25-01-01. Definitions. [Effective through August 31, 2022]

In this title, unless the context or subject matter otherwise requires:

1. “Licensed physician” means an individual licensed under the laws of this state to practice medicine and also means a medical officer of the government of the United States while in this state in the performance of the physician’s official duties.
2. “Mentally ill individual” means an individual having a psychiatric or other disease which substantially impairs the individual’s mental health.
3. “North Dakota vision services - school for the blind” means the North Dakota vision services - school for the blind as maintained under section 25-06-01.
4. “School for the deaf” means the school for the deaf of North Dakota.
5. “State hospital” means the state hospital for the mentally ill.
6. “Superintendent” means the superintendent of the state hospital, of the life skills and transition center, of North Dakota vision services - school for the blind, or of the school for the deaf, as the case may be.
7. “Supervising officer” means the executive director of the department of human services or the superintendent of public instruction, as the case may be.
8. “Tier 1 mental health professional” means a tier 1a or tier 1b mental health professional.
   1. A tier 1a mental health professional is a psychiatrist licensed under chapter 43-17 or a psychologist licensed under chapter 43-32.
   2. A tier 1b mental health professional is a licensed physician or a physician assistant licensed under chapter 43-17 or an advanced practice registered nurse licensed under chapter 43-12.
9. “Tier 2 mental health professional” means a tier 2a or a tier 2b mental health professional.
   1. A tier 2a mental health professional is an independent clinician who is a licensed clinical social worker licensed under chapter 43-41, a licensed professional clinical counselor licensed under chapter 43-47, or a licensed marriage and family therapist licensed under chapter 43-53.
   2. A tier 2b mental health professional is an addiction counselor licensed under chapter 43-45 or a registered nurse licensed under chapter 43-12.
10. “Tier 3 mental health professional” means a licensed associate professional counselor licensed under chapter 43-47, a licensed master social worker or licensed baccalaureate social worker licensed under chapter 43-41, a licensed professional counselor licensed under chapter 43-47, an associate marriage and family therapist licensed under chapter 43-53, an occupational therapist licensed under chapter 43-40, a licensed practical nurse licensed under chapter 43-12, a behavior analyst licensed or registered under chapter 43-32, a vocational rehabilitation counselor practicing under chapter 50-06.1, a school psychologist, or a human relations counselor.
11. “Tier 4 mental health professional” means a direct care associate or technician.

25-01-01. Definitions. [Effective September 1, 2022]

In this title, unless the context or subject matter otherwise requires:

1. “Licensed physician” means an individual licensed under the laws of this state to practice medicine and also means a medical officer of the government of the United States while in this state in the performance of the physician’s official duties.
2. “Mentally ill individual” means an individual having a psychiatric or other disease which substantially impairs the individual’s mental health.
3. “North Dakota vision services - school for the blind” means the North Dakota vision services - school for the blind as maintained under section 25-06-01.
4. “School for the deaf” means the school for the deaf of North Dakota.
5. “State hospital” means the state hospital for the mentally ill.
6. “Superintendent” means the superintendent of the state hospital, of the life skills and transition center, of North Dakota vision services - school for the blind, or of the school for the deaf, as the case may be.
7. “Supervising officer” means the executive director of the department of health and human services or the superintendent of public instruction, as the case may be.
8. “Tier 1 mental health professional” means a tier 1a or tier 1b mental health professional.
   1. A tier 1a mental health professional is a psychiatrist licensed under chapter 43-17 or a psychologist licensed under chapter 43-32.
   2. A tier 1b mental health professional is a licensed physician or a physician assistant licensed under chapter 43-17 or an advanced practice registered nurse licensed under chapter 43-12.
9. “Tier 2 mental health professional” means a tier 2a or a tier 2b mental health professional.
   1. A tier 2a mental health professional is an independent clinician who is a licensed clinical social worker licensed under chapter 43-41, a licensed professional clinical counselor licensed under chapter 43-47, or a licensed marriage and family therapist licensed under chapter 43-53.
   2. A tier 2b mental health professional is an addiction counselor licensed under chapter 43-45 or a registered nurse licensed under chapter 43-12.
10. “Tier 3 mental health professional” means a licensed associate professional counselor licensed under chapter 43-47, a licensed master social worker or licensed baccalaureate social worker licensed under chapter 43-41, a licensed professional counselor licensed under chapter 43-47, an associate marriage and family therapist licensed under chapter 43-53, an occupational therapist licensed under chapter 43-40, a licensed practical nurse licensed under chapter 43-12, a behavior analyst licensed or registered under chapter 43-32, a vocational rehabilitation counselor practicing under chapter 50-06.1, a school psychologist, or a human relations counselor.
11. “Tier 4 mental health professional” means a direct care associate or technician.

25-01-01.1. State council on developmental disabilities. [Effective through August 31, 2022]

There must be maintained in the department of human services a state council on developmental disabilities consisting of one representative of each of the following departments, divisions, institutions, and organizations designated by the head of such agency or organization:

1. Office of superintendent of public instruction.
2. North Dakota department of human services.
3. State department of health.
4. Life skills and transition center.
5. Job service North Dakota.

