangement, as defined in
28 section 8-02-07.
29 11. "Commissioner" means the director of the department of transportation of this state,
30 acting directly or through authorized agents as provided by section 24-02-01.3.
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1 12. "Controlled-access highway" means every highway, street, or roadway in respect to

2 which owners or occupants of abutting lands and other persons have no legal right of
3 access to or from the same except at such points only and in such manner as may be
4 determined by the public authority having jurisdiction over such highway, street, or
5 roadway.
6 13. "Conviction" means a final order or judgment or conviction by the North Dakota
7 supreme court, any lower court having jurisdiction, a tribal court, or a court in another
8 state if an appeal is not pending and the time for filing a notice of appeal has elapsed.
9 Subject to the filing of an appeal, the term includes:
10 a. An imposed and suspended sentence;
11 b. A deferred imposition of sentence under subsection 4 of section 12.1-32-02; or
12 c. A forfeiture of bail or collateral deposited to secure a defendant's appearance in
13 court and the forfeiture has not been vacated.
14 14. "Crosswalk" means that part of a roadway at an intersection included within the
15 connections of the lateral lines of the sidewalks on opposite sides of the highway
16 measured from the curbs, or, in the absence of curbs, from the edges of the
17 traversable roadway; or any portion of a roadway at an intersection or elsewhere
18 distinctly indicated for pedestrian crossing by lines or other markings on the surface.
19 15. "Dealer" means every person, partnership, corporation, or limited liability company
20 engaged in the business of buying, selling, or exchanging motor vehicles, or who
21 advertises, or holds out to the public as engaged in the buying, selling, or exchanging
22 of motor vehicles, or who engages in the buying of motor vehicles for resale. Any
23 person, partnership, corporation, limited liability company, or association doing
24 business in several cities or in several locations within a city must be considered a
25 separate dealer in each such location.
26 16. "Department" means the department of transportation of this state as provided by
27 section 24-02-01.1.
28 17. "Director" means the director of the department of transportation of this state as
29 provided by section 24-02-01.3.
30 18. "Driver" means every person who drives or is in actual physical control of a vehicle.
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1 19. "Electronic communication device" means an electronic device, including a wireless