The council shall, at a minimum, include representation that conforms to federal law requirements regarding state councils on developmental disabilities. All members of the council must be appointed by the governor. The council shall select its own officers who shall serve for a term of two years commencing on October first of each year. Meetings must be held at least twice a year or at the call of the chairman or upon notice in writing signed by not less than three members of the council. A simple majority of the council constitutes a quorum and may act upon any matter coming before the council. Members of the council are entitled to reimbursement in the same manner and at the same rate provided by law for other state officials.

The council shall assist in the development of the state plan for developmental disabilities, monitor and evaluate the implementation of such state plan, and review and comment on all state plans in the state which relate to programs affecting individuals with developmental disabilities. The council may take any action reasonably necessary to secure and administer any money made available to state councils on developmental disabilities through the Developmentally Disabled and Bill of Rights Act [Pub. L. 95-602; 92 Stat. 2955; 42 U.S.C. 6000 et seq.]. The council, if approved by the governor, shall appoint a full-time director who shall assist the council. The director must be classified under the state personnel merit system. The council shall also perform studies and surveys of the needs of individuals with developmental disabilities in North Dakota and shall facilitate coordination of the activities of all state departments, divisions, agencies, and institutions having responsibilities in the field of developmental disabilities.

25-01-01.1. State council on developmental disabilities. [Effective September 1, 2022]

1. There must be maintained in the department of health and human services a state council on developmental disabilities consisting of:
   1. One representative of each of the following departments, divisions, institutions, and organizations designated by the head of such agency or organization:
      1. Office of superintendent of public instruction.
      2. Job service North Dakota.
   2. Three representatives of the department of health and human services to include at least:
      1. One representative from the life skills and transition center designated by its superintendent; and
      2. One representative from the department’s health division.
2. The council shall, at a minimum, include representation that conforms to federal law requirements regarding state councils on developmental disabilities. All members of the council must be appointed by the governor. The council shall select its own officers who shall serve for a term of two years commencing on October first of each year. Meetings must be held at least twice a year or at the call of the chairman or upon notice in writing signed by not less than three members of the council. A simple majority of the council constitutes a quorum and may act upon any matter coming before the council. Members of the council are entitled to reimbursement in the same manner and at the same rate provided by law for other state officials.
3. The council shall assist in the development of the state plan for developmental disabilities, monitor and evaluate the implementation of such state plan, and review and comment on all state plans in the state which relate to programs affecting individuals with developmental disabilities. The council may take any action reasonably necessary to secure and administer any money made available to state councils on developmental disabilities through the Developmentally Disabled and Bill of Rights Act [Pub. L. 95-602; 92 Stat. 2955; 42 U.S.C. 6000 et seq.]. The council, if approved by the governor, shall appoint a full-time director who shall assist the council. The director must be classified under the state personnel merit system. The council shall also perform studies and surveys of the needs of individuals with developmental disabilities in North Dakota and shall facilitate coordination of the activities of all state departments, divisions, agencies, and institutions having responsibilities in the field of developmental disabilities.

25-01-02. Transfer of patients between institutions.

The supervising officer may transfer patients of the state hospital or life skills and transition center between such institutions whenever the superintendent of any such institution shall recommend such transfer and the supervising department is satisfied, upon investigation, that such transfer is advisable. If any patient, so transferred, is maintained at the expense of the county from which the patient was committed, the cost of the patient’s maintenance in the institution to which the patient is transferred must be charged to such county and must be collected therefrom upon notice to the county auditor of such county by the supervising officer.

25-01-02.1. Health council to investigate mental health of patients. [Repealed]

Repealed by S.L. 1987, ch. 570, § 45.

25-01-03. Supervising officer to appoint superintendent of institutions — Salaries — Removal.

1. The supervising officer shall appoint a superintendent for each of the institutions under its control, except for the state hospital, where the supervising officer shall appoint a superintendent in consultation with a state hospital governing body.
2. The tenure of office of each superintendent is two years from the date of the superintendent’s appointment, and the superintendent must possess qualifications required by this title. Any superintendent may be removed by the supervising officer for misconduct, neglect of duty, incompetency, or other proper cause showing the superintendent’s inability or refusal properly to perform the duties of office. A removal at a time other than a termination of the superintendent’s two-year tenure may be had only after an opportunity is given to the person to be heard before a board consisting of the governor, attorney general, and supervising officer of the institution on preferred written charges. A removal when made, however, is final. This subsection does not apply to the superintendent of North Dakota vision services — school for the blind or the superintendent of the school for the deaf, whose positions are included in the classified service as provided in section 54-44.3-20.
3. The supervising officer shall fix the compensation of each superintendent within the limits prescribed in this title and within the appropriations made by the legislative assembly for compensation.

25-01-04. Superintendent of each institution to qualify.

The superintendent of each of the institutions mentioned in this chapter, before entering upon the duties of office, shall take the oath prescribed for civil officers.

25-01-05. General powers and duties of superintendents of various institutions.