2 telephone, personal digital assistant, a portable or mobile computer or other device,
3 and video display equipment. The term does not include a global positioning system or
4 navigation system or a device that is physically or electronically integrated into the
5 motor vehicle.
6 20. "Essential parts" means all integral and body parts of a vehicle of a type required to be
7 registered hereunder, the removal, alteration, or substitution of which would tend to
8 conceal the identity of the vehicle or substantially alter its appearance, model, type, or
9 mode of operation and includes all integral parts and body parts, the removal,
10 alteration, or substitution of which will tend to conceal the identity or substantially alter
11 the appearance of the vehicle.
12 21. "Explosives" means any chemical compound or mechanical mixture that is commonly
13 used or intended for the purpose of producing an explosion and which contains any
14 oxidizing and combustive units or other ingredients in such proportions, quantities, or
15 packing that an ignition by fire, by friction, by concussion, by percussion, or by
16 detonator of any part of the compound or mixture may cause such a sudden
17 generation of highly heated gases that the resultant gaseous pressures are capable of
18 producing destructive effects on contiguous objects or by destroying life or limb.
19 22. "Farm tractor" includes every motor vehicle designed and used primarily as a farm
20 implement for drawing plows, moving machines, and other implements of husbandry.
21 23. "Farm trailer" includes those trailers and semitrailers towed by a bona fide resident
22 farmer hauling the farmer's own agricultural, horticultural, dairy, and other farm
23 products if the gross weight, not including the towing vehicle, does not exceed
24 twenty-four thousand pounds [10886.22 kilograms].
25 24. "Fifth-wheel travel trailer" means a vehicular unit mounted on wheels, designed to
26 provide temporary living quarters for recreational, camping, or travel use, of such size
27 or weight as not to require a special highway movement permit and designed to be
28 towed by a motorized vehicle that contains a towing mechanism that is mounted
29 above or forward of the tow vehicle's rear axle.
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1 25. "Flammable liquid" means any liquid which has a flash point of seventy degrees
2 Fahrenheit [21.11 degrees Celsius], or less, as determined by a tagliabue or
3 equivalent closed-cup test device.
4 26. "Foreign vehicle" means every motor vehicle which is brought into this state other than
5 in the ordinary course of business by or through a manufacturer or dealer and which
6 has not been registered in this state.
7 27. "Gross weight" means the weight of a vehicle without load plus the weight of any load
8 thereon.
9 28. "Guest" means and includes a person who accepts a ride in any vehicle without giving
10 compensation therefor.
11 29. "Highway" means the entire width between the boundary lines of every way publicly
12 maintained when any part thereof is open to the use of the public for purposes of
13 vehicular travel and of every way privately maintained within a mobile home park,
14 trailer park, or campground containing five or more lots for occupancy by mobile
15 homes, travel trailers, or tents when any part thereof is open for purposes of vehicular
16 travel.
17 30. "House car" or "motor home" means a motor vehicle which has been reconstructed or
18 manufactured primarily for private use as a temporary or recreational dwelling and
19 having at least four of the following permanently installed systems:
20 a. Cooking facilities.
21 b. Icebox or mechanical refrigerator.
22 c. Potable water supply including plumbing and a sink with faucet either
23 self-contained or with connections for an external source, or both.
24 d. Self-contained toilet or a toilet connected to a plumbing system with connection
25 for external water disposal, or both.
26 e. Heating or air-conditioning system, or both, separate from the vehicle engine or
27 the vehicle engine electrical system.
28 f. A 110-115 volt alternating current electrical system separate from the vehicle
29 engine electrical system either with its own power supply or with a connection for
30 an external source, or both, or a liquefied petroleum system and supply.
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1 31. "Implement of husbandry" means every vehicle designed and adapted exclusively for
2 agricultural, horticultural, or livestock raising operations or for lifting or carrying an
3 implement of husbandry and in either case not subject to registration if used upon the
4 highway.
5 32. "Intersection" means the area embraced within the prolongation or connection of the
6 lateral curb lines, or, if none, then the lateral boundary lines of the roadways of two
7 highways which join one another at, or approximately at, right angles, or the area
8 within which vehicles traveling upon different highways joining at any other angle may
9 come in conflict. Where a highway includes two roadways thirty feet [9.14 meters] or
10 more apart, then every crossing of each roadway of such divided highway by an
11 intersecting highway must be regarded as a separate intersection. In the event such
12 intersecting highway also includes two roadways thirty feet [9.14 meters] or more
13 apart, then every crossing of two roadways of such highways must be regarded as a
14 separate intersection.
15 33. "Intoxicating liquor" means and includes any beverage containing alcohol.
16 34. "Judgment" means any judgment which has become final by expiration without appeal
17 of the time within which an appeal might have been perfected, or by final affirmation
18 on appeal, rendered by a court of competent jurisdiction of any state of the United
19 States, upon a claim for relief arising out of ownership, maintenance, or use of any
20 motor vehicle, for damages, including damages for care and loss of services, because
21 of bodily injury to or death of any person, or for damages because of injury to or
22 destruction of property, including the loss of use thereof, or upon a claim for relief on
23 an agreement of settlement for such damages.
24 35. "Legal owner" means a person who holds the legal title to a vehicle.
25 36. "Licensed health care provider" means doctor of medicine, doctor of osteopathy,
26 doctor of chiropractic, optometrist, psychologist, advanced practice registered nurse,
27 or physician assistant who is licensed, certified, or registered in accordance with laws
28 and regulations in this or another state.
29 37. "Lienholder" means a person holding a security interest in a vehicle.
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1 38. "Local authorities" includes every county, municipal, and other local board or body
2 having authority to adopt local police regulations under the constitution and laws of
3 this state.
4 39. "Mail" means to deposit mail properly addressed and with postage prepaid with the
5 United States postal service.
6 40. "Manifest injustice" means a specific finding by the court that the imposition of
7 sentence is unreasonably harsh or shocking to the conscience of a reasonable
8 person, with due consideration of the totality of circumstances.
9 41. "Manufactured home" means a structure, transportable in one or more sections, that,
10 in the traveling mode, is eight body feet [2.44 meters] or more in width or forty body
11 feet [12.19 meters] or more in length, or, when erected onsite, is three hundred twenty
12 square feet [29.73 square meters] or more, and which is built on a permanent chassis
13 and designed to be used as a dwelling with or without a permanent foundation when
14 connected to the required utilities, and includes the plumbing, heating, air-conditioning,
15 and electrical systems contained therein. The term includes any structure that meets
16 all of the requirements of this subsection except the size requirements and with
17 respect to whether the manufacturer voluntarily files a certification required by the
18 United States secretary of housing and urban development and complies with the
19 standards established under title 42 of the United States Code.
20 42. "Manufacturer" means any person who manufactures, assembles, or imports and sells
21 new motor vehicles to new motor vehicle dealers for resale in the state; but such term
22 does not include a person who assembles or specially builds interior equipment on a
23 completed vehicle supplied by another manufacturer, distributor, or supplier.
24 43. "Metal tires" includes all tires the surface of which in contact with the highway is wholly
25 or partly of metal or other hard, nonresilient material except that this provision does
26 not apply to pneumatic tires.
27 44. "Mobile home" means a structure, either single or multisectional, which is built on a
28 permanent chassis, ordinarily designed for human living quarters, either on a
29 temporary or permanent basis, owned or used as a residence or place of business of
30 the owner or occupant, which is either attached to utility services or is twenty-seven
31 feet [8.23 meters] or more in length.
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1 45. "Modular unit" includes every factory fabricated transportable building unit designed to
2 be incorporated with similar units at a building site into a modular structure to be used
3 for residential, commercial, educational, or industrial purposes.
4 46. "Motor vehicle" includes every vehicle that is self-propelled, every vehicle that is
5 propelled by electric power obtained from overhead trolley wires, but not operated
6 upon rails, and, for purposes of motor vehicle registration, title registration, and
7 operator's licenses, motorized bicycles. The term does not include a snowmobile as
8 defined in section 39-24-01.
9 47. "Motorcycle" means every motor vehicle having a seat or saddle for the use of the
10 rider and designed to travel on not more than three wheels in contact with the ground,
11 but excluding implements of husbandry.
12 48. "Motorized bicycle" means a vehicle equipped with two or three wheels, foot pedals to
13 permit muscular propulsion or footrests for use by the operator, a power source
14 providing up to a maximum of two brake horsepower having a maximum piston or
15 rotor displacement of 3.05 cubic inches [49.98 milliliters] if a combustion engine is
16 used, which will propel the vehicle, unassisted, at a speed not to exceed thirty miles
17 [48.28 kilometers] per hour on a level road surface, and a power drive system that
18 functions directly or automatically only, not requiring clutching or shifting by the
19 operator after the drive system is engaged, and the vehicle may not have a width
20 greater than thirty-two inches [81.28 centimeters].
21 49. "Motor-powered recreational vehicle" means a motorcycle, unconventional vehicle, or
22 off-highway vehicle as defined in section 39-29-01, or a snowmobile as defined in
23 section 39-24-01.
24 50. "Nonresident" means any person who is not a resident of this state.
25 51. "Nonresident's operating privilege" means the privilege conferred upon a nonresident
26 by the laws of this state pertaining to the operation by such person of a motor vehicle,
27 or the use of a vehicle owned by such person, in this state.
28 52. "Official traffic-control devices" means all signs, signals, markings, and devices not
29 inconsistent with this title placed or erected by authority of a public body or official
30 having jurisdiction, for the purpose of regulating, warning, or guiding traffic.
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1 53. "Operator" means every person who drives or is in actual physical control of a motor
2 vehicle upon a highway or who is exercising control over or steering a vehicle being
3 towed by a motor vehicle.
4 54. "Operator's license", "driver's license", or "license to operate a motor vehicle" means
5 any operator's or driver's license or any other license or permit to operate a motor
6 vehicle issued under, or granted by, the laws of this state, including:
7 a. Any temporary license or instruction permit;
8 b. The privilege of any person to drive a motor vehicle whether such person holds a
9 valid license; or
10 c. Any nonresident's operating privilege as defined in this section.
11 55. "Owner" means a person, other than a lienholder, having the property in or title to a
12 vehicle. The term includes a person entitled to the use and possession of a vehicle
13 subject to a security interest in another person, but excludes a lessee under a lease
14 not intended as security.
15 56. "Park", when prohibited, means the standing of a vehicle, whether occupied or not,
16 otherwise than temporarily for the purpose of and while actually engaged in loading or
17 unloading.
18 57. "Passenger motor vehicle" means every motor vehicle designed principally for the
19 transportation of persons and includes vehicles which utilize a truck chassis, but have
20 a seating capacity for four or more passengers.
21 58. "Pedestrian" means any person afoot.
22 59. "Person" includes every natural person, firm, copartnership, association, corporation,
23 or limited liability company.
24 60. "Pneumatic tires" includes all tires inflated with compressed air.
25 61. "Pole trailer" means every vehicle without motive power designed to be drawn by
26 another vehicle and attached to the towing vehicle by means of a reach, or pole, or by
27 being boomed or otherwise secured to the towing vehicle, and ordinarily used for
28 transporting long or irregularly shaped loads such as poles, pipes, or structural
29 members capable, generally, of sustaining themselves as beams between the
30 supporting connections.
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1 62. "Police officer" means every officer authorized to direct or regulate traffic or to make
2 arrests for violations of traffic regulations.
3 63. "Primary source identity document" means documentary evidence of an individual's
4 name, date of birth, and legal presence required in chapters 39-06 and 39-06.2 related
5 to the issuance of permits, licenses, and nondriver photo identification cards, and
6 retained in the driver record.
7 64. "Private road or driveway" means every way or place in private ownership and used
8 for vehicular travel by the owner and those having express or implied permission from
9 the owner, but not by other persons.
10 65. "Proof of financial responsibility" means proof of ability to respond in damages for
11 liability, on account of accidents occurring after the effective date of the proof, arising
12 out of the ownership, maintenance, or use of a motor vehicle, in the amount of
13 twenty-five thousand dollars because of bodily injury to or death of one person in any
14 one accident, and, subject to the limit for one person, in the amount of fifty thousand
15 dollars because of bodily injury to or death of two or more persons in any one
16 accident, and in the amount of twenty-five thousand dollars because of injury to or
17 destruction of property of others in any one accident.
18 66. "Railroad" means a carrier of persons or property upon cars, other than streetcars,
19 operated upon stationary rails.
20 67. "Railroad sign or signal" means any sign, signal, or device erected by authority of a
21 public body or official or by a railroad and intended to give notice of the presence of
22 railroad tracks or the approach of a railroad train.
23 68. "Reconstructed vehicle" means any vehicle, of a type required to be registered,
24 materially altered from its original construction by the removal, addition, or substitution
25 of new or used essential parts.
26 69. "Recreational vehicle" means any motorcycle not qualified for registration, off-highway
27 vehicle, snowmobile, vessel, or personal watercraft.
28 70. "Residence district" means territory contiguous to a highway not comprising a
29 business district, when the frontage on such highway for a distance of three hundred
30 feet [91.44 meters] or more is occupied mainly by dwellings, or by dwellings and
31 buildings in use for business.
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1 71. "Revocation" means that the operator's license is terminated and may not be renewed
2 or restored, except on application for a new license presented to and acted upon by
3 the director after the expiration of the period of revocation.
4 72. "Right of way" means the privilege of the immediate use of a roadway.
5 73. "Road tractor" means every motor vehicle designed and used for drawing other
6 vehicles and not so constructed as to carry any load thereon either independently or
7 any part of the weight of a vehicle or load so drawn.
8 74. "Roadway" means that portion of a highway improved, designed, or ordinarily used for
9 vehicular travel, exclusive of the berm or shoulder. In the event a highway includes two
10 or more separate roadways, the term "roadway" as used herein refers to any such
11 roadway separately but not to all such roadways collectively.
12 75. "Saddle mount" means placing the front wheels of the drawn vehicle upon the bed of
13 the drawing vehicle.
14 76. "Safety zone" means the area or space officially set aside within a highway for the
15 exclusive use of pedestrians and which is so plainly marked or indicated by proper
16 signs as to be plainly visible at all times while set aside as a safety zone.
17 77. "Salvage certificate of title" means a document issued by the department for purposes
18 of proof of ownership of a salvage or destroyed vehicle and not acceptable for motor
19 vehicle registration purposes.
20 78. "Schoolbus" means a commercial motor vehicle used to transport preprimary, primary,
21 or secondary school students from home to school, from school to home, or to and
22 from school-related events. For the purposes of chapter 39-21, "schoolbus" means
23 any motor vehicle that is owned or leased by a public or governmental agency and
24 used to transport primary or secondary school students to or from school or to or from
25 school-related events, or is privately owned and operated for compensation to
26 transport primary or secondary school students to or from school or to or from
27 school-related events. Schoolbus does not include a bus used as a common carrier.
28 79. "Semitrailer" includes every vehicle of the trailer type so designed and used in
29 conjunction with a truck or truck tractor that some part of its own weight and that of its
30 own load rests upon or is carried by a truck or truck tractor, except that it does not
31 include a "housetrailer" or "mobile home".
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1 80. "Sidewalk" means that portion of a street between the curb lines, or the lateral lines of
2 a roadway, and the adjacent property lines, intended for use of pedestrians.
3 81. "Solid tire" includes every tire made of rubber or other resilient material other than a
4 pneumatic tire.
5 82. "Special mobile equipment" means every vehicle not designed or used primarily for
6 the transportation of persons or property and only incidentally operated or moved over
7 a highway.
8 83. "Specially constructed vehicle" means any vehicle which was not constructed
9 originally under the distinct name, make, model, or type by a generally recognized
10 manufacturer of vehicles.
11 84. "Stand" or "standing" means the halting of a vehicle, whether occupied or not,
12 otherwise than temporarily for the purpose of and while actually engaged in receiving
13 or discharging passengers.
14 85. "State" means a state, territory, or possession of the United States, the District of
15 Columbia, the Commonwealth of Puerto Rico, or a province of the Dominion of
16 Canada.
17 86. "Stop", when required, means complete cessation from movement.
18 87. "Stop" or "stopping", when prohibited, means any halting, even momentarily, of a
19 vehicle, whether occupied or not, except when necessary to avoid conflict with other
20 traffic or in compliance with the directions of a police officer or traffic-control sign or
21 signal.
22 88. "Street" means the entire width between boundary lines of every way publicly
23 maintained when any part thereof is open to the use of the public for purposes of
24 vehicular travel.
25 89. "Superintendent" means the superintendent of the North Dakota state highway patrol,
26 acting directly or through authorized employees of the superintendent.
27 90. "Suspension" means that the operator's license is temporarily withdrawn but only
28 during the period of the suspension.
29 91. "Through highway" means every highway or portion thereof on which vehicular traffic
30 is given preferential right of way, and at the entrances to which vehicular traffic from
31 intersecting highways is required by law to yield right of way to vehicles on such
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1 through highway and in obedience to either a stop sign or yield sign, when such signs
2 are erected by law.
3 92. "Trackless trolley coach" means every motor vehicle which is propelled by electric
4 power obtained from overhead trolley wires but not operated upon rails.
5 93. "Traffic" means pedestrians, ridden or herded animals, vehicles, streetcars, and other
6 conveyances either singly or together while using any highway for purposes of travel.
7 94. "Traffic-control signal" means any device, whether manually, electrically, or
8 mechanically operated, by which traffic is alternately directed to stop and to proceed.
9 95. "Trailer" includes every vehicle without motive power designed to carry property or
10 passengers wholly on its own structure and to be drawn by a motor vehicle, except
11 that it does not include a "housetrailer" or "mobile home", which terms mean a vehicle
12 as defined in this subsection which is designed and intended for use as living or
13 sleeping quarters for people and which is not used for commercial hauling of
14 passengers.
15 96. "Travel trailer" means a vehicular unit mounted on wheels, designed to provide
16 temporary living quarters for recreational, camping, or travel use, and of such size or
17 weight as not to require a special highway movement permit when towed by a
18 motorized vehicle.
19 97. "Truck" includes every motor vehicle designed, used, or maintained primarily for
20 transportation of property.
21 98. "Truck camper" means a portable unit that is constructed to provide temporary living
22 quarters for recreational, camping, or travel use; consists of a roof, floor, and sides;
23 and is designed to be loaded onto and unloaded from the bed of a pickup truck.
24 99. "Truck tractor" includes every motor vehicle designed and used primarily for drawing
25 other vehicles and not so constructed as to carry a load other than a part of the weight
26 of the vehicle and load so drawn.
27 100. "Urban district" means the territory contiguous to and including any street which is built
28 up with structures devoted to business, industry, or dwelling houses situated at
29 intervals of less than one hundred feet [30.48 meters] for a distance of a quarter of a
30 mile [402.34 meters] or more.
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1 101. "Used vehicle" means a motor vehicle which has been sold, bargained, exchanged,
2 given away, or the title to which has been transferred to another, by the person who
3 first acquired it from the manufacturer or importer, dealer, or agent of the manufacturer
4 or importer.
5 102. "Vehicle" includes every device in, upon, or by which any person or property may be
6 transported or drawn upon a public highway, except devices moved by human power
7 or used exclusively upon stationary rails or tracks.
10 5. Except as provided in this subsection, two dollars of each fee for issuance of a
11 certificate and one dollar of each fee for issuance of an additional certificate under this
12 section must be deposited in the state highway department fund for purposes of
13 defraying the cost of issuing the certificate. The rest of the fee, and the five dollar fee
14 received for the issuance of an additional certificate under subsection 4, must be
15 deposited in the state treasury and credited to the state rehabilitation council fund. The
16 fees deposited in the fund are hereby appropriated on a continuing basis to the
17 department of health and human services for use by the state rehabilitation council to
18 accomplish the council's statutory duties provided under section 50-06.1-16. If a
19 certificate is lost, mutilated, or destroyed, the individual to whom the certificate was
20 issued is entitled to a replacement. The individual shall furnish proof satisfactory to the
21 director that the certificate has been lost, mutilated, or destroyed, and shall pay a
22 replacement fee of three dollars.
25 39-01-19. Permits for vending machines at rest areas.
26 A vending machine that allows access to a tobacco product may not be placed or remain
27 upon a rest area, and any other vending machine may not be placed or remain upon a rest area
28 under the supervision of the director without a permit from the director. The director shall charge
29 a fee for the issuance of a vending machine permit. The amount of the permit fee must relate to
30 the department's actual cost of administration, annual review, and enforcement of the permit
31 process, but may not exceed twenty-five dollars annually. The permit process may not be
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1 affected by the content of a publication. The director shall require permittees to comply with
2 appropriate indemnification, insurance, and other risk management provisions of the permit.
3 Vending machines must be secured in a manner that prevents tipping and moving, deters theft,
4 and leaves state property undamaged. Plexiglass, safety glass, or other shatter-resistant
5 materials must be employed in windows or displays. All vending machines must be sufficiently
6 enclosed to prevent the distributed product from inadvertently being removed or blown from the
7 machine or weathered by the elements. Stolen or damaged vending machines do not result in
8 liability to the department and must be repaired, restored, or replaced within thirty calendar
9 days. All cashboxes and accesses to cashboxes must be metal and securely locked in place. All
10 vending machines must be placed in a well-lighted area visible from the rest area roadway. All
11 vending machines must be placed on a route allowing parallel access by motorized or standard
12 wheelchairs, with at least sixty-six inches [1676.400 millimeters] of clear width. A vending
13 machine may not have a component or function used by the public which requires more than
14 five pounds [2.268 kilograms] of force to be applied. The height of controls, doors, or access
15 points necessary for use by the public may not exceed sixty inches [1524 millimeters]. The
16 director may determine the maximum number of vending machine placements at a given rest
17 area. Priority must be given to vending machines placed pursuant to the Randolph Sheppard
18 Act [Pub. L. 74-732; 49 Stat. 1559; 20 U.S.C. 107], as administered by the vocational
19 rehabilitation division of the department of health and human services under section 50-06.1-13.
20 When, after allowing for the placement of vending machines pursuant to the Randolph
21 Sheppard Act [Pub. L. 74-732; 49 Stat. 1559; 20 U.S.C. 107], the director determines that the
22 number of permit applications for a particular rest area would exceed the remaining available
23 space or would prevent compliance with this section or other law, the director shall grant
24 permits by means of a lottery, with permits allocated pro rata according to the number of
25 applications for each type. The permittee is solely responsible to ensure that any trash,
26 wrapping, boxes, or debris, generated when stocking or servicing vending machines is not left
27 on or at the rest area. The permittee is solely responsible for all installation, maintenance,
28 replacement, inspection, access area cleaning, and stocking of vending machines. Vandalism
29 and graffiti on vending machines must be repaired or removed within fourteen days of written
30 notice by the director. The permittee must inspect and stock vending machines as needed, but
31 at least monthly, to provide adequate service to the public. Vending machines removed for
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1 repair or for other reasons must be restored or replaced by the permittee within thirty days.
2 Vending machines in violation of this section or any other applicable law may be removed by
3 the director fourteen days after notice of violation is provided and without liability to the director.
4 Vending machines judged by the director to pose a risk to safety may be removed immediately
5 without liability to the director and without prior notice to the permittee. The director shall retain
6 any removed vending machines for thirty days to allow retrieval by the permittee, after
7 compensation to the director for removal costs. The director may dispose of or sell machines
8 not retrieved within thirty days of removal, but removal costs must be satisfied only to the extent
9 of proceeds received by the director. The director has a cause of action to recover any
10 deficiency, attorney's fees, and litigation expenses. The director, upon the determination that a
11 rest area must be closed for a period of greater than thirty days, may order the permittee, at the
12 permittee's expense, to remove all vending machines in a manner that does not damage state
13 property, or remove all product and money and place upon the vending machine a prominent
14 notice that all product and money have been removed. Should the director determine that
15 removal of vending machines is necessary to conduct repairs, construction, surveys, or other
16 duties of the department, the permittee, at the permittee's expense, shall remove all vending
17 machines in a manner that does not damage state property, upon fourteen days' notice. The
18 current address and telephone number where customer service or business is conducted by the
19 permittee must be legibly and prominently posted upon the vending machine. The director shall
20 cancel the permit should the permittee remove vending machines, except as provided in this
21 section. The cost of any removal must be borne by the permittee. The permittee, at the
22 permittee's own expense, must restore the site the machine formerly occupied to the
23 satisfaction of the director. For purposes of this section, "vending machine" means any device
24 that allows access to a newspaper, magazine, beverage, concession, or other item for public
25 consumption or use. For purposes of this section, "permittee" means any person or
26 organization, including any corporation, partnership, firm, or any other legal entity capable of
27 owning property and transacting business, which has applied for a permit under this chapter.
28 For purposes of this section, "notice" consists of a written communication and must be deemed
29 to have occurred within seventy-two hours of mailing, if mailed within North Dakota, or one
30 hundred twenty hours of mailing, if mailed outside North Dakota. "Notice" to a vendor of the
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1 condition of a vending machine also occurs if a period of time greater than the required
2 inspection interval for the vending machines has passed.
3 SECTION 354. AMENDMENT. Subdivision b of subsection 1 of section 39-04-10.16 of the
5 b. "Volunteer emergency responder" means an emergency medical services
6 provider certified by the state department of health and human services and the
7 individual's squad leader for a continuous period exceeding two years and who
8 receives an annual compensation of less than ten thousand dollars.
11 1. It may prescribe sanitary regulations for barbershops and barber schools. Such
12 regulations shall be subject to the approval of the state department of health and
13 human services. A copy of the rules and regulations adopted by the board and
14 approved by the state department of health and human services shall be furnished by
15 the board to the owner or manager of every barbershop and barber school and shall
16 be posted by such owner or manager in a conspicuous place in such barbershop or
17 barber school.
20 8. Rules of the state department of health and human services and the board governing
21 the practice of funeral service.
24 43-10-23. Inspections - Hearings - Revocations - Appeal.
25 The funeral establishment, or that part of a funeral establishment in which is conducted or
26 intended to be conducted any funeral service business, must be open at all times for inspection
27 by the board or the state department of health and human services. The board or agents
28 employed by it and the state department of health and human services may make such
29 inspections as are necessary of facilities and equipment of funeral establishments to ensure
30 compliance with safety and sanitary rules adopted by the board or any other rules or federal
31 regulations pertaining to funeral service whenever either deems the inspection advisable. The
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1 board may subpoena witnesses, administer oaths, and take testimony. All proceedings under
2 this section must be conducted in accordance with chapter 28-32. The board may, after a
3 hearing, revoke, suspend, or refuse to issue or renew a license upon good cause. A person
4 aggrieved by the action of the board may appeal to the district court of the county in which the
5 person resides or the district court of Burleigh County in accordance with chapter 28-32.
8 43-11-11. Sanitary rules - Practice outside salon.
9 The board with the approval of the state department of health and human services shall
10 adopt sanitary rules necessary to prevent the creating and spreading of infectious and
11 contagious diseases. A cosmetology salon must be at a fixed location and may not be used for
12 living or sleeping quarters. A cosmetologist or esthetician may practice outside of the
13 establishment under the direction and control of a master cosmetologist or master esthetician
14 thereof under rules adopted by the board.
17 43-12.1-04. Persons exempt from provisions of chapter.
18 This chapter does not apply to a person that is not licensed or registered under this chapter
19 and is:
20 1. A person that performs nursing interventions in cases of emergency or disaster.
21 2. A student practicing nursing as a part of an in-state board-approved nursing education
22 program.
23 3. A licensed nurse of another state who is in good standing and who is employed in this
24 state by the United States government or any of its bureaus, divisions, or agencies.
25 4. A nurse licensed by another state or Canada, whose employment requires the nurse
26 to accompany and care for a patient in transit for health care.
27 5. A nurse licensed by another state whose employment by a resident of that state
28 requires the nurse to accompany and care for the resident in North Dakota.
29 6. An individual who performs nursing tasks for a family member.
30 7. A person that renders assistance pursuant to chapter 23-27.
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1 8. A person licensed or registered under another chapter of this title and carrying out the
2 therapy or practice for which the person is licensed or registered.
3 9. A person that provides medications, other than by the parenteral route:
4 a. Within a correctional facility, in compliance with section 12-44.1-29;
5 b. Within a psychiatric residential treatment facility for children licensed under
6 chapter 25-03.2 and North Dakota Administrative Code chapter 75-03-17;
7 c. Within a treatment or care center for individuals with developmental disabilities
8 licensed under chapter 25-16;
9 d. Within a group home, a qualified residential treatment program, or an adult foster
10 care facility licensed under section 50-11-01;
11 e. Within the life skills and transition center, to the extent the individual who
12 provides medications is a direct training technician or a vocational training
13 technician as approved by the department of health and human services;
14 f. Within a human service center licensed under chapter 50-06; or
15 g. Within a primary or secondary school under a program established under section
16 15.1-19-23 if the individual has received education and training in medication
17 administration and has received written consent of the student's parent or
18 guardian; or
19 h. Who is an employee of a qualified service provider agency who meets the criteria
20 set forth in subsection 2 of section 50-24.1-18.
21 10. A nurse currently licensed to practice nursing by another jurisdiction:
22 a. Whose practice in another state requires that nurse to attend orientation,
23 meetings, or continuing education in North Dakota;
24 b. Who serves as a guest lecturer or short-term consultant; or
25 c. Who provides evaluation undertaken on behalf of an accrediting organization.
26 11. An individual, including a feeding assistant, performing nonhands-on tasks while
27 employed in a Medicare-funded organization.
28 12. A student practicing nursing as part of an out-of-state board-recognized nursing
29 education program, upon written notification to the board and contingent upon clinical
30 site availability.
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1 13. An individual who is registered on the state department of health and human services
2 nurse aide registry, including a certified nurse aide, home health aide, nurse aide, and
3 medication assistant.
6 14. To adopt, amend, and repeal rules determined necessary by the board for the proper
7 administration and enforcement of this chapter, chapter 19-02.1 as that chapter
8 pertains to drugs, subject to approval of the director of the state department of health
9 and human services, and chapter 19-03.1.
12 4. Requirements relating to the reporting of the administration to a patient's primary
13 health care provider and to the state department of health and human services.
16 5. To the practice of dentistry in the discharge of their official duties by graduate dentists
17 or dental surgeons in the United States army, navy, air force, public health service,
18 coast guard, veterans' bureau, or director of the dental division of the state department
22 43-29.1-02. Loan repayment program - Veterinarians - Powers of state health council.
23 The state health council may:
24 1. Determine the eligibility and qualifications of an applicant for loan repayment funds
25 under this chapter;
26 2. Identify communities that are in need of a veterinarian and establish a priority ranking
27 for participation in the program by the selected communities;
28 3. Create and distribute a loan repayment application;
29 4. Determine the amount of the loan repayment funds for which an applicant may be
30 eligible under this chapter and, in making this determination, examine any outstanding
31 education loans incurred by the applicant;
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1 5. Establish conditions regarding the use of the loan repayment funds;