The superintendent of each of the institutions mentioned in this chapter is the chief executive officer of the institution of which the person is superintendent and, in connection with such institution, shall:

1. Employ all employees and assistants required in the management of the institution, the number of whom must be determined in cooperation with the supervising officer.
2. Have general charge of the institution and of the grounds thereof.
3. Have general charge of the direction, treatment, control, and discipline of all persons, employees, and patients at or connected with the institution.
4. Formulate, subject to the approval of the supervising officer, all rules and regulations relating to the conduct of the persons within and employees of the institution.
5. Maintain salutary discipline among all employees and persons or patients in or connected with the institution and enforce strict obedience to all rules and regulations thereof.
6. Cause complete records to be kept of all persons admitted to the institution.
7. Submit to the supervising officer reports of the institution in such form, at such times, and containing such information, as may be required by the supervising officer.
8. Employ only licensed physicians as members of the institutional physician staff.

25-01-06. Duty of superintendent and the supervising officer in case of questionable commitment.

The superintendent of the state hospital and the superintendent of the life skills and transition center shall notify the supervising officer immediately if there is any question as to the propriety of the commitment or detention of any person received at the institution, and the supervising officer, upon such notification, shall inquire into the matter presented and shall take such action as may be deemed proper in the premises.

25-01-07. Salaries of officers and employees other than superintendent — How fixed.

The supervising officer in cooperation with the superintendent, prior to July first in each year, shall fix the annual or monthly salaries of all of the officers, exclusive of the superintendent, and all of the employees in each of the several institutions mentioned in this chapter. It shall classify such officers and employees into grades, and the salaries paid to those in each grade, all other factors being equal, must be uniform in the several institutions. The schedule of salaries fixed by the supervising officer shall become operative on July first in the year in which the same are fixed. The supervising officer in cooperation with the superintendent may fix the salaries of additional employees hired after July first and may increase the salary of any employee deemed worthy of such increase. Such salaries must be paid in the same manner as other expenses of the several institutions are paid. All of the salaries in each institution, however, must be within the limits fixed by the appropriations made by the legislative assembly for salaries in such institution.

25-01-08. Discharge of subordinate officers and employees.

The superintendent of any institution mentioned in this chapter may discharge any person employed therein, subject to such restrictions as may be placed upon such power by the supervising officer. The superintendent shall show in the record of any person discharged the reason therefor.

25-01-09. Officers of institutions to be furnished food supplies. [Repealed]

Repealed by S.L. 1971, ch. 501, § 2.

25-01-10. Supervising officer may accept gifts and bequests — State treasurer to have custody of funds.

The supervising officer may accept in the name of the state and hold in trust for any institution mentioned in this chapter any lands conveyed or devised and any money or other personal property given or bequeathed for application to any purpose connected with such institution. All moneys and property coming into the hands of the supervising officer as grants, donations, devises, gifts, and bequests must be used for the specific purposes for which they are granted, donated, devised, bequeathed, or given. If no terms are imposed upon the use of any grant, donation, devise, bequest, or gift, it must be used for the general maintenance of the institution for the benefit of which it is made.

25-01-11. State treasurer to have custody of income from granted lands.

The state treasurer is custodian of all funds arising from the sale of any lands granted to any institution named in this chapter, and such funds must be deposited with the state treasurer. The state treasurer shall keep a separate account for each such institution to which a land grant has been made, and moneys in each such separate fund must be used exclusively for the benefit of the institution to which the same belongs.

25-01-12. Drawing of funds — Sale of lands — Release of mortgages — Appropriations limit power to contract.

Moneys appropriated or given to any institution mentioned in this chapter shall be expended only upon order of the supervising officer. The supervising officer, however, does not have the power to bind the state for any purpose in connection with any such institution beyond the amount of the appropriation which may have been made to such institution for such purpose, nor to sell or convey any part of the real estate belonging to any such institution without the consent of the legislative assembly, except that it may release any mortgage or convey any real estate which may have been received by it through any gift, bequest, or devise or upon any trust, the terms of which authorize such satisfaction or conveyance.

25-01-13. Members of board and officers of institutions not to be interested in certain contracts. [Repealed]

Repealed by S.L. 1965, ch. 203, § 86.

25-01-14. Claim for or proceedings to recover money in inmates’ or patients’ fund — Limitation. [Repealed]

Repealed by S.L. 1961, ch. 211, § 9.

25-01-15. Money remaining in inmates’ or patients’ personal accounts transferred to general welfare account of institution. [Repealed]

Repealed by S.L. 1975, ch. 425, § 29.

25-01-16. Treating patients cruelly — Penalty.

Any person responsible for the care or custody of any person admitted to a state institution in accordance with the provisions of this title, who treats the person admitted with severity, harshness, or cruelty, or who abuses that person in any way, is guilty of a class A misdemeanor.

25-01-17. Religious exercise of patient or resident under the care of the department of human services. [Effective through August 31, 2022]

1. The department of human services may not:
   1. Substantially burden the exercise of religion by patient or resident under the department’s care unless the burden is in furtherance of a compelling governmental interest and is the least restrictive means of furthering that compelling governmental interest;
   2. Treat religious conduct more restrictively than any comparable secular conduct unless the department demonstrates the disparate treatment is necessary to further a compelling governmental interest and is the least restrictive means of furthering that compelling governmental interest; or
   3. Deny clergy access to a patient or resident for the purpose of providing religious services unless the department demonstrates the denial is necessary to further a compelling governmental interest and is the least restrictive means of furthering that compelling governmental interest.
2. A patient or resident of the department of human services claiming to be aggrieved by a violation of this section, may assert, after exhausting appropriate administrative remedies, that violation as a claim or defense in a judicial proceeding and obtain appropriate relief, including costs and reasonable attorney’s fees.