2 6. Enter a nonrenewable contract with the selected applicant and the selected
3 community to provide to the applicant funds for the repayment of education loans in
4 exchange for the applicant agreeing to actively practice in the selected community;
5 7. Receive and use funds appropriated for the program;
6 8. Enforce any contract under the program;
7 9. Cancel a contract for reasonable cause;
8 10. Participate in federal programs that support the repayment of education loans incurred
9 by veterinarians and agree to the conditions of the federal programs;
10 11. Accept property from an entity; and
11 12. Cooperate with the state department of health and human services to effectuate this
12 chapter.
15 2. "Nursing home" means any institution or facility defined as such for licensing purposes
16 under North Dakota state law or pursuant to the rules and regulations for nursing
17 homes by the state department of health and human services, whether proprietary or
18 nonprofit, including nursing homes owned or administered by the state government or
19 an agency or political subdivision thereof.
22 1. Two members of the board must be the state health officer and the executive director
23 of the department of health and human services or the members' designees.
26 43-38-03. Rulemaking authority of statedepartment of health counciland human
27 services.
28 The statedepartment of health counciland human services shall establish standards, rules,
29 and regulations whichthat are found necessary for the maintenance of public health, including
30 sanitation and disease control. The councildepartment of health and human services has the
31 following powers:
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1 1. To establish minimum age levels.

2 2. To establish education and training levels for electrologists and electronic hair removal
3 technicians.
4 3. To issue, deny, suspend, or revoke licenses.
5 4. To develop application and licensure forms.
6 5. To delegate the administration of the program to the state health officer, subject to
7 such provisions as the council may make for appeal to it.
8 6. To promulgate such requirements as may be found necessary to carry out the intent of
9 this chapter.
10 All electrologists and electronic hair removal technicians practicing in North Dakota prior to
11 July 1, 1979, may, without examination, be issued a license by the councildepartment of health
12 and human services upon proof, satisfactory to the councildepartment, of having met the
13 qualifications.
16 2. The board shall require from each applicant for licensure and may require from any
17 licensee written consent to a child abuse information index check and authorization for
18 the department of health and human services or its designee to release to the board
19 reports of decisions that services are required for child abuse or neglect filed pursuant
20 to section 50-25.1-05.2. All information obtained from the department or its designee is
21 confidential and closed to the public except that it may be disclosed for use in an
22 adjudicative or judicial proceeding. All costs associated with obtaining the reports are
23 the responsibility of the applicant or licensee.
26 43-43-03. Advisory board duties and compensation.
27 The advisory board shall meet at the request of the state health officer to assist in
28 implementation of duties as defined in section 43-43-04. The advisory board must be
29 reimbursed for any necessary expenses, but shall serve without further compensation except as
30 may be authorized and fixed by the state health officerdepartment of health and human services
31 by rule.
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3 43-43-04. Powers and duties of statedepartment of health officerand human services.
4 The state health officerdepartment of health and human services shall adopt rules
5 consistent with and necessary for the implementation and enforcement of this chapter, including
6 rules concerning the:
7 1. Qualifications and requirements for licensure under this chapter.
8 2. Application for licensure and renewal of license.
9 3. Licensure.
10 4. Fees that may not exceed fifty dollars for licensure fees.
11 5. Scope of practice.
12 6. Ethical standards of conduct.
13 7. Continuing competency and education requirements.
14 8. Grievances and complaints.
15 9. Reimbursement of advisory board expenses.
16 10. Emergency exemptions as to requirements for licensure under this chapter.
17 11. Qualifications and requirements for specialty licenses or credentials within the scope
18 of practice of an environmental health practitioner, including specialty licenses or
19 credentials for limited practice areas.
22 43-43-06. Environmental health practitioner licensure fee administration fund.
23 There must be maintained in the state treasury a special fund to be known as the
24 environmental health practitioner licensure fee administrative fund. All money deposited or paid
25 into this fund must be continuously available to the state health officerdepartment of health and
26 human services for reimbursement to the advisory board, and may not lapse at any time or be
27 transferred to any other fund. The fund must consist of any money collected by the state health
28 officerdepartment of health and human services in accordance with section 43-43-04.
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1 43-43-07. Denial, suspension, revocation of license.

2 The state health officerdepartment of health and human services may refuse to issue or
3 renew a license or may suspend or revoke a license when the licensee or applicant for license
4 has engaged in unprofessional conduct. Unprofessional conduct includes:
5 1. Obtaining a license by means of fraud, misrepresentation, or concealment of material
6 facts.
7 2. Engaging in unprofessional conduct, as defined by the rules adopted by the state
8 health officerdepartment of health and human services, or violating the code of ethics
9 adopted by the state health officerdepartment of health and human services.
10 3. Conviction of an offense, as defined by section 12.1-01-04, determined by the state
11 health officerdepartment of health and human services to have a direct bearing on the
12 person's ability to serve the public in the capacity of a licensed environmental health
13 practitioner; or the state health officerdepartment of health and human services
14 determines that such applicant or licensee, following conviction of any offense, is not
15 sufficiently rehabilitated under section 12.1-33-02.1.
16 4. Violation of any order or rule adopted by the state health officerdepartment of health
18 5. Violation of this chapter.
19 The person may apply to the state health officerdepartment of health and human services for
20 reinstatement after one year from the date of revocation of a license. The state health
21 officerdepartment of health and human services may accept or reject an application for
22 reinstatement, or may require conditions and an examination for reinstatement.
25 11. Personnel of the division of laboratory services of the state department of health and
26 human services or department of environmental quality who are participating in the
27 centers for disease control and prevention's chemical terrorism toxic metals
28 determination program.
29 SECTION 373. AMENDMENT. Subdivision e of subsection 3 of section 43-60-02 of the
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1 e. An employee of the state department of health and human services in the

2 provision of education regarding single gene conditions, including sickle cell,
3 cystic fibrosis, and hemoglobinopathies; and
6 3. This section does not limit or otherwise affect a record pertaining to any rule of the
7 state department of health and human services or department of environmental quality
8 or to any record pertaining to the application for a permit or license necessary to do
9 business or to expand business operations within this state, except as otherwise
10 provided by law.
11 SECTION 375. AMENDMENT. Subdivision b of subsection 1 of section 44-04-18.30 of the
13 b. "Public social services agency" means a state, county, or local public agency that
14 provides human services, and includes regional human service centers, county
15 social services boards, multicounty social services districts, and the department
19 2. Shall comply with the written eligibility standards for general assistance established by
20 the human service zone director or department of health and human services. A copy
21 of the written standards must be available upon request. Pursuant to this requirement,
22 the ownership of property by an applicant for general assistance, or by the spouse of
23 the applicant, either individually or jointly, or of insurance on the life of the applicant
24 does not preclude the granting of assistance if the applicant is without funds for the
25 applicant's support.
28 50-01-13. Medical attention and hospitalization furnished poor.
29 Within the limits of the human service zone appropriation, the human service zone promptly
30 shall provide necessary medical services, covered in the written eligibility standards for general
31 assistance, for any poor person in the human service zone who is not provided for in a public
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1 institution. The human service zone shall cause to be furnished to the person the necessary
2 covered medicines prescribed by a physician. Necessary covered hospitalization must be
3 furnished by the human service zone upon approval or subsequent ratification by the human
4 service zone director or the director's designee. If the poor person is a nonresident of the state,
5 the human service zone furnishing the medical services must be reimbursed within the limits of
6 funds appropriated for that purpose by the legislative assembly for eighty percent of the
7 expenses incurred in carrying out this section. The reimbursement must be made upon
8 vouchers having the approval of the department of health and human services.
11 50-01-17.2. Community work experience programs - Development.
12 The department of health and human services may develop community work experience
13 programs through agreements with any public entity, nonprofit agency or organization, or in
14 conjunction with, or through utilization of, applicable federal programs. The number of hours to
15 be worked may be determined by dividing the amount of the assistance payment by the
16 prevailing minimum wage.
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1 50-06-01.1. Department of health and human services to be substituted for public

2 welfare board of North Dakota and social service board of North Dakota, members of
3 board, and executive director, and department of human services.
4 When the terms "public welfare board of North Dakota", "social service board of North
5 Dakota", "executive director of the public welfare board", "executive director of the social service
6 board", "department of human services", or "executive director of the department of human
7 services", "member of the public welfare board", or "member of the social service board", or any
8 derivative of those terms which, when used in context indicates an intention to refer to those
9 persons or that board, appear in the North Dakota Century Code, the term "department of
10 health and human services", or the term "executive director of the department of health and
11 human services", as the case may be, must be substituted therefor. It is the intent of the
12 legislative assembly that the department of health and human services must be substituted for,
13 shall take any action previously to be taken by, and shall perform any duties previously to be
14 performed by the public welfare board of North Dakota or, by the social service board of North
15 Dakota, by the department of human services, or by the state department of health. The
16 legislative council may replace references to the "department of human services" or "executive
17 director of the department of human services" any derivatives of those terms with "department
18 of health and human services" or "executive director of the department of health and human
19 services" in any measure enacted by the sixty-seventh legislative assembly.
22 50-06-01.4. Structure of the department.
23 1. The department includes the state hospital, the regional human service centers, a
24 vocational rehabilitation unit, health division, and other units or offices and
25 administrative and fiscal support services as the executive director determines
26 necessary. The department must be structured to promote efficient and effective
27 operations and, consistent with fulfilling its prescribed statutory duties, shall act as the
28 official agency of the state in the discharge of the following functions not otherwise by
29 law made the responsibility of another state agency:
30 a. Administration of programs for children and families, including adoption services
31 and the licensure of child-placing agencies, foster care services and the licensure
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1 of foster care arrangements, child protection services, children's trust fund,

2 licensure of early childhood programs, refugee services, in-home
3 community-based services, quality control, and administration of the interstate
4 compacts on the placement of children and juveniles.
5 b. Administration of programs for individuals with developmental disabilities,
6 including licensure of facilities and services, and the design and implementation
7 of a community-based service system for persons in need of habilitation.
8 c. Administration of aging service programs, including nutrition, transportation,
9 advocacy, social, ombudsman, recreation, and related services funded under the
10 Older Americans Act of 1965 [42 U.S.C. 3001 et seq.], home and
11 community-based services, licensure of adult foster care homes, and the
12 committee on aging.
13 d. Administration of behavioral health programs, including:
14 (1) A policy division responsible for reviewing and identifying service needs and
15 activities in the state's behavioral health system in an effort to ensure health
16 and safety, access to services, and quality of services; establishing quality
17 assurance standards for the licensure of substance use disorder program
18 services and facilities; and providing policy leadership in partnership with
19 public and private entities; and
20 (2) A service delivery division responsible for providing chronic disease
21 management, regional intervention services, and twenty-four-hour crisis
22 services for individuals with behavioral health disorders.
23 e. Administration of economic assistance programs, including temporary assistance
24 for needy families, the supplemental nutrition assistance program, home energy
25 assistance, child care assistance, refugee assistance, work experience, work
26 incentive, and quality control.
27 f. Administration of medical service programs, including medical assistance for
28 children's health insurance program, Medicaid waivers, early and periodic
29 screening, diagnosis and treatment, utilization control, autism services, and
30 claims processing.
31 g. Administration of general assistance.
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1 h. Administration of child support.