25-01-17. Religious exercise of patient or resident under the care of the department of health and human services. [Effective September 1, 2022]

1. The department of human services may not:
   1. Substantially burden the exercise of religion by patient or resident under the department’s care unless the burden is in furtherance of a compelling governmental interest and is the least restrictive means of furthering that compelling governmental interest;
   2. Treat religious conduct more restrictively than any comparable secular conduct unless the department demonstrates the disparate treatment is necessary to further a compelling governmental interest and is the least restrictive means of furthering that compelling governmental interest; or
   3. Deny clergy access to a patient or resident for the purpose of providing religious services unless the department demonstrates the denial is necessary to further a compelling governmental interest and is the least restrictive means of furthering that compelling governmental interest.
2. A patient or resident of the department of health and human services claiming to be aggrieved by a violation of this section, may assert, after exhausting appropriate administrative remedies, that violation as a claim or defense in a judicial proceeding and obtain appropriate relief, including costs and reasonable attorney’s fees.

25-01.1-01. Definition of supervising department.

In this chapter unless the context or subject matter otherwise requires, “supervising department” means that department, division, board, or office responsible for and exercising supervision, control, and administration over the state hospital, as provided by law.

25-01.1-02. Heads of institutions responsible to supervising department.

For the exercise of the duties of general supervision over the institutions subject to the control of the supervising department, the heads of the institutions are responsible to the supervising department.

25-01.1-03. Adopt uniform system of accounting.

The supervising department shall devise and install a system of accounting and auditing of all moneys appropriated, received, and expended. Such system must be adapted to the institutions under its control and must be made as nearly uniform as the necessities of the case may permit and in accordance with requirements of the office of management and budget.

25-01.1-04. Books and accounts kept by supervising department.

The supervising department shall keep at its office a proper and complete system of books and accounts with each institution under its control which must show every expenditure authorized and made thereat. The book must exhibit an account of each extraordinary or special appropriation made by the legislative assembly, with each item of expenditure thereof.

25-01.1-05. Blanks and forms furnished by supervising department.

The supervising department shall formulate and furnish to each institution under its control proper blanks and forms for all statements and accounts necessary to furnish the information required of the institution.

25-01.1-06. Supervising department to have access to institutions and to books and records of institutions.

The supervising department shall have access to all the state institutions under its management and control and to all books, accounts, vouchers, supplies, and equipment of each of the institutions so that the supervising department may familiarize itself with the conditions, needs, and requirements of the institutions. All books, documents, and records relating to the concerns and business of such institutions except personal records of patients at all times must be open to the examination of any citizen of this state. Personal records of patients must be made available upon court order or in accordance with rules and regulations established by the supervising department.

25-01.1-07. Rules for procedure and administration of institutions.

The supervising department shall make all necessary rules for its own procedure and for the general administration, supervision, and management of the institutions under its control and management.

25-01.1-08. Inspection of institutions.

The supervising department or its duly authorized representative shall visit and inspect the institutions under its administration and control concerning administration, treatment, or finances of such institutions at any time, but shall make such inspection at least twice each year. If deemed necessary, the supervising department shall examine under oath the officers and attendants, guards, and other employees and make such inquiries as will determine their fitness for their respective duties.

25-01.1-09. Investigation of institutions — Witnesses — Fees — Not excused from testifying.

The supervising department, in aid of the investigation of any institution under its control, may summon and compel the attendance of witnesses and examine the same under oath, which any member thereof shall have the power to administer. The supervising department shall have access to all books, accounts, papers, and property material to such investigation and may order the production of any other books or papers material thereto. Witnesses other than those in the employ of the state are entitled to the same fees as are allowed in civil cases in the district court. The claim that any testimony or evidence sought to be elicited or produced on such examination may tend to incriminate the person giving or producing it, or expose that person to public ignominy, does not excuse that person from testifying or producing evidence, documentary or otherwise, but no person may be prosecuted or subjected to any penalty or forfeiture for and on account of any matter or thing concerning which the person may testify or produce such evidence. The witness is not exempt from prosecution and punishment for perjury committed in so testifying.

25-01.1-10. Testimony taken at investigation transcribed and filed.

The supervising department shall cause the testimony taken at any investigation to be transcribed and filed in its office within ten days after the same is taken, or as soon thereafter as practicable. When so filed, the evidence must be open for inspection of any person.

25-01.1-11. Failure to testify — Contempt.

Any person who fails or refuses to obey the orders of the supervising department issued in an investigation of any institution under its control, or to give or produce evidence when required, must be reported by the supervising department to the district court or any judge thereof and must be dealt with by the court or judge as for contempt of court.

25-01.1-12. Report to governor any abuses and wrongs existing in institutions.

The supervising department shall investigate and report to the governor any abuses or wrongs alleged to exist in the institutions under its control and management.

25-01.1-13. Supervising department to keep record of persons in institutions.

The supervising department shall keep in its office a record showing:

1. The residence, sex, age, nativity, occupation, religion, civil condition, and date of entrance or commitment of every person, patient, or inmate in the institutions under its control and administration.
2. The date of discharge of every such person from the institutions, and whether such discharge was final.
3. The condition of the person at the time the person left the institution.
4. If a person is transferred from one institution to another, to what institution transferred.
5. If a person, patient, or inmate of an institution dies, the date and cause of death.

This information must be furnished to the supervising department by the institutions under its control. Such other obtainable facts must be furnished as the supervising department, from time to time, may require. No one may have access to the records, except as authorized by the supervising department, or on the order of a court of record.

25-01.1-14. Entrance and discharge record of persons at institutions.

The managing officer of each institution, within thirty days after the commitment or entrance of a person, patient, or inmate to the institution, shall cause a true copy of the entrance record to be made and forwarded to the office of the supervising department. When a patient or inmate leaves, or is discharged, transferred, or dies in any institution, the superintendent or person in charge, within ten days thereafter, shall send such information to the supervising department having control of such institution. All such information must be furnished on forms which the supervising department may prescribe.

25-01.1-14.1. Heads of institutions — Duty to appoint surrogate parents.

The heads of each of the state institutions shall establish as required by the state superintendent a procedure for determining whether a patient under the age of twenty-one years needs a surrogate parent and for assigning such a surrogate parent for the purpose of special education and related services.

25-01.1-15. Supervising department to provide protection against fire — Means of escape.

The supervising department under advisement of the state fire marshal shall compel the superintendent of each of the institutions under its control to:

1. Provide at each institution adequate and ready means of protection against fire.
2. Construct proper means of escape for the patients and attendants where the same are not already constructed.
3. Establish and enforce rigid rules and regulations by which the danger of fire shall be minimized.
4. Prevent, as far as possible, injury to the patients or pupils and loss or destruction, by any cause, of the property of the state.

25-01.1-16. Inventory of stocks and supplies.

The supervising department, annually on June thirtieth of each year, shall require the superintendent of each institution under its charge to make a complete, minute, and accurate inventory of the stock and supplies on hand, and the amount and value thereof. The inventory must be under the following heads:

1. Livestock.
2. Produce of the farm on hand.
3. Automobiles, trucks, and other vehicles.
4. Agricultural implements.
5. Machinery.
6. Mechanical fixtures.
7. Real estate.
8. Beds and bedding in patients’ department.
9. Other furniture in patients’ department.
10. Personal property of the state in superintendent’s department.
11. Readymade clothing.
12. Dry goods.
13. Provisions and groceries.
14. Drugs and medicines.
15. Fuel.
16. Library property.
17. All other property under such heads as the supervising department may deem proper.

A like inventory must be submitted by the proper superintendent of each institution to the supervising department when requested by the supervising department.

25-01.1-17. Moneys remitted to state treasurer.

All moneys belonging to the state, derived from any source at any of the institutions under the control of the supervising department, must be accounted for and remitted to the state treasurer not later than the tenth day of each month. The state treasurer shall maintain a special operating fund within the state treasury for each remitting institution. All rents, interests, or income from land, money, or property donated or granted by the United States and allocated to specific charitable institutions under the terms of the Enabling Act and the Constitution of North Dakota must be deposited in such special operating fund of each institution and expended in accordance with section 1 of article IX of the Constitution of North Dakota. The state treasurer shall make periodic transfers upon order of the director of the office of management and budget from each institutional general fund appropriation to the appropriate institutional special operating fund whenever its balance falls so low as to require supplementation. All funds for necessary expenditures of such institutions must be drawn from the special operating fund in the state treasury as provided by this chapter.

25-01.1-18. Property of institution is property of state.

All public property of every kind and all public money in the charge of the superintendent of any institution under the control of the supervising department, or that comes to the superintendent’s control on account of the institution under the superintendent’s charge, or from the business thereof, is the property of the state and at all times must be kept separate and apart from the property of such superintendent.

25-01.1-19. Funds belonging to institutions or patients to be paid to superintendent.

Each officer and employee of all state institutions under the management and control of the supervising department shall pay over to the superintendent of the institution without delay any funds which may come into the officer’s or employee’s hands belonging to any patient of the institution and of which the superintendent is the legal custodian. An officer or employee shall pay over to the proper officer of the institution without delay any funds belonging to the institution.

25-01.1-20. Care and custody of funds belonging to patients of state institutions.

The superintendent of any state institution under the management and control of the supervising department, when the care and custody of any funds belonging to patients of a state institution are by law devolved upon the superintendent, shall keep accurate accounts of these funds in books provided for that purpose and shall pay out these funds under rules as may be prescribed by law or by the supervising department, taking proper vouchers of the funds in all cases from the patient or responsible representative of the patient. Each superintendent shall give a bond conditioned for the faithful performance of duties.

25-01.1-21. Property of patients to be returned.

The money and effects, except clothing, in possession of each patient when committed to any institution under control of the supervising department must be preserved by the superintendent of such institution and returned to such patient when discharged.

25-01.1-22. Estimate of expenditures of institutions presented to supervising department and office of management and budget — Revision.