2 i. Administration of program, services, and licensing outlined in title 23 and other
3 previous duties of the state department of health.
4 2. The executive director shall consult with and maintain a close working relationship with
5 the state department of health; with the department of corrections and rehabilitation
6 and the superintendents of the school for the deaf and the North Dakota vision
7 services - school for the blind to develop programs for individuals with developmental
8 disabilities; and with the superintendent of public instruction to maximize the use of
9 resource persons in regional human service centers in the provision of special
10 education services. The executive director shall also maintain a close liaison with
11 human service zones.
12 3. By August 1, 2019, the department shall establish a template for the development of
13 human service zone plans, including process and content requirements, access point
14 expectations, client grievances procedures, human resources, and locally funded
15 programs or services and how those services will be addressed.
16 4. The department shall develop, with assistance from the North Dakota association of
17 counties, a process for consultation and technical assistance for human service zone
18 working groups by August 1, 2019.
21 1. The department of human services shall administratively restructure the behavioral
22 health division to require the division to develop and revise, when necessary, the state
23 mental health plan and provide the behavioral health division the authority to
24 implement and supervise a unified mental health delivery system and to assure the
25 mental health services provided by the human service centers, the state hospital, and
26 contracted services are in accordance with the state plan.
29 50-06-06.3. Facility staff training.
30 It is the intent of the legislative assembly that the department of human services design and
31 implement a facility staff training system in cooperation with the board of higher education to
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1 assure adequate and appropriate staff development and training for the providers of
2 community-based care on behalf of individuals with developmental disabilities.
5 50-06-06.4. Comprehensive community residential program.
6 It is the intent of the legislative assembly that the department of human services implement
7 a comprehensive community residential program for children with developmental disabilities,
8 including the use of intermediate care facilities and other such foster home and group home
9 resources as deemed appropriate.
12 50-06-06.6. Department of human services may lease real and personal property.
13 The executive director of the department of human services may lease surplus farm and
14 pastureland at the state hospital and the life skills and transition center. The executive director
15 also may enter into further leases of real or personal property at the life skills and transition
16 center or the state hospital upon a specific finding that the granting of each such leasehold
17 interest will result in a net economic gain for the department, taking into account all identifiable
18 costs. Any lease of space for the purpose of providing child care services must meet
19 requirements as determined by the department. The executive director may prescribe the terms
20 and conditions of any leases entered into pursuant to this section and may renew existing
21 leases. Any lease entered into must be subject to renewal or cancelable each biennium.
24 50-06-06.10. Family life education program.
25 The department of human services shall enter into an agreement with the North Dakota
26 state university extension service for the design of a program to educate and support individuals
27 at all points within the family life cycle. The program must provide support for families and youth
28 with research-based information relating to personal, family, and community concerns and must
29 contain a research component aimed at evaluation of planned methods or programs for
30 prevention of family and social problems. The program must address the following inter-related
31 topics:
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1 1. Child and youth development.

2 2. Parent education with an emphasis on parents as educators.
3 3. Human development.
4 4. Interpersonal relationships.
5 5. Family interaction and family systems.
6 6. Family economics.
7 7. Intergenerational issues.
8 8. Impact of societal changes on the family.
9 9. Coping skills.
10 10. Community networks and supports for families.
13 50-06-06.11. Child care provider payments.
14 Within the limits of federal regulations, the department of human services, at the election of
15 the early childhood facility, shall directly pay early childhood facilities monthly under child care
16 assistance programs administered by the department.
19 50-06-14.1. Limitation on state reimbursement for rental expenses of long-term care
20 facilities.
21 The department of human services shall limit the reimbursement for rental expense paid by
22 a provider of services when a provider sells its skilled nursing facility, intermediate care facility,
23 basic care facility, or other facility furnishing care to its residents, when a care rate is based, in
24 part, upon property costs unique to that facility, to a third party who leases the facility back to
25 the provider. The department's reimbursement for rental expense may not exceed the lesser of
26 the rental expense paid by the provider or the cost of ownership of the facility. The cost of
27 ownership includes depreciation, interest, real estate taxes, and other expenses properly
28 related to the facility. The department of human services shall apply this limit to rates set for
29 each facility's first fiscal year beginning on or after July 1, 1985, but shall consider, in setting
30 such rates, all sales occurring on or after July 18, 1984.
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3 50-06-21. Gambling disorder prevention, awareness, crisis intervention,
4 rehabilitation, and treatment services.
5 The department of human services shall contract with qualified treatment service providers
6 for the development and implementation of a program for gambling prevention, awareness,
7 crisis intervention, rehabilitation, financial counseling, and mental health treatment services. The
8 program may provide outpatient services, partial care services, aftercare services, intervention
9 services, financial counseling services, consultation services, or other forms of preventive,
10 rehabilitative, or treatment services for individuals with a gambling disorder. An individual who
11 provides treatment services must be a licensed professional operating within the individual's
12 scope of practice. An individual who provides financial counseling services must be a certified
13 consumer credit counselor with an accredited financial counseling agency. The department of
14 human services may establish a sliding payment scale for services under the program. The
15 department of human services may establish a centrally located repository of educational
16 materials on identifying and treating gambling disorders. Any service fee collected by qualified
17 treatment service providers for services provided under the contract must be applied toward the
18 program's gambling disorder services. The term "qualified treatment service provider" means an
19 entity based in North Dakota which is experienced in and capable of delivering gambling
20 disorder education, prevention, awareness, crisis intervention, rehabilitation, financial
21 counseling, and mental health treatment services as defined by the department of health and
22 human services. The term "gambling disorder" means a chronic, progressive disease that is
23 characterized by a preoccupation with gambling, loss of control over gambling behaviors, and
24 oftentimes disregard for the negative consequences as a result of gambling. Gambling disorder
25 includes gambling behavior that compromises, disrupts, or damages personal, family, or
26 vocational pursuits.
29 50-06-24. Guardianship services.
30 The department of human services may create and coordinate a unified system for the
31 provision of guardianship services to vulnerable adults who are ineligible for developmental
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1 disabilities program management services. The system must include a base unit funding level at
2 the same level as developmental disability corporate guardianship rates, provider standards,
3 staff competency requirements, and guidelines and training for guardians. The department shall
4 adopt rules for guardianship services to vulnerable adults which are consistent with chapters
5 30.1-26, 30.1-28, and 30.1-29.
8 50-06-26. Alternatives-to-abortion services program.
9 The department of human services shall disburse funds available through title IV-A of the
10 Social Security Act [42 U.S.C. 601 et seq.] to nongovernmental entities that provide
11 alternatives-to-abortion services and expend funds to inform the public about this program. The
12 services must be outcome-based with positive outcome-based results. The department, in
13 consultation with a nongovernmental entity that provides alternatives-to-abortion services, shall
14 contract to inform the public about this program. For purposes of this section,
15 "alternatives-to-abortion services" are those services that promote childbirth instead of abortion
16 by providing information, counseling, and support services that assist pregnant women or
17 women who believe they may be pregnant to choose childbirth and to make informed decisions
18 regarding the choice of adoption or parenting with respect to their children.
21 50-06-29. Application for aging and disability resource center funding.
22 The department of human services shall operate an aging and disability resource center for
23 the state. The resource center will be a single point of information program at the community
24 level which will help people make informed decisions about the full range of long-term care
25 service and support options, including both institutional and home and community-based care,
26 and which will provide unbiased information and assistance to individuals needing either public
27 or private resources, to professionals seeking assistance on behalf of their clients, and to
28 individuals planning for their future long-term care needs. The resource center must be free
29 from a conflict of interest which would inappropriately influence or bias the actions of a
30 contractor, staff member, board member, or volunteer of the resource center to limit the
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1 information given to a consumer to steer the consumer to services that may also be provided by
2 the resource center.
5 50-06-30. Interagency agreement between the department of health and human
6 services and the department of corrections and rehabilitation.
7 The executive director of the department of human services and the director of the
8 department of corrections and rehabilitation may amend the interagency agreement entered
9 under this section which became effective August 1, 2007. The amended agreement must
10 provide that the department of corrections and rehabilitation shall train, consult, and assist the
11 department of health and human services with the provision and enforcement of safety and
12 security procedures at the state hospital for all patients at the state hospital, including those
13 committed to the state hospital under chapter 25-03.1 or placed at the state hospital for
14 evaluation or civil commitment and treatment under chapter 25-03.3 and for all staff, visitors,
15 and volunteers at the state hospital. The amended interagency agreement must provide that the
16 executive director of the department of human services shall continue to be responsible for the
17 custody and care of patients at the state hospital, including those committed to the state
18 hospital under chapter 25-03.1 or placed at the state hospital for evaluation or civil commitment
19 and treatment under chapter 25-03.3, including responsibility for all assessments, evaluations,
20 and treatment required under chapter 25-03.3, the provision of all necessary staffing, including
21 maintenance staff, and the provision of all daily care and health care.
24 50-06-31. Report to legislative council - Individuals committed to state hospital.
25 Before March first of each even-numbered year, the department of human services shall
26 report to the legislative council on services provided by the department of corrections and
27 rehabilitation relating to individuals at the state hospital who have been committed to the care
28 and custody of the executive director of the department of human services.
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1 50-06-32. Autism spectrum disorder task force - Appointment - Duties - Annual

2 reports.
3 1. The autism spectrum disorder task force consists of:
4 a. (1) The state health officer, or the officer's designee;
5 (2) The director of the department of human services, or the director's
6 designee;
7 (3) The superintendent of public instruction, or the superintendent's designee;
8 and
9 (4) The executive director of the protection and advocacy project, or the
10 director's designee; and
11 b. The following members appointed by the governor:
12 (1) A pediatrician with expertise in the area of autism spectrum disorder;
13 (2) A psychologist with expertise in the area of autism spectrum disorder;
14 (3) A college of education faculty member with expertise in the area of autism
15 spectrum disorder;
16 (4) A behavioral specialist;
17 (5) A licensed teacher with expertise in the area of autism spectrum disorder;
18 (6) An occupational therapist;
19 (7) A representative of a health insurance company doing business in this state;
20 (8) A representative of a licensed residential care facility that provides care and
21 services to individuals with autism spectrum disorder;
22 (9) A representative who is an enrolled member of a federally recognized Indian
23 tribe;
24 (10) An adult self advocate with autism spectrum disorder;
25 (11) A parent of a child with autism spectrum disorder;
26 (12) A family member of an adult with autism spectrum disorder; and
27 (13) A member of the legislative assembly.
28 2. The director of the department of human services, or the director's designee, shall
29 serve as the chairman. The task force shall meet at the call of the chairman, at least
30 quarterly.
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1 3. The task force shall examine early intervention services, family support services that
2 would enable an individual with autism spectrum disorder to remain in the least
3 restrictive home-based or community setting, programs transitioning an individual with
4 autism spectrum disorder from a school-based setting to adult day programs and
5 workforce development programs, the cost of providing services, and the nature and
6 extent of federal resources that can be directed to the provision of services for
7 individuals with autism spectrum disorder.
8 4. The task force shall develop a state autism spectrum disorder plan and present the
9 plan to the governor and the legislative council before July 1, 2010. Thereafter, the
10 task force shall continue to review and periodically update or otherwise amend the
11 state plan so that it best serves the needs of individuals with autism spectrum disorder.
12 The task force shall provide an annual report to the governor and the legislative
13 council regarding the status of the state autism spectrum disorder plan.
16 50-06-32.1. Autism spectrum disorder voucher program pilot project - Legislative
17 management report - Appeal.
18 1. The department of human services shall establish a voucher program pilot project
19 beginning July 1, 2014, to assist in funding equipment and general educational needs
20 related to autism spectrum disorder for individuals below two hundred percent of the
21 federal poverty level from age three to under age eighteen who have been diagnosed
22 with autism spectrum disorder. The program may include funding for assistive
23 technology; video modeling videos or equipment; language-generating devices;
24 training and educational material for parents; parenting education; sensory equipment;
25 tutors; safety equipment; travel tools; self-care equipment; timers; visual
26 representation systems; respite care; specialized day care; language comprehension
27 equipment; and registration and related expenses for workshops and training to
28 improve independent living skills, employment opportunities, and other executive or
29 social skills.
30 2. The department shall adopt rules addressing management of this voucher program
31 pilot project and establishing the eligibility requirements and exclusions for this
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1 voucher program pilot project. The program may not provide a voucher for early
2 intensive behavioral intervention, including applied behavioral analysis, intensive early
3 interventional behavioral therapy, intensive behavioral intervention, the Lovaas
4 method, the Denver model, LEAP (learning experiences - an alternative program for
5 preschoolers and parents), TEACCH (treatment and education of autistic and related
6 communication handicapped children), pivotal response training, or discrete trial
7 training.
8 3. A decision on a voucher application which is issued by the department under this
9 section may be appealed as provided under chapter 28-32.
10 4. The department of human services shall report to the legislative management
11 regarding the autism spectrum disorder program pilot project.
14 50-06-35. Department of human services food assistance contracts.
15 The department of human services shall contract with a statewide charitable food recovery
16 and distribution organization to develop and implement new methods of delivering charitable
17 food assistance services in underserved counties, to include a mobile food pantry program and
18 prepacked food basket program; expand the recovery of surplus food from the retail and
19 wholesale food industry for distribution to charitable feeding programs; provide training,
20 technical assistance, and equipment grants to community food pantries and emergency meal
21 programs; and develop a cross-referral system between charitable feeding programs and
22 government assistance programs that help clients achieve self-sufficiency.
25 50-06-37. Developmental disabilities system reimbursement project.
26 The department of human services, in conjunction with developmental disabilities
27 community providers, shall maintain a prospective payment system based on a state-approved
28 assessment.
29 1. The department shall maintain a steering committee consisting of no more than
30 eighteen representatives from all interested providers which must include no more
31 than two clients, no more than one family member of a client, a representative of the
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1 department, and a representative of the North Dakota protection and advocacy

2 project.
3 2. The department may contract with a consultant to continuously improve, in
4 collaboration with the steering committee, the payment system and the resource
5 allocation model tying funding to the state-approved assessment.
6 3. The department shall conduct the standardized assessment of eligible individuals
7 residing at the life skills and transition center.
8 4. Data must be analyzed by the steering committee, and the steering committee shall
9 recommend to the department any rate adjustments, resource allocation modifications,
10 or process assumptions, including the state-approved assessment.
11 5. The department and the steering committee shall report development activities and
12 status information to an interim legislative committee.
15 50-06-38. Review and limitation.
16 Intermediate care facility providers shall submit all facility construction or remodeling
17 proposals to the department of human services prior to enactment of a contract for the
18 completion of the project. The department of human services shall review all intermediate care
19 facility construction or remodeling proposals and may limit allowable construction and
20 remodeling costs to ensure the costs are reasonable and appropriate.
23 50-06-41. Behavioral health services quarterly report.
24 The department of human services shall publish a quarterly report of all behavioral health
25 services provided by or supported by the department. The report must include each type of
26 behavioral health service, the number of clients served for each service, and the amount of
27 state and federal funds budgeted and spent for each service. Data must be identified for
28 behavioral health services by human service region and by mental health services provided to
29 children, mental health services provided to adults, and substance abuse services.
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1 50-06-41.2. Community behavioral health program.