At the times and in the manner provided by the office of management and budget, the superintendent shall cause to be prepared triplicate estimates of all expenditures required for the institution. Two of the said triplicate estimates must be sent to the supervising department and the third must be kept by the superintendent. The supervising department may revise the estimates for supplies or other expenditures and shall certify that it has carefully examined the same and that the articles contained in such estimates as approved, or revised by it, are, to its best knowledge and belief, actually required for the use of the institution. An approved copy containing any revisions of the estimate by the supervising department must be forwarded by the supervising department to the office of management and budget which shall contract for the required purchases.

25-01.1-23. Office of management and budget to advertise for bids for supplies — State firm given preference. [Repealed]

Repealed by S.L. 1979, ch. 568, § 11.

25-01.1-24. Contract for supplies sent to institution.

When the estimates for supplies for the institutions under the control of the supervising department have been certified and revised by the supervising department and bids for the supplies enumerated and described therein have been received and contracts for furnishing the supplies have been let by the office of management and budget, a copy of such revised estimates and the contract for furnishing the supplies enumerated and described in such revised estimates, duly certified, must be sent to the institution and another copy must be sent to the supervising department having control of such institution.

25-01.1-25. Office of management and budget may purchase supplies on open market. [Repealed]

Repealed by S.L. 1979, ch. 568, § 11.

25-01.1-26. Bill presented to institution — Form — Thirty days allowed to pay for supplies.

The supplies purchased for the institutions under the control of the supervising department must be purchased so as to permit at least thirty days’ time to pay therefor. The officer of the institution designated by the supervising department shall require itemized bills to be rendered by the person who furnishes supplies, in duplicate, for all purchases whether made upon contract or otherwise, which must be in the form prescribed by the office of management and budget and certified as required for other claims against the state.

25-01.1-27. Rules for purchase of supplies — Jobbers to file address with office of management and budget or institutions. [Repealed]

Repealed by S.L. 1979, ch. 568, § 11.

25-01.1-28. Supplies of institutions — Duties of officers.

The officer of each institution who is designated by the supervising department to have charge of and to be accountable for all the supplies and stores of the institution must be charged therewith at their invoice value, and shall:

1. Direct all purchases of such institution as may be ordered by the office of management and budget under the estimates as provided in section 25-01.1-22, in conjunction with the superintendent of each institution.
2. Issue all the supplies upon requisition approved by the superintendent or other officer designated by the supervising department. The requisition shall be the officer’s voucher therefor.
3. Examine and register all goods delivered, according to their amount and quality, and if found to correspond with the samples and in good order and correct in charge, the officer shall certify the bills.
4. Make a consolidated report of all purchases to the office of management and budget and the supervising department and all other transactions of such institution to such supervising department at the close of the annual period.

25-01.1-29. Shortage in supplies — Liability of officer in charge.

If it appears that there is a shortage in the supplies of any institution, the supervising department having control of such institution shall appoint a committee to investigate the cause thereof. If it appears that the shortage resulted from unavoidable loss, without the negligence of the officer designated to have charge of the supplies, such officer must be credited therewith, otherwise the officer must be charged with the amount thereof and must be required to pay the same into the state treasury within sixty days after the determination of the loss. If default is made in such payment, the officer shall forfeit the office and suit must be instituted upon the officer’s official bond to recover the same.

25-01.1-30. Monthly statement of institutional expenditures and payroll to supervising department.

An officer designated by the supervising department for each institution under its control shall prepare two monthly statements showing first the payroll and second the expenditures of every kind during the preceding month. Such statement must be signed by the officer, approved by the superintendent of the institution, and filed with the supervising department on a date fixed by the supervising department for the examination and audit of such department. Attached thereto must be the affidavit of the officer stating that the services therein specified were rendered and that the goods and other articles therein specified were purchased and received by the officer or under the officer’s direction at the institution and were purchased at a fair cash market price on credit not exceeding thirty days, that neither the officer nor any person in the officer’s behalf had any pecuniary or other interest in the purchases made, that the officer did not receive any pecuniary or other benefit therefrom, directly or indirectly, by commission, percentage, deductions or in any other manner whatever, and that the articles contained in such bill conformed in all respects to the invoiced goods received and ordered by the officer or the samples from which the goods were purchased, both in quality and quantity. Such monthly statement must be accompanied by the original invoices of all institutional purchases and a complete itemized statement of each institutional expenditure. If any invoice or statement, or any part thereof, is found objectionable, the supervising department having control of such institution shall endorse its disapproval thereon with its reasons therefor, and shall return it to the management of the institution, and when the matter disapproved of is corrected, the statement and invoice must be returned to the supervising department.

25-01.1-31. Audit of monthly statements of expenditures — Abstracts of statement — Payment.

When the monthly statement of expenditures of an institution have been audited by the supervising department having control of such institution and found correct, the supervising department shall prepare an abstract, in duplicate, showing the name, residence, and the amount due each claimant, and the institution and the fund thereof on account of which the payment shall be made. The supervising department shall deliver one copy thereof to the office of management and budget and the other copy must be retained in the office of the department. The office of management and budget, upon receipt of the certified abstract, after approval by the office of the budget, shall issue a warrant or warrants for the amount or amounts thereof and shall deliver the same to the supervising department for delivery to the proper officer of the institution, to be paid out in conformity with such rules as the supervising department may prescribe.

25-01.1-32. Examination of monthly payroll — Payment.

When the monthly statement of the payroll of an institution has been audited by the supervising department and found correct, the supervising department shall prepare an abstract, in duplicate, showing the name, residence, and the amount due each claimant, and the institution and the fund from which the payment shall be made. The supervising department shall deliver one copy thereof to the office of management and budget and the other copy must be retained in the office of the supervising department. The office of management and budget, upon receipt of the certified abstract, after approval by the office of the budget, shall issue a warrant or warrants for the amounts thereof and shall deliver the same to the supervising department for delivery to the proper officer of the institution, to be paid out in accordance with such rules as the supervising department may prescribe.

25-01.1-33. Use of patient labor in erection or repair of buildings of institutions.

All work for the erection, repair, or improvement of buildings, grounds, or properties under the control of the supervising department must be let by contract, except that the work of patients in such institutions may be utilized if approved by the superintendent of such institution as having possible benefits to the patient and not detrimental to the patient’s health or treatment and when the use of such labor will not substantially depart from the requirements of chapter 48-01.2.

25-01.1-34. Supervising department, employees, or employees of institutions not to be interested in contracts.

No member of the supervising department, nor any employee of any of the same, nor any employee of the institutions under control of the supervising department, may be interested, directly or indirectly, in any contract, purchase, or sale for or on account of any of the institutions under control of such supervising department. Any violation of the provisions of this section is sufficient cause for removal from office.

25-01.1-35. Members of supervising department and officers and employees of institutions prohibited from accepting gifts — Penalty.

No member of the supervising department, nor any officer, agent, or employee thereof, and no superintendent, officer, manager, or employee of any of the institutions under the charge and control of the supervising department, directly or indirectly, for that person or to benefit any other person, may receive or accept any gift or gratuity from any person dealing in goods, merchandise, or supplies which may be used in any of the institutions, or from any employee, servant, or agent of such person. Any person violating the provisions of this section is guilty of a class A misdemeanor. Such violation is cause for removal from office.

25-01.1-36. Employees — Penalty for influencing appointment.

Any member of the supervising department and any officer thereof who exerts any improper influence, by solicitation or otherwise, on the superintendent of any institution under the control of the supervising department, in the selection of any employee or assistant, is guilty of a class A misdemeanor.

25-01.1-37. Political influence or contribution by members of supervising department or employees of institution prohibited.

Any member or officer of the supervising department, or any officer or employee of an institution subject to control of the supervising department, who, by solicitation or otherwise, exerts the person’s influence, directly or indirectly, to induce other officers or employees of the state to adopt the person’s political views must be removed from the person’s office or position by the proper authorities.

25-01.1-38. Child welfare — Powers and duties of supervising department.

In addition to the other duties prescribed by law, the supervising department has the following duties and powers:

1. To accept the guardianship of the persons or children who may be committed to its care by courts of competent jurisdiction as neglected, delinquent, dependent, or defective.
2. To make such provisions for children committed to its care as are within the resources of the supervising department, and as will afford them proper care and protection.
3. To take the initiative in protecting and conserving the rights and interests of neglected, dependent, delinquent, illegitimate, and defective children.
4. To act as parole officers of juveniles upon the request of courts of the state to which dependent, neglected, handicapped, or delinquent children may be committed.

25-01.2-01. Definitions. [Effective through August 31, 2022]

In this chapter, unless the context or subject matter otherwise requires:

1. “Applicant” means an entity that has requested licensure from the department.
2. “Department” means the department of human services.
3. “Developmental disability” means a severe, chronic disability of an individual which:
   1. Is attributable to a mental or physical impairment or combination of mental and physical impairments, including Down syndrome;
   2. Is manifested before the individual attains age twenty-two;
   3. Is likely to continue indefinitely;
   4. Results in substantial functional limitations in three or more of the following areas of major life activity:
      1. Self-care;
      2. Receptive and expressive language;
      3. Learning;
      4. Mobility;
      5. Self-direction;
      6. Capacity for independent living; and
      7. Economic sufficiency; and
   5. Reflects the individual’s needs for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services which are of lifelong or extended duration and are individually planned and coordinated.
4. “Individualized setting” means a setting where an individual owns or rents the individual’s residence and a public or private agency or organization provides services to an individual with a developmental disability.
5. “Institution or facility” means any school, hospital, residence center, group home, or any other setting operated by any public or private agency or organization, that provides services to an individual with a developmental disability.
6. “Least restrictive appropriate setting” means that setting that allows an individual with a developmental disability to develop and realize the individual’s fullest potential and enhances the individual’s ability to cope with the individual’s environment without unnecessarily curtailing fundamental personal liberties.
7. “License” means authorization by the department to provide services to individuals with developmental disabilities, pursuant to chapter 25-16.
8. “Service or services to an individual with a developmental disability” means services provided by any public or private agency or organization, directed toward the alleviation of a developmental disability or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability.