2 1. The department of health and human services shall establish and implement a
3 community behavioral health program to provide comprehensive community-based
4 services for individuals who have serious behavioral health conditions.
5 2. In developing the program, the department shall:
6 a. Establish a referral and evaluation process for access to the program.
7 b. Establish eligibility criteria that includes consideration of behavioral health
8 condition severity.
9 c. Establish discharge criteria and processes.
10 d. Develop program oversight and evaluation processes that include outcome and
11 provider reporting metrics.
12 e. Establish a system through which the department:
13 (1) Contracts with and pays behavioral health service providers.
14 (2) Supervises, supports, and monitors referral caseloads and the provision of
15 services by contract behavioral health service providers.
16 (3) Requires contract behavioral health service providers to accept eligible
17 referrals and to provide individualized care delivered through integrated
18 multidisciplinary care teams.
19 (4) Provides payments to contract behavioral health service providers on a
20 per-month per-referral basis based on a pay-for-performance model that
21 includes consideration of identified outcomes and the level of services
22 required.
25 50-06-43.1. Children's cabinet - Membership - Duties. (Effective through July 31, 2025)
26 1. The children's cabinet is created to assess, guide, and coordinate the care for children
27 across the state's branches of government and the tribal nations.
28 2. The children's cabinet consists of the following members:
29 a. The governor, or the governor's designee;
30 b. The chief justice of the supreme court, or the chief justice's designee;
31 c. The speaker of the house of representatives, or the speaker's designee;
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1 d. The president pro tempore of the senate, or the president pro tempore's
2 designee;
3 e. The superintendent of public instruction, or the superintendent's designee;
4 f. The director of the committee on protection and advocacy, or the director's
5 designee;
6 g. A representative of the tribal nations in the state, who is appointed by the
7 governor; and
8 h. Four individuals representing parents, private service providers, or other
9 community interests, who are appointed by the governor to serve a term of two
10 years, at the pleasure of the governor, and who are entitled to reimbursement
11 from the department of human services for travel and lodging at the same rate as
12 provided for state officers and employees.
13 3. The chairman of legislative management, shall serve as the presiding officer of the
14 cabinet. The cabinet shall meet at least quarterly. Additional meetings may be held at
15 the discretion of the presiding officer.
16 4. The children's cabinet shall:
17 a. Coordinate broad-based leadership across programs, agencies, branches of
18 government, and tribal nations to meet the needs of children;
19 b. Develop strategies to address gaps or needs regarding early care and education,
20 medical and behavioral health, community, child welfare, and juvenile justice;
21 c. Develop strategies to provide for the full continuum of care in the delivery of
22 services, including promotion, prevention, early identification and intervention,
23 service delivery, and recovery;
24 d. Seek to engage cooperation across public and private service providers;
25 e. Provide a comprehensive vision for how and where children are best served,
26 attending to children in a respectful and relevant manner;
27 f. Seek strategies to provide services to children without consideration of prior
28 engagement with juvenile services;
29 g. Provide for the active participation of consumers and providers statewide on
30 advisory committees; and
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1 h. Receive information and recommendations from the department of health and

2 human services, department of corrections and rehabilitation, and other state
3 agencies.
4 5. The department of human services shall provide the children's cabinet with staffing
5 and administrative services.
6 SECTION 405. AMENDMENT. Subdivision e of subsection 1 of section 50-06-43.2 of the
8 e. The executive director of the department of human services, or the executive
9 director's designee;
12 1. "Department" means the North Dakota department of health and human services.
15 50-06.1-15. Cooperation between agencies.
16 The office of vocational rehabilitation and other divisions of the department of human
17 services shall work cooperatively to locate eligible clients and to identify and provide them with
18 the services they require to lead a full and meaningful life.
21 50-06.1-16. State rehabilitation council.
22 1. There is established a state rehabilitation council in accordance with section 105 of the
23 Rehabilitation Act of 1973 [29 U.S.C. 725].
24 2. The state rehabilitation council:
25 a. Shall fulfill the duties outlined in section 105 of the Rehabilitation Act of 1973
26 [29 U.S.C. 725].
27 b. Shall collaborate, coordinate, and improve employment outcomes for
28 working-age adults with disabilities, including:
29 (1) Reviewing and aligning policies, procedures, eligibility, and enrollment and
30 planning for services for individuals, with the objective of increasing
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1 opportunities for community employment for North Dakotans with

2 disabilities.
3 (2) Developing cross-agency tools to document eligibility, order of selection,
4 assessment, and planning for services for individuals with disabilities.
5 (3) Identifying best practices, effective partnerships, sources of available
6 federal funds, opportunities for shared services among existing providers,
7 and means to expand model programs to increase community employment
8 opportunities for individuals with disabilities.
9 (4) Identifying and addressing areas where sufficient support is not currently
10 available or where additional options are needed to assist individuals with
11 disabilities to work in competitive employment in integrated settings.
12 (5) Establishing interagency agreements to improve coordination of services
13 and allow for data sharing as appropriate to assist individuals with
14 disabilities.
15 (6) Setting benchmarks for improving community employment outcomes and
16 services for individuals with disabilities.
17 3. The department of human services division of vocational rehabilitation shall
18 provide the state rehabilitation council with administrative services.
21 8. "State agency" means the department of health and human services.
27 50-06.4-02. Department to be lead agency - Cooperation of other agencies - Joint
28 meeting.
29 The department shall act as lead agency in the state for the purpose of coordinating
30 services to individuals with brain injury. At least annually the department shall call a joint
31 meeting of the adjutant general, the state department of health, the department of veterans'
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1 affairs, and the superintendent of public instruction to discuss the provision of services to
2 individuals with brain injury. State agencies and political subdivision agencies shall cooperate
3 with the department to permit the department to efficiently coordinate services to individuals
4 with brain injury while avoiding duplication of services. Neither this chapter, nor any activity
5 undertaken by the department under this chapter, may be construed as creating a right to any
6 benefit or service not specifically required to be granted as a condition of the receipt of grants of
7 federal funds.
10 3. Each of the following entities shall appoint a representative to serve as a nonvoting
11 member of the council who serves at the pleasure of the appointing entity:
12 a. Protection and advocacy project, one representative;
13 b. State department of healthDepartment, one individual representing injury
14 prevention and one representative representing emergency medical services and
15 trauma;
16 c. Department of human services, one individual representing behavioral health,
17 one individual representing Medicaid, and one individual representing vocational
18 rehabilitation; and
19 d.c. Department of public instruction, one representative.
22 4. "Designated state entity" means the vocational rehabilitation division of the department
23 of health and human services as defined in the state plan for independent living.
26 12. "State agency" means the North Dakota department of health and human services.
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7 50-11-01.5. Fire prevention training.
8 Before initial licensure and each renewal under this chapter, each foster parent shall
9 complete a course of instruction related to fire prevention and safety. The state fire marshal
10 shall design the course in cooperation with the department of health and human services. The
11 course must be available on videotape or any equivalent medium as designed by the
12 department. The department of health and human services shall offer the course throughout the
13 state.
16 50-11-01.6. Self-declaration form.
17 The department of health and human services shall prescribe self-declaration forms to be
18 completed and signed by each foster parent before initial licensure and each renewal under this
19 chapter. The self-declaration forms must include references to smoke detectors, fire
20 extinguishers, fire escape plans, and inspections of appliances, electrical systems, and heating
21 systems.
24 50-11-03.1. Reduction of number of children in foster care - Goals.
25 On or before October 1, 1982, and annually thereafter, the department of health and human
26 services shall attempt to reduce the number of children receiving assistance under title IV-E of
27 the Social Security Act, who have been in foster care for more than twenty-four months, by the
28 following amounts:
29 1. For the year beginning October 1, 1982, one percent of the number of children, in
30 foster care for more than twenty-four months, and receiving benefits under title IV-A of
31 the Social Security Act from July 1, 1979, through June 30, 1980;
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1 2. For the years beginning October 1, 1983, and ending September 30, 1990, one
2 percent of the maximum number permitted in the previous year; and
3 3. For all subsequent years, one-half percent of the maximum number permitted in the
4 previous year.
10 2. Upon request of the department or its authorized agent, the state department of health
11 or the state fire marshal, or the fire marshal's designee, shall inspect the premises for
12 which a license or self-declaration is applied or issued and shall report the findings to
13 the department or the department's authorized agent.
16 a. The department of health and human services;
19 50-11.2-01. Foster care parent grievance.
20 A foster parent who is duly licensed to care for a foster child may object to any decision
21 made by the department of human services or human service zone which substantially affects
22 the foster parent or the needs of the foster child. An objection may be made in the form of a
23 grievance, which must be filed in the county of the foster care parent's residence with the
24 human service zone. The human service zone shall notify foster parents of the grievance
25 procedure and provide them with grievance procedure forms.
28 50-11.2-02. Grievance procedure.
29 The grievance procedure to be followed by the department of health and human services,
30 human service zone, and foster parents is:
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1 1. Any decision made by the department of health and human services or human service
2 zone which substantially affects the licensed foster parent or the needs of a foster
3 child must be sent in writing to the foster parents who have been given the
4 responsibility of providing foster care for that child. Nothing herein may be construed
5 to prohibit the department of health and human services or human service zone from
6 immediately implementing a decision, when the best interests of the child require such
7 immediate action, as long as notice is given to the foster parent as soon as possible.
8 2. A foster parent may object to any decision referred to in subsection 1. Upon the filing
9 of a grievance by the foster care parents, the human service zone shall schedule an
10 informal meeting to be held within ten days of the filing of the grievance. The needs
11 and responsibilities of all interested parties must be discussed at this meeting in an
12 attempt to maintain a continuing relationship which will serve the best interests of the
13 foster child. A written resolution relating to the grievance should be agreed to and
14 signed by both parties.
15 3. If no written resolution between the parties relating to the grievance is made at the
16 informal meeting, the foster parents may request a formal hearing to be held at a
17 conflict-free human service zone office. This meeting must be held within ten working
18 days of the informal meeting unless both parties agree to an extension. The human
19 service zone director or the director's designee shall provide for a record of this
20 hearing. The human service zone director or the director's designee shall review all
21 prior contact between the foster care parents and the department of health and human
22 services or human service zone relating to the grievance. The human service zone
23 director or the director's designee shall then make a final determination relating to the
24 grievance. The human service zone director's or the director's designee's findings and
25 conclusions must be sent to the human service zone and the foster care parents.
26 4. All decisions relating to a grievance under this chapter are final.
27 5. The department of health and human services shall adopt rules to carry out the
28 purpose and intent of this section and these rules must be given to the foster parent
29 upon licensing.
30 6. Denial or revocation of a foster care license may be appealed as provided in chapter
31 28-32.
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1 7. Nothing herein may be construed to require a grievance proceeding under this

2 chapter, when the department of health and human services or human service zone is
3 acting to implement a specific placement decision issued by a court with competent
4 jurisdiction.
7 50-11.3-01. Criminal history record investigation required.
8 1. Before appointment as a legal guardian under chapter 27-20, the individual to be
9 appointed legal guardian must be subject to an assessment that includes the result of
10 a criminal history record investigation made under this section. In addition, any adult
11 living in the household of the individual to be appointed legal guardian must be subject
12 to a criminal history record investigation made under this section.
13 2. An individual to be appointed legal guardian or any adult living in that individual's
14 household as described in subsection 1 shall secure, from a law enforcement agency
15 or other agency authorized to take fingerprints, two sets of fingerprints and shall
16 provide all other information necessary to secure state criminal history record
17 information and a nationwide background check under federal law. Upon a request
18 made under this section, a law enforcement agency shall take fingerprints of any
19 individual to be appointed legal guardian or any adult living in that individual's
20 household as described in subsection 1 and may charge a reasonable fee to offset the
21 cost of fingerprinting.
22 3. An individual to be appointed legal guardian or any adult living in that individual's
23 household as described in subsection 1 shall assure that information obtained under
24 subsection 2 is provided to the department of health and human services.
25 4. Upon receipt of all fingerprints and necessary information relating to a criminal history
26 record investigation, the department of health and human services shall submit those
27 fingerprints and that information to the bureau of criminal investigation.
28 5. The bureau of criminal investigation shall request a nationwide background check from
29 the federal bureau of investigation and, upon receipt of a response, provide the
30 response of the federal bureau of investigation to the department of health and human
31 services. The bureau of criminal investigation shall also provide any criminal history
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1 record information that may lawfully be made available under chapter 12-60 to the
2 department of health and human services. The bureau of criminal investigation may
3 charge a reasonable fee to offset the cost of providing any criminal history record
4 information and may require payment of any charge imposed by the federal bureau of
5 criminal investigation for a nationwide background check.
6 6. The department of health and human services shall provide an individual to be
7 appointed legal guardian or any adult living in that individual's household, who
8 provided the department with information under subsection 2, with any information
9 received under this section from the bureau of criminal investigation which the
10 department of health and human services is not prevented by federal law from
11 disclosing to the individual to be appointed legal guardian or any adult living in that
12 individual's household.
13 7. The department of health and human services may adopt emergency rules under this
14 section without the finding otherwise required under section 28-32-02.
15 8. A criminal history record investigation completed under this section may be used to
16 satisfy the criminal history record investigation requirements of sections 50-11-06.8
17 and 50-12-03.2.
20 50-12-02. Child-placing agency licensed - Rules.
21 Every child-placing agency shall secure a license from the department of health and human
22 services. The department shall adopt rules establishing the requirements for licensure as a
23 child-placing agency.
26 2. A child-placing agency that does not maintain an office in this state shall name on its
27 license application at least one resident child-placing agency. Resident child-placing
28 agencies named on the application shall certify their willingness to:
29 a. Receive service of process for papers to be served on the out-of-state
30 child-placing agency;
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1 b. Assist when requested by the department of health and human services in the
2 supervision and visitation of children placed in either temporary or permanent
3 homes by the out-of-state child-placing agency; and
4 c. Provide at the request of the department of health and human services all other
5 facts, information, and reports to be made on behalf of the out-of-state
6 child-placing agency.
9 50-12-03. Requirements for licensure and employment - Term - Moral or religious
10 conviction not bar to licensure or employment.
11 The department of health and human services shall issue licenses for the conduct of
12 child-placing agencies upon application. A child-placing agency shall require a criminal history
13 record investigation on the owner and each employee of a child-placing agency who has direct
14 contact with families, with children, or with both. The department of health and human services
15 shall consider any criminal history record information available about the owner at the time a
16 licensing decision is made and about an employee prior to the owner or the employee having
17 direct contact with families, with children, or with both. Licenses must be granted for a period
18 not exceeding two years. Licenses must be issued to reputable and responsible applicants
19 upon a showing that they, and their agents, are equipped properly by training and experience to
20 find and select suitable temporary or permanent homes for children and to supervise the homes
21 when children are placed in them, to the end that the health, morality, and general well-being of
22 children placed by them will be properly safeguarded. The department of health and human
23 services may not deny a license because of the applicant's objection to performing, assisting,
24 counseling, recommending, facilitating, referring, or participating in a placement that violates the
25 applicant's written religious or moral convictions or policies.
28 50-12-03.1. Conviction not bar to licensure or employment - Exceptions.
29 Conviction of an offense does not disqualify a person from licensure or employment under
30 this chapter unless the department of health and human services determines that the offense
31 has a direct bearing upon a person's ability to serve the public as the owner or employee of a
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1 child-placing agency, or that, following the person's conviction of any offense, the person is not
5 50-12-03.2. Criminal history record investigation required.
6 1. A child-placing agency shall include, in any adoptive home study report, the results of
7 a criminal history record investigation made under this section. If the results reveal a
8 conviction of a crime described in chapter 50-11.3 or determined by the department to
9 have a direct bearing upon the person's ability to provide a suitable home for
10 placement of any child, or the department determines, following conviction of any
11 other offense, the person is not sufficiently rehabilitated under section 12.1-33-02.1,
12 the home study report must include a determination that a home provided by the
13 prospective adoptive parent is not a suitable home for the placement of any child and
14 a recommendation that the petition for adoption be denied. A child-placing agency
15 shall consider any criminal history record information available when making a
16 recommendation in a home study report.
17 2. A child-placing agency shall secure, from a law enforcement agency or any other
18 agency authorized to take fingerprints, two sets of fingerprints and shall provide all
19 other information necessary to secure state criminal history record information and a
20 nationwide background check under federal law from any prospective adoptive parent
21 and any adult living in the prospective adoptive parent's household. Upon a request of
22 a child-placing agency, a law enforcement agency shall take fingerprints of any
23 prospective adoptive parent and any adult living in the prospective adoptive parent's
24 household for purposes of this section. An agency that takes fingerprints as provided
25 under this section may charge a reasonable fee to offset the cost of fingerprinting.
26 3. The child-placing agency shall assure that information obtained under subsection 2 is
27 provided to the department of health and human services and shall arrange payment
28 to the bureau of criminal investigation sufficient to defray the cost of securing criminal
29 history record information under this section.
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1 4. Upon receipt of all fingerprints and necessary information relating to a criminal history
2 record investigation, the department of health and human services shall submit those
3 fingerprints and that information to the bureau of criminal investigation.
4 5. The bureau of criminal investigation shall request a nationwide background check from
5 the federal bureau of investigation and, upon receipt of a response, provide the
6 response of the federal bureau of investigation to the department of health and human
7 services. The bureau of criminal investigation shall also provide any criminal history
8 record information that may lawfully be made available under chapter 12-60 to the
9 department.
10 6. The department of health and human services shall provide the child-placing agency
11 with any information, received under this section from the bureau of criminal
12 investigation, that the department of human services is not prevented by federal law
13 from disclosing to the child-placing agency.
14 7. The department of health and human services may adopt emergency rules under this
15 section without the finding otherwise required under section 28-32-02.
16 8. A criminal history record investigation completed under this section may be used to
17 satisfy the criminal history record investigation requirements of sections 50-11-06.8
18 and 50-11.3-01.
21 50-12-05. Department may prescribe form of records - Make rules - Records open for
22 inspection.
23 The department of health and human services may prescribe the forms for the registration
24 and record of children placed by a child-placing agency. The department shall make such
25 reasonable rules and regulations in connection with such placements as are necessary to carry
26 out the purposes of this chapter. All records must be open to the inspection of the department.
29 2. For the return of the child to the placing agency whenever in the opinion of the agency,
30 or of the department of health and human services, the best interests of the child
31 require the return.
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3 2. Report to the department of health and human services:
4 a. The name and address of each child to be placed in a foster or an adoptive
5 home;
6 b. The name and address of the proposed foster or adoptive parents; and
7 c. Any other facts and information as requested by the department.
10 50-12-08. Child must be placed in suitable home - Department may remove child.
11 A child may not be placed in any foster or adoptive home until adequate investigation has
12 been made as to the suitability of the proposed foster or adoptive parents and their home
13 surroundings. When the department of health and human services is satisfied that a child has
14 been placed in an unsuitable home, the department shall order the child-placing agency, in
15 writing, to remove the child and place the child in a home that meets the approval of the
16 department. If within a reasonable period of time it appears that suitable arrangements have not
17 been made for the care of the child, the department shall refer the child to the county social
18 service board of the county in which the child has legal settlement. The county social service
19 board shall make immediate arrangements, subject to the approval of the department, for the
20 care and support of the child. If the child has no legal settlement within the state, or in case of a
21 dispute as to the determination of the child's legal settlement or responsibility for the child's
22 support, the child must be brought before the juvenile court as a dependent child in the county
23 in which the child is found, as provided by law.
26 50-12-10. Revocation of license - Grounds.
27 The department of health and human services may revoke the license of any child-placing
28 agency upon a proper showing of any of the following:
29 1. The licensee has violated any requirements under this chapter.
30 2. The license was issued upon fraudulent or untrue representations.
31 3. The licensee has violated any of the rules and regulations of the department.
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1 4. The licensee has been guilty of an offense determined by the department to have a
2 direct bearing upon a person's ability to serve the public as a licensee, or the
3 department determines, following conviction of any offense, the person is not
7 50-12-11. Revocation of license - False reports.
8 If any child-placing agency licensed under the provisions of this chapter makes any false or
9 misleading report to the department of health and human services, the license must be
10 suspended immediately. Upon hearing before the department, if such false or misleading
11 reports are found to have been made, the license forthwith must be revoked.
14 50-12-14.1. Conditions for placement of children in state - Consent of department
15 required.
16 Any person undertaking to bring or to send a child into this state for placement in foster
17 care, as a preliminary to a possible adoption, or for guardianship shall furnish the department of
18 health and human services with written notice of the intention to send, bring, or place the child
19 in the state and shall obtain prior written consent from the department for each child to be so
20 placed. The notice must contain:
21 1. The name, date, and place of birth of the child;
22 2. The identity and address or addresses of the parent or legal guardian;
23 3. The name and address of the person, agency, or institution to or with which the child is
24 proposed to be placed;
25 4. A full statement of the reasons for such proposed action and evidence of the authority
26 pursuant to which the placement is proposed to be made; and
27 5. Any supporting or additional information as the department determines necessary
28 under the circumstances.
29 This section does not apply to the sending or bringing of a child into this state by the child's
30 parent, stepparent, grandparent, adult brother or sister, adult uncle or aunt, or the child's
31 guardian and leaving the child with any such relative or nonagency guardian in this state.
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3 50-12-16. Taking children from state for placement in family homes - Consent of
4 department - Report.
5 No person, partnership, voluntary association, corporation, or limited liability company may
6 take or send any child out of the state for placement in a family home in another state without
7 first securing the consent of the department of health and human services so to do and without
8 first reporting to the department:
9 1. The name and address of the child to be taken or sent;
10 2. The name and address of the family which is to receive the child; and
11 3. Such other information concerning the family and the child as the department may
12 require.
13 This section does not apply to a parent who personally removes the parent's child from the
14 state.
17 50-12-17. Licensure requirement - Registration requirement - Penalty.
18 A person may not place or cause to be placed any child in a family home for adoption
19 without a license to do so from the department of health and human services except that a
20 parent, upon giving written notice to the department, may place the parent's child in the home of
21 the child's parent, stepparent, grandparent, adult brother or sister, adult uncle or aunt, or
22 guardian for adoption by the person receiving the child. The child must be considered
23 abandoned if proceedings for the adoption or guardianship of the child are not initiated by such
24 relative within one year following the date of notice of placement. A person who willfully violates
25 this chapter is guilty of a class C felony. For purposes of this section, "to place or cause to be
26 placed" means to place a child for adoption; arrange or provide for short-term foster care for a
27 child pending an adoptive placement; facilitate placement of a child by maintaining a list in any
28 form of birth parents or prospective adoptive parents; or advertise in any public medium that the
29 person knows of a child who is available for adoption or is willing to accept a child for adoption
30 or that the person knows of prospective adoptive parents of a child.
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6 50-19-04. Inspection and report by statethe department of health and state fire
7 marshal.
8 The department shall give notice to the state department of health and state fire marshal of
9 each application for a license to operate a maternity home. Upon receipt of the notice, the
10 stateThe department of health and the state fire marshal shall inspect the facilities and
11 premises of the applicant to determine compliance with health and fire safety standards, and
12 the state fire marshal shall report theirthe marshal's findings to the department.
15 50-19-10. Records of maternity home confidential.
16 Except as otherwise authorized by law, no agent of the state department of health, the state
17 fire marshal, or the department, or the licensee, under this chapter, may disclose the contents of
18 the records of a maternity home nor of the reports received from them, except:
19 1. In a judicial or administrative proceeding in response to an order of a court or
20 administrative tribunal; or
21 2. For a law enforcement purpose to a law enforcement official or a health oversight
22 agency for oversight activities authorized by law.
25 50-19-14. Cooperation of interested persons and agencies.
26 The licensee of a maternity home, the state department of health and its agents, the state
27 fire marshal and the state fire marshal's designees, and the department and its agents shall
28 cooperate in all measures and services for improving and safeguarding the health and social
29 well-being of mothers and their infants who receive services in a maternity home.
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1 50-21-02. Administration of revolving fund.

2 The revolving fund and loans made therefrom must be supervised and administered by the
3 Bank of North Dakota. All applications for loans under the provisions of this chapter for the
4 construction of nursing homes or combination nursing homes and basic care facilities must be
5 made to the state department of health and human services, which department is authorized,
6 subject to the approval of the North Dakota health council, to promulgate such rules and
7 regulations as may be necessary to carry out the provisions of this chapter. All applications for
8 the construction of basic care facilities must be made to the state department of health and
9 human services, which department shall promulgate such rules and regulations as may be
10 necessary to carry out the provisions of this chapter. Applications approved by the state
11 department of health and human services and the North Dakota health council must be
12 forwarded to the Bank of North Dakota. Upon approval of such application by the president of
13 the Bank of North Dakota, loans must be granted by the Bank of North Dakota from the
14 revolving fund in accordance with the provisions of this chapter.
17 50-21-03. Amount of loan - Terms and conditions.
18 Loans in an amount not exceeding one-half of the cost of construction or reconstruction
19 including the cost or value of real estate upon which the facility is located and in no event
20 exceeding one hundred fifty thousand dollars to any one applicant shall be made by the Bank of
21 North Dakota to nonprofit corporations to be used in the construction or reconstruction in this
22 state of nursing homes, basic care facilities, or combination nursing homes and basic care
23 facilities. Such loans must bear interest at the rate of seven percent per annum and must be
24 repayable in the manner prescribed by the president of the Bank of North Dakota within a
25 period of not more than twenty-five years. In addition, in consideration of the granting of the
26 loans, each nonprofit corporation shall execute a contract with the state to operate such basic
27 care facility for a period of not less than twenty years and to operate and maintain the basic
28 care facility in accordance with the standards prescribed for the licensing of such basic care
29 facility by the state department of health and human services. Such contract must also require
30 the nonprofit corporation to maintain facilities for not less than five persons referred to such
31 basic care facility by any county social service board. Such contract must also provide that if the
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1 use of such basic care facility is discontinued or if it is diverted to other purposes, the full
2 amount of the loan provided under this chapter immediately becomes due and payable. Loans
3 may be made only to an applicant who is not receiving other loans or grants of funds from this
4 state for such construction or reconstruction. Payments of interest and principal upon such
5 loans must be made to the Bank of North Dakota and credited to the revolving fund.
8 50-21-04. Standards - Administration procedure.
9 The state department of health, subject to the approval of the state health council, and
10 human services shall establish standards of construction which must be followed by all
11 applicants receiving loans of funds for the construction of nursing homes or combination nursing
12 homes and basic care facilities. The state department of health and human services shall
13 establish standards of construction which must be followed by all applicants for loans for the
14 construction of basic care facilities. The health council, in the case of the construction of nursing
15 homes or basic care facilities or combination nursing homes and basic care facilities, shall
16 approve all building plans and specifications for any facilities to be constructed in whole or in
17 part with loans of funds provided under the provisions of this chapter prior to the disbursement
18 of any such funds. Administrative procedures established by the state department of health with
19 the approval of the health counciland human services must, except to construction standards,
20 be in general in accordance with the procedures established for the administration of the federal
21 grant-in-aid program for similar purposes under the Hill-Burton Act, or federal acts supplemental
22 thereto.
28 50-24.1-01.3. Department to comply with federal requirements - Interagency
29 cooperation - Civil money penalty fund.
30 1. The department shall take any action necessary to comply with the requirements of
31 section 1919(h) of the federal Social Security Act [42 U.S.C. 1396r(h)], including
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1 establishing a process to enforce compliance by nursing facilities with requirements for

2 participation in the medical assistance program that conforms to any federal
3 regulations implementing that section.
4 2. The state department of health and the department shall cooperate to achieve prompt
5 and effective implementation of subsection 1.
6 3. The state treasurer shall establish a fund for the receipt of any civil money penalties
7 imposed under subsection 1. Any civil money penalty paid to the department under
8 subsection 1 must be deposited in that fund and, subject to the limits of legislative
9 appropriation, may be expended for the purpose allowed by the federal government.
10 4.3. This section may not be construed to create any right or authorize any activity not
11 provided for in section 1919(h) of the federal Social Security Act [42 U.S.C. 1396r(h)]
12 or its implementing federal regulations.
13 5.4. Before the establishment and assessment of civil money penalties permitted by
14 section 1919(h) of the federal Social Security Act [42 U.S.C. 1396r(h)], the department
15 is encouraged to submit a plan of alternative remedies in accordance with section
16 1919(h)(2)(B)(ii) of that Act.
19 a. "Department" means the department of health and human services or its agent.
22 50-24.1-34. Processing of claims submitted on behalf of inmates.
23 The department of health and human services shall process claims submitted by enrolled
24 medical providers on behalf of inmates at county jails. Each county shall pay the department for
25 the paid amount for the claims processed and also a processing fee for each claim submission.
26 The department may establish a processing fee that may not exceed fifty dollars and shall
27 update the fee annually on July first. The processing fee must be based on the actual costs to
28 the department of the claims processing operations divided by the annual volume of claims
29 submitted. The department shall invoice each county for payment of the processing fee.
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1 50-24.1-37. Medicaid expansion - Legislative management report. (Effective July 1,

2 2019, through December 31, 2019 - Contingent repeal - See note)
3 1. The department of human services shall expand medical assistance coverage as
4 authorized by the federal Patient Protection and Affordable Care Act [Pub. L. 111-148],
5 as amended by the Health Care and Education Reconciliation Act of 2010
6 [Pub. L. 111-152] to individuals under sixty-five years of age with income below one
7 hundred thirty-eight percent of the federal poverty line published by the federal office
8 of management and budget applicable to the household size.
9 2. The department shall inform new enrollees in the medical assistance expansion
10 program that benefits may be reduced or eliminated if federal participation decreases
11 or is eliminated.
12 3. The department shall implement the expansion by bidding through private carriers or
13 utilizing the health insurance exchange.
14 4. The contract between the department and the private carrier must:
15 a. Provide a reimbursement methodology for all medications and dispensing fees
16 which identifies the minimum amount paid to pharmacy providers for each
17 medication. The reimbursement methodology, at a minimum, must:
18 (1) Be available on the department's website; and
19 (2) Encompass all types of pharmacy providers regardless of whether the
20 pharmacy benefits are being paid through the private carrier or contractor or
21 subcontractor of the private carrier under this section.
22 b. Provide full transparency of all costs and all rebates in aggregate.
23 c. Allow an individual to obtain medication from a pharmacy that provides mail order
24 service; however, the contract may not require mail order to be the sole method
25 of service and must allow for all contracted pharmacy providers to dispense any
26 and all drugs included in the benefit plan and allowed under the pharmacy
27 provider's license.
28 d. Ensure that pharmacy services obtained in jurisdictions other than this state and
29 its three contiguous states are subject to prior authorization and reporting to the
30 department for eligibility verification.
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1 e. Ensure the payments to pharmacy providers do not include a required payback

2 amount to the private carrier or one of the private carrier's contractors or
3 subcontractors which is not representative of the amounts allowed under the
4 reimbursement methodology provided in subdivision a.
5 5. The contract between the department and the private carrier must provide the
6 department with full access to provider reimbursement rates. The department shall
7 consider provider reimbursement rate information in selecting a private carrier under
8 this section. Before August first of each even-numbered year, the department shall
9 submit a report to the legislative management regarding provider reimbursement rates
10 under the medical assistance expansion program. This report may provide cumulative
11 data and trend data but may not disclose identifiable provider reimbursement rates.
12 6. Provider reimbursement rate information received by the department under this
13 section and any information provided to the department of human services or any
14 audit firm by a pharmacy benefit manager under this section is confidential, except the
15 department may use the reimbursement rate information to prepare the report to the
16 legislative management as required under this section.
17 Medicaid expansion - Legislative management report. (Effective January 1, 2020,
18 through July 31, 2021 - Contingent repeal - See note)
19 1. The department of health and human services shall expand medical assistance
20 coverage as authorized by the federal Patient Protection and Affordable Care Act
21 [Pub. L. 111-148], as amended by the Health Care and Education Reconciliation Act of
22 2010 [Pub. L. 111-152] to individuals under sixty-five years of age with income below
23 one hundred thirty-eight percent of the federal poverty line published by the federal
24 office of management and budget applicable to the household size.
25 2. The department shall inform new enrollees in the medical assistance expansion
26 program that benefits may be reduced or eliminated if federal participation decreases
27 or is eliminated.
28 3. Except for pharmacy services, the department shall implement the expansion by
29 bidding through private carriers or utilizing the health insurance exchange.
30 4. The contract between the department and the private carrier must provide the
31 department with full access to provider reimbursement rates. The department shall
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1 consider provider reimbursement rate information in selecting a private carrier under

2 this section. Before August first of each even-numbered year, the department shall
3 submit a report to the legislative management regarding provider reimbursement rates
4 under the medical assistance expansion program. This report may provide cumulative
5 data and trend data but may not disclose identifiable provider reimbursement rates.
6 5. Provider reimbursement rate information received by the department under this
7 section is confidential, except the department may use the reimbursement rate
8 information to prepare the report to the legislative management as required under this
9 section.
12 50-24.1-38. Health-related services - Licensed community paramedics.
13 The department of human services shall adopt rules governing payments to licensed
14 community paramedics, advanced emergency medical technicians, and emergency medical
15 technicians for health-related services provided to recipients of medical assistance, subject to
16 necessary limitations and exclusions. A physician or an advanced practice registered nurse
17 must supervise any care provided by a licensed community paramedic, an advanced
18 emergency medical technician, or emergency medical technician.
21 2. The department of human services shall facilitate care coordination agreements. Of
22 any federal funding received in excess of the state's regular share of federal medical
23 assistance funding which results from care coordination agreements, the department
24 shall deposit sixty percent in the tribal health care coordination fund and forty percent
25 in the general fund.
28 50-24.3-01. Targeted case management.
29 The department of health and human services shall establish a targeted case management
30 service for disabled and elderly individuals eligible for benefits under chapter 50-24.1 who are at
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1 risk of requiring long-term care services to ensure that an individual is informed of alternatives
2 available to address the individual's long-term care needs.
5 50-24.3-03. Department of human services - Targeted case management - Powers and
6 duties.
7 The department of health and human services has the following powers and duties which it
8 may delegate to any entity that provides targeted case management services approved by the
9 department:
10 1. To seek cooperation from other public and private entities in the community that offer
11 services to individuals with disabilities or the elderly.
12 2. To provide information and education to the general public regarding availability of
13 targeted case management.
14 3. To accept referrals from an interested party including individuals, families, human
15 services program professionals, nursing facility personnel, and acute care facility
16 personnel.
17 4. To assess the health and social needs of, and provide targeted case management to,
18 referred individuals who wish to receive this service.
19 5. To identify available noninstitutional services to meet the needs of referred individuals.
20 6. To prepare an individual care plan for each individual receiving targeted case
21 management services.
22 7. To inform referred individuals of the extent to which long-term care services are
23 available, including institutional and community-based services, and of the individual's
24 opportunity to choose, in consultation with an attending physician, family members,
25 and other interested parties, among the appropriate alternatives that may be available.
26 8. To monitor the results of targeted case management and report to each legislative
27 assembly on these results and the cost-effectiveness of these services.
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1 50-24.3-03.1. Department of human services - Assessment services - Powers and

2 duties.
3 The department of health and human services has the following powers and duties which it
4 may delegate to any entity that provides assessment services approved by the department:
5 1. To seek cooperation from other public and private agencies in the community which
6 offer services to disabled and elderly persons.
7 2. To provide information and education to the general public regarding availability of the
8 assessment program.
9 3. To accept referrals from individuals, families, human services program professionals,
10 nursing facility personnel, and acute care facility personnel.
11 4. To assess the health and social needs of referred individuals.
12 5. To identify available noninstitutional services to meet the needs of referred individuals.
13 6. To prepare recommendations for individuals receiving assessment program services
14 as to the need for skilled nursing care or other care available in the community.
15 7. To inform referred individuals of the extent to which home and community-based
16 services are available and of their opportunity to choose, in consultation with an
17 attending physician and family member, among the appropriate alternatives that may
18 be available.
24 50-24.4-12. Avoiding detrimental effect on quality of care.
25 If the department learns that expenditures for direct resident care have been reduced in
26 amounts large enough to indicate a possible detrimental effect on the quality of care, the
27 department shall notify the state department of healthlicensing division shall be notified.
30 1. Charging private-paying residents rates for similar services which exceed those rates
31 which are approved by the department for medical assistance recipients, as
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1 determined by the prospective desk audit rate, except under the following
2 circumstances: the nursing home may charge private-paying residents a higher rate
3 for a private room and charge for special services which are not included in the daily
4 rate if medical assistance residents are charged separately at the same rate for the
5 same services in addition to the daily rate paid by the department of human services.
6 Services covered by the payment rate must be the same regardless of payment
7 source. Special services, if offered, must be offered to all residents and charged
8 separately at the same rate. Residents are free to select or decline special services.
9 Special services must not include services which must be provided by the nursing
10 home in order to comply with licensure or certification standards and that if not
11 provided would result in a deficiency or violation by the nursing home. Services
12 beyond those required to comply with licensure or certification standards must not be
13 charged separately as a special service if they were included in the payment rate for
14 the previous reporting year. A nursing home that charges a private-paying resident a
15 rate in violation of this chapter is subject to an action by the state or any of its
16 subdivisions or agencies for civil damages. A private-paying resident or the resident's
17 legal representative has a cause of action for civil damages against a nursing home
18 that charges the resident rates in violation of this chapter. The damages awarded shall
19 include three times the payments that result from the violation, together with costs and
20 disbursements, including reasonable attorney's fees or their equivalent.
26 50-24.5-02.2. Basic care facility private room rates.
27 The department of human services shall allow a basic care facility to charge a higher rate
28 for a private room used by a recipient of benefits under this chapter if the private room is not
29 necessary to meet the resident's care needs; the resident, or a person acting on behalf of the
30 resident, has requested the private room and the facility informs the person making the request,
31 at the time of the request, of the amount of payment and that the payment must come from
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1 sources other than a resident's monthly income; and the payment does not exceed the amount
2 charged to private pay residents.
5 50-24.5-10. Compensation for top management personnel - Department to adopt
6 emergency rules.
7 Notwithstanding the requirements of subsection 2 of section 28-32-03, the department of
8 human services has the authority to create emergency rules related to the compensation for top
9 management personnel of a basic care facility combined with a hospital.
21 9. "Department" means the department of health and human services or its designee.
24 17. "State child protection team" means a multidisciplinary team consisting of the
25 designee of the department and, where possible, of a physician, a representative of a
26 child-placing agency, a representative of the state department of health, a
27 representative of the attorney general, a representative of the superintendent of public
28 instruction, a representative of the department of corrections and rehabilitation, one or
29 more representatives of the lay community, and, as an ad hoc member, the designee
30 of the chief executive official of any institution named in a report of institutional abuse
31 or neglect. All team members, at the time of their selection and thereafter, must be
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1 staff members of the public or private agency they represent or shall serve without
2 remuneration. An attorney member of the child protection team may not be appointed
3 to represent the child or the parents at any subsequent court proceeding nor may the
4 child protection team be composed of fewer than three persons.
7 50-25.1-04.2. Child fatality review panel.
8 The state child protection team shall serve as a child fatality review panel. The department
9 shall appoint a peace officer licensed in the state, a mental health professional, and any other
10 person as appropriate to assist the panel in the performance of its duties. The department, in
11 coordination with the state department of health, shall adopt rules for the operation of the panel.
12 Panel members are not entitled to compensation or reimbursement of expenses for service on
13 the panel.
16 10. The state department of health, in coordination with the department of human
17 services, shall develop and implement a public awareness campaign to provide
18 information, public service announcements, and educational materials regarding this
19 section to the public, including medical providers, law enforcement, and social service
20 agencies.
26 50-27-01. Creation and administration of children's trust fund.
27 There is hereby created in the state treasury a special fund known as the children's trust
28 fund. The children and family services division of the department of health and human services
29 shall administer the fund. All moneys designated for the fund from whatever source derived
30 must be deposited with the state treasurer in the children's trust fund. The state treasurer shall
31 invest such funds in interest-bearing accounts as is designated by the children and family
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1 services division, and the interest earned must be deposited in the children's trust fund. The
2 children and family services division shall designate the administrator of child protective
3 services as executive secretary of the children's trust fund.
6 50-27-03. Authority of the children and family services division of the department of
8 The children and family services division may:
9 1. Create such advisory committees as may be deemed necessary to assure public
10 involvement in the planning, development, and administration of the children's trust
11 fund.
12 2. Hire or arrange for appropriate staff, as deemed necessary, to administer and maintain
13 properly the children's trust fund.
14 3. Develop, implement, and periodically review a written plan to be used in administering
15 the funds expended from and retained in the children's trust fund. The written plan
16 must include the types of activities to be funded, the nature of organizations preferred
17 for funding, the criteria for eligible fund applicants, and the mechanisms for the
18 monitoring and evaluating of funded activities.
19 4. Award grants from the children's trust fund in accordance with this chapter and any
20 rules that have been adopted.
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7 50-32-02.1. Continuation of existing licenses.
8 1. An assisted living facility that possessed a valid license issued by the department of
9 human services before August 1, 2005, may not be subsequently denied a license by
10 the department of human services merely due to failure to meet the requirements of
11 sections 23-09-01, 50-32-01, and 50-32-02 provided that the assisted living facility
12 meets all other licensing requirements.
13 2. If there is a change in ownership of an assisted living facility that possessed a valid
14 license issued before August 1, 2005, the department of human services shall allow a
15 continuance of the exception to the licensure requirements under subsection 1 for the
16 new owner. The continuance provided under this subsection applies to the first change
17 in ownership after July 31, 2005, and does not apply to any subsequent change in
18 ownership.
27 3. Job service North Dakota may provide workforce safety and insurance, the labor
28 commissioner, the driver's license division of the department of transportation, the
29 department of health and human services, the department of commerce, the state tax
30 commissioner, and the information technology department for purposes of the
31 statewide longitudinal data system with information obtained pursuant to the
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1 administration of the unemployment insurance program, and may enter into

2 interagency agreements with those entities for the exchange of information that will
3 enhance the administration of the unemployment insurance program. Any information
4 furnished pursuant to this subsection or pursuant to interagency agreements
5 authorized by this subsection is to be used only for governmental purposes.
8 5. If two or more claimant agencies have delinquent accounts for the same player, the
9 director shall apportion the prize equally among them. However, a setoff to the
10 department of health and human services for child support payments has priority over
11 all other setoffs.
14 1. The following executive and administrative officers and departments shall submit to
15 the governor and the secretary of state reports covering their operations for the two
16 preceding fiscal years, except as otherwise provided by law, not later than the first day
17 of December each year after the regular session of the legislative assembly:
18 a. Secretary of state.
19 b. State auditor.
20 c. Insurance commissioner.
21 d. Attorney general.
22 e. Agriculture commissioner.
23 f. Superintendent of public instruction.
24 g. State tax commissioner.
25 h. Public service commission.
26 i. Department of corrections and rehabilitation.
27 j. Department of transportation.
28 k. State department of health.
29 l. Department of health and human services.
30 m.l. Workforce safety and insurance.
31 n.m. Office of management and budget.
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1 o.n. State treasurer.

2 p.o. Labor commissioner.
3 q.p. Department of financial institutions.
4 r.q. Game and fish department.
5 s.r. Industrial commission.
6 t.s. Job service North Dakota.
7 u.t. Board of university and school lands.
8 v.u. Department of environmental quality.
11 3. The attorney general may require payment for legal services rendered by any
12 assistant or special assistant attorney general to any state official, board, department,
13 agency, or commission and those entities shall make the required payment to the
14 attorney general. Moneys received by the attorney general in payment for legal
15 services rendered must be deposited into the attorney general's operating fund.
16 General fund moneys may not be utilized for the payment of legal services provided by
17 the attorneys employed by the attorney general, except for those payments required of
18 the department of health and human services, state department of health, department
19 of environmental quality, and the state hospital.
22 54-23.3-10. Community behavioral health program - Reports to legislative
23 management and governor.
24 1. The department of corrections and rehabilitation shall establish and implement a
25 community behavioral health program to provide comprehensive community-based
26 services for individuals who have serious behavioral health conditions, as a term and
27 condition of parole under chapter 12-59, and as a sentencing alternative under section
28 12.1-32-02.
29 2. In developing the program under this section, the department of corrections and
30 rehabilitation shall collaborate with the department of health and human services to:
31 a. Establish a referral and evaluation process for access to the program.
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1 b. Establish eligibility criteria that includes consideration of recidivism risk and

2 behavioral health condition severity.
3 c. Establish discharge criteria and processes, with a goal of establishing a
4 seamless transition to postprogram services to decrease recidivism.
5 d. Develop program oversight, auditing, and evaluation processes that must
6 include:
7 (1) Oversight of case management services through the department of health
8 and human services;
9 (2) Outcome and provider reporting metrics; and
10 (3) Annual reports to the legislative management and the governor on the
11 status of the program.
12 e. Establish a system through which:
13 (1) The department of health and human services:
14 (a) Contracts with and pays behavioral health service providers; and
15 (b) Supervises, supports, and monitors referral caseloads and the
16 provision of services by contract behavioral health service providers.
17 (2) Contract behavioral health service providers accept all eligible referrals,
18 provide individualized care delivered through integrated multidisciplinary
19 care teams, and continue services on an ongoing basis until discharge
20 criteria are met.
21 (3) Contract behavioral health service providers receive payments on a
22 per-month per-referral basis. The payment schedule must be based on a
23 pay-for-performance model that includes consideration of identified
24 outcomes and the level of services required.
25 (4) Contract behavioral health service providers bill third-parties for services
26 and direct payment to the general fund.
27 3. The department of health and human services may adopt rules as necessary to
28 implement this program.
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1 1. The department of corrections and rehabilitation, with contracts through the

2 department of health and human services and through the implementation of the
3 community behavioral health program, shall allow faith-based organizations to provide
4 services to individuals who need addiction treatment services.
9 54-44.1-12 of the North Dakota Century Code is amended and reenacted as follows:
10 (2) General fund appropriations to the department of health and human
11 services for direct care programs.
14 54-44.3-30. Agencies subject to merit system.
15 All personnel employed by the department of health and human services, the regional
16 offices of that department, job service North Dakota, North Dakota human resource
17 management services, the state department of health, department of environmental quality, and
18 other agencies or political subdivisions as may by federal law or rule be required to be subject
19 to a merit system in order to obtain federal grants-in-aid are covered by the merit system
20 provided in this chapter. Merit system coverage must also be provided to personnel employed
21 as purchasing agents or buyers in the purchasing division of the office of management and
22 budget. Other agencies, departments, or divisions and positions must be placed under a merit
23 system in the manner and to the extent required by law.
26 54-44.3-31. Political subdivision may request to be exempted from state merit
27 system.
28 A political subdivision subject to the merit system under this chapter may file a request with
29 the division and the executive director of the department of health and human services to be
30 exempted from the merit system. The request must describe a plan and policy that assures the
31 political subdivision has developed a merit system plan that meets federal standards for
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1 personnel administration. The division and the executive director of the department of health
2 and human services shall authorize the political subdivision plan within sixty days of receiving a
3 request under this section if the plan and policies meet federal requirements. If the division and
4 the executive director of the department of health and human services determine that the
5 proposed plan and policies fail to meet the federal requirements, the division and the executive
6 director shall deny the request and notify the requester of the specific reasons for the denial.
9 54-44.3-32. Political subdivision merit system compliance.
10 The division and the department of health and human services shall develop oversight and
11 audit procedures for political subdivision merit systems to assure compliance with federal merit
12 system principles. If the division and the department of health and human services determine
13 that a political subdivision has failed to maintain compliance with federal merit system
14 principles, the division and the department shall notify the political subdivision of the
15 noncompliance and order the political subdivision to take corrective action. If a political
16 subdivision does not take the necessary corrective action to comply with federal merit system
17 principles, the division and the department of health and human services shall revoke the
18 political subdivision's exemption from the state merit system and return the political subdivision
19 to the state merit system. The political subdivision is responsible for any penalty assessed by a
20 federal authority for a noncompliant political subdivision merit system.
23 3. The department of health and human services shall furnish specialized
24 telecommunications equipment to meet the needs of individuals who are
25 communications impaired and who might be otherwise disadvantaged in their ability to
26 obtain such equipment. The department of health and human services shall determine
27 eligibility and may provide the specialized telecommunications equipment to
28 individuals determined eligible within the limits of funding made available to the
29 department of health and human services through gifts and grants received under
30 section 54-44.8-06 and from funding made available by the information technology
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1 department from the surcharge collected pursuant to section 54-44.8-08, which are
2 appropriated.
5 54-44.8-06. Gifts and grants.
6 The department of health and human services may accept contributions and gifts and may
7 apply for and accept grants, in money or otherwise, to the program. Monetary contributions,
8 gifts, and grants must be deposited in the state treasury to be credited to the department of
9 health and human services operating account.
12 54-46-13. Rules for state and human service zone records - Administrator to adopt.
13 The administrator shall adopt rules in accordance with chapter 28-32 for state and human
14 service zone records. The rules adopted by the administrator must be consistent with records
15 retention requirements imposed by federal law with respect to those records. The administrator,
16 prior to adoption, amendment, or repeal of rules concerning state and human service zone
17 records, shall consult with the executive director of the department of health and human
18 services.
21 1. The health information technology advisory committee consists of the state chief
22 information officer or the chief information officer's designee, the state health officer or
23 the state health officer's designee, the governor or the governor's designee, the
24 executive director of the department of health and human services or the executive
25 director's designee, the chairman of the house human services committee and the
26 chairman of the senate human services committee or if either or both of them are
27 unwilling or unable to serve then the chairman of the legislative management shall
28 appoint a replacement who is a member of the same legislative chamber as the
29 individual being replaced, and individuals appointed by the governor to represent a
30 broad range of public and private health information technology stakeholders. A
31 committee member who is not an ex officio member, designee of an ex officio
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1 member, state employee, or legislator is entitled to mileage and expenses as provided

2 by law for state officers and employees, to be paid by the health information
3 technology office. A committee member who is an ex officio member, designee of an
4 ex officio member, state employee, or legislator is entitled to receive that member's
5 regular salary and receive mileage and expenses, to be paid by the employing agency.
6 SECTION 497. AMENDMENT. Subdivision i of subsection 2 of section 54-59-26 of the
8 i. Consult and coordinate with the state department of health and the department of
9 human services to facilitate the collection of health information from health care
10 providers and state agencies for public health purposes, including identifiable
11 health information that may be used by state agencies, departments, or
12 institutions to comply with applicable state or federal laws.
13 SECTION 498. AMENDMENT. Subdivision g of subsection 1 of section 54-59-33 of the
15 g. The executive director of the department of health and human services or the
16 director's designee;
19 a. Consult with partners in the state's system for workforce development, workforce
20 training, and talent attraction, including job service North Dakota, the department
21 of career and technical education, the superintendent of public instruction, the
22 state board of higher education, the department of health and human services,
23 and other divisions of the department of commerce.
26 57-38-01.16. Income tax credit for employment of individuals with developmental
27 disabilities or chronically mentally ill persons.
28 A taxpayer filing an income tax return under this chapter may claim a credit against the tax
29 liability imposed under section 57-38-30 for a portion of the wages paid to an employee with a
30 developmental disability or a chronically mentally ill employee. The credit allowed under this
31 section equals five percent of up to six thousand dollars in wages paid during the first twelve
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1 months of employment by the taxpayer for each employee with a developmental disability or
2 chronically mentally ill employee of the taxpayer. Only wages actually paid during the taxpayer's
3 taxable year may be considered for purposes of this section. An employee of a subcontractor is
4 considered an employee of the contractor to the extent of any wages paid under the contract.
5 The total of credits allowed under this section may not exceed fifty percent of the taxpayer's
6 liability under this chapter.
9 1. "Claimant agency" means the department of health and human services, job service
10 North Dakota, workforce safety and insurance, state institutions of higher education,
11 the North Dakota student loan service center, the insurance commissioner, the North
12 Dakota guaranteed student loan program, the industrial commission acting as the
13 state housing finance agency under chapter 54-17, a housing authority created under
14 section 23-11-02, or the state court administrator on behalf of the state courts for
15 purposes of court-ordered fines, fees, or costs due the state. On or before September
16 first of each year, the state housing finance agency shall conduct an election by mail
17 among housing authorities of the state and certify to the tax commissioner which
18 housing authority received the greatest number of votes and is capable of compliance
19 with the duties of a claimant agency under section 57-38.3-05. During the ensuing
20 calendar year, the housing authority certified as selected under this subsection shall
21 act as the claimant agency for all housing authorities for the purposes of submitting
22 debtor information to the tax commissioner for fund transfers and for providing notice
23 to the debtor as required by section 57-38.3-05.
26 3. A claim made by any child support unit of the department of health and human
27 services has priority in setting off any refund. Other claims rank by date of certification
28 under section 57-38.3-05 in the office of the commissioner with the claim earlier
29 certified having priority.
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1 24. Gross receipts from all sales when made to an eligible facility or emergency medical
2 services provider for the use or benefit of its patient or occupant. For the purposes of
3 this subsection:
4 a. "Eligible facility" means any hospital, skilled nursing facility, intermediate care
5 facility, or basic care facility licensed by the state department of health, or any
6 assisted living facility licensed by the department of health and human services;
7 and
8 b. "Emergency medical services provider" means an emergency medical services
9 operation licensed by the state department of health and human services under
10 chapter 23-27.
11 SECTION 504. AMENDMENT. Subdivision f of subsection 4 of section 57-40.6-10 of the
13 f. Dispatch the emergency medical service that has been determined to be the
14 quickest to arrive to the scene of medical emergencies regardless of city, county,
15 or district boundaries. The state department of health and human services shall
16 provide public safety answering points with the physical locations of the
17 emergency medical services necessary for the implementation of this
18 subdivision.
21 57-63-03. Basis of assessment.
22 Every year beginning July first, each intermediate care facility for individuals with intellectual
23 disabilities must be assessed a quarterly rate per licensed bed as of the first day of each
24 quarter. The quarterly rate may not exceed a rate calculated by the department of health and
25 human services as an annual aggregate of gross revenues as of December thirty-first of the
26 preceding year for all intermediate care facilities for individuals with intellectual disabilities,
27 multiplied by one and one-half percent, and divided by licensed beds as of December thirty-first
28 of the preceding year.
29 SECTION 506. AMENDMENT. Subdivision n of subsection 2 of section 59-09-02 of the
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1 n. A trust managed by a nonprofit association for disabled individuals under

2 42 U.S.C. 1396p(d)(4), as in effect on the effective date of chapters 59-09, 59-10,
3 59-11, 59-12, 59-13, 59-14, 59-15, 59-16, 59-17, 59-18, and 59-19 and under the
4 rules adopted by the department of health and human services.
7 61-38-03. Permits - Certification from state department of health and human services
8 required. (Contingent effective date - See note)
9 The state engineer may not issue a permit under this chapter without a certification from the
10 state department of health and human services that the permitted activity will not adversely
11 affect water quality.
12 SECTION 508. AMENDMENT. Paragraph 3 of subdivision a of subsection 16 of section
14 (3) Human service zone general assistance workers, except those who are
15 engaged in repaying to human service zones or the department of health
16 and human services moneys the human service zones or the department of
17 human services have been compelled by statute to expend for general
18 assistance.
21 65-05.1-06.3. Rehabilitation services pilot programs - Reports.
22 The organization may implement a system of pilot programs to allow the organization to
23 assess alternative methods of providing rehabilitation services. A pilot program may address
24 one or more of the organization's comprehensive rehabilitation services, including vocational,
25 medical, psychological, economic, and social rehabilitation services. The goal of a pilot program
26 must be to improve the outcome of the rehabilitation services offered by the organization to
27 assist the injured employee in making adjustments necessitated from the employee's injury and
28 to improve the effectiveness of vocational rehabilitation services in returning an employee to
29 substantial gainful employment. Notwithstanding laws to the contrary, a pilot program may
30 address a broad range of approaches, including collaborative efforts between the organization
31 and the injured employee through which there are variances from the rehabilitation services
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1 hierarchy; return-to-work trial periods during which cash benefits are suspended; intensive job
2 search assistance; recognition of and focused services for injured employees who are at risk;
3 and coordination of services of public and private entities. If a pilot program utilizes coordination
4 of services of other state agencies, such as job service North Dakota, department of health and
5 human services, North Dakota university system, or department of public instruction, the
6 organization shall consult with the state agency in establishing the relevant portions of the pilot
7 program and the state agency shall cooperate with the organization in implementing the pilot
8 program. The organization shall provide status reports on current pilot programs in accordance
9 with section 65-01-19.
10 SECTION 510. LEGISLATIVE INTENT. It is the intent of the sixty-seventh legislative
11 assembly that:
12 1. The state department of health merge into the department of human services and both
13 agencies be called the department of health and human services;
14 2. The state department of health, including the state health officer, fall under the
15 authority of the executive director of the department of human services, now known as
16 the executive director of the department of health and human services;
17 3. The executive director of the former department of human services review and
18 reorganize the structure of the former department of human services to incorporate the
19 former state department of health and to find efficiencies in the newly formed
20 department of health and human services;
21 4. The office of management and budget transfer the state department of health's
22 appropriation into the department of human services appropriation for the biennium
23 beginning July 1, 2021, and ending June 30, 2023;
24 5. Section 1 of Senate Bill No. 2004, as approved by the sixty-seventh legislative
25 assembly, shall transfer into subdivisions 1 and 2 of section 1 of House Bill No. 1012,
26 as approved by the sixty-seventh legislative assembly, for the biennium beginning
27 July 1, 2021, and ending June 30, 2023;
28 6. The combined budget of the department of human services and state department of
29 health be referred to the budget of the department of health and human services; and
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1 7. Department of health and human services is to be substituted for, shall take any action
2 previously to be taken by, and shall perform any duties previously to be performed by
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House Bill 1247

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House Bill 1247

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21.0621.

Representatives Weisz, Devlin, Kreidt, Rohr, M. Ruby

Senators Anderson, Lee

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1 19-02.1-01, section 19-02.1-07, subsection 5 of section 19-02.1-10, section 19-02.1-10.1,

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1 subsection 2 of section 23-10-01, subsection 11 of section 23-12-09, subdivision a of

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1 section 26.1-36.5-03, subsection 2 of section 26.1-36.5-04, sections 26.1-45-13, 26.1-47-01,

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27 BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:

28 SECTION 1. AMENDMENT. Subsection 3 of section 4.1-26-20 of the North Dakota Century

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1 ordered by a court, a financial service provider may determine whether to refuse a

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1 2. This section does not impose a duty on a financial institution to investigate a

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1 c. "Qualified individual" means any agent, investment adviser representative, or

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1 or law enforcement pursuant to an investigation. The records may include historical

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1 SECTION 14. AMENDMENT. Subdivision e of subsection 1 of section 12-44.1-28 of the

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1 p. The state board of pharmacy for applicants or disciplinary investigations under

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1 whichever is greater, in addition to any other remedy or damages permitted by law.

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1 enforcement may be obtained by calling state public assistance agencies or

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1 d. Specify the circumstances that should be considered in reducing support

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1 14-12.2-47.3. (703) Relationship of department of health and human services to

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1 SECTION 52. AMENDMENT. Subdivision d of subsection 1 of section 14-19-06 of the North

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1 SECTION 62. AMENDMENT. Subsection 1 of section 14-20-22 of the North Dakota

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