25-01.2-01. Definitions. [Effective September 1, 2022]

In this chapter, unless the context or subject matter otherwise requires:

1. “Applicant” means an entity that has requested licensure from the department.
2. “Department” means the department of health and human services.
3. “Developmental disability” means a severe, chronic disability of an individual which:
   1. Is attributable to a mental or physical impairment or combination of mental and physical impairments, including Down syndrome;
   2. Is manifested before the individual attains age twenty-two;
   3. Is likely to continue indefinitely;
   4. Results in substantial functional limitations in three or more of the following areas of major life activity:
      1. Self-care;
      2. Receptive and expressive language;
      3. Learning;
      4. Mobility;
      5. Self-direction;
      6. Capacity for independent living; and
      7. Economic sufficiency; and
   5. Reflects the individual’s needs for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services which are of lifelong or extended duration and are individually planned and coordinated.
4. “Individualized setting” means a setting where an individual owns or rents the individual’s residence and a public or private agency or organization provides services to an individual with a developmental disability.
5. “Institution or facility” means any school, hospital, residence center, group home, or any other setting operated by any public or private agency or organization, that provides services to an individual with a developmental disability.
6. “Least restrictive appropriate setting” means that setting that allows an individual with a developmental disability to develop and realize the individual’s fullest potential and enhances the individual’s ability to cope with the individual’s environment without unnecessarily curtailing fundamental personal liberties.
7. “License” means authorization by the department to provide services to individuals with developmental disabilities, pursuant to chapter 25-16.
8. “Service or services to an individual with a developmental disability” means services provided by any public or private agency or organization, directed toward the alleviation of a developmental disability or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability.

25-01.2-02. Appropriate treatment, services, and habilitation — Treatment in least restrictive appropriate setting.

All individuals with developmental disabilities have a right to appropriate treatment, services, and habilitation for those disabilities. Treatment, services, and habilitation for individuals with a developmental disability must be provided in the least restrictive appropriate setting.

25-01.2-03. Presumption of incompetence prohibited — Discrimination prohibited — Deprivation of constitutional, civil, or legal rights prohibited.

An individual with a developmental disability may not be presumed to be incompetent and may not be deprived of any constitutional, civil, or legal right solely because of admission to or residence at an institution, facility, or individualized setting or solely because of receipt of services to individuals with developmental disabilities. However, nothing in this section may be construed to limit or modify section 16.1-01-04. The constitutional, civil, or legal rights which may not be varied or modified under the provisions of this section include:

1. The right to vote at elections;
2. The free exercise of religion;
3. The right of reasonable opportunities to interact with members of the opposite sex; and
4. The right to confidential handling of personal and medical records.

25-01.2-04. Communication rights.

1. Except as provided in this section, every individual with a developmental disability who resides in an institution, facility, or individualized setting has the right of private, unimpeded, and uncensored communication, including visitation, with persons of the individual’s choice.
2. A public or private agency or organization licensed by the department to provide services to an individual with a developmental disability shall document any restrictions of these rights in the individual’s person-centered service plan.
3. A public or private agency or organization not licensed by the department may establish in writing reasonable times and places for use of telephones and for visits, provided that an individual’s ability to contact an attorney, guardian, or custodian, may not be restricted and provided that any rules or restrictions must be posted in each institution, facility, or individualized setting.
4. A copy of any rules or restrictions must be given to all individuals over eighteen years of age, to the parents or custodians of all individuals under eighteen years of age, or guardian, upon admission.

25-01.2-05. Personal property.

1. Except as provided in this subsection, every individual with a developmental disability who resides in an institution, facility, or individualized setting must be permitted to receive, possess, and use lawful personal property and must be provided with a secure, convenient, and reasonable amount of storage space for that property.
2. A public or private agency or organization providing services to an individual with a developmental disability may restrict the possession and use of certain classes of property which may be dangerous or may harm an individual.
3. Notice of any restrictions must be immediately given in writing to all individuals over eighteen years of age, to the parents or custodian of all individuals under eighteen years of age, or guardian.
4. A restriction of the rights of an individual with a developmental disability which is imposed by a public or private agency or organization that provides services to the individual must be reviewed at least annually as part of the individual’s individualized habilitation, person-centered service, or individual education plan team meeting.
5. Unless a restriction applies universally, the restricting agency or organization shall remove the restriction placed on an individual with a developmental disability at the earliest point at which the individual demonstrates the ability to mitigate the need for the restriction.
6. When an individual is discharged from services provided from a public or private agency or organization, all of the individual’s lawful personal property that is in the custody of the public or private agency or organization must be returned to the individual.
7. A public or private agency or organization licensed by the department to provide services to an individual with a developmental disability shall document any restrictions of these rights in the individual’s person-centered service plan.

25-01.2-06. Labor — Wages — Money.

1. An individual with a developmental disability who is receiving services from a public or private agency or organization must be permitted to seek employment and work in integrated settings if this is a desire of the individual.
2. An individual with a developmental disability who performs labor that is of any consequential economic benefit to a public or private agency or organization shall receive wages that are commensurate with the value of the work performed, in accordance with applicable federal and state laws and regulations. An individual of an institution, facility, or individualized setting may be required to perform tasks of a personal housekeeping nature in the individual’s living quarters without compensation.
3. An individual with a developmental disability may use the individual’s money as the individual chooses, unless the individual is a minor or is prohibited from doing so under a court guardianship or conservatorship order.
4. An individual with a developmental disability may deposit money, or cause money to be deposited, in the individual’s name with a financial institution of the individual’s choice, or the individual may deposit the money with a public or private agency or organization. The public or private agency or organization may not retain any money deposited with the public or private agency or organization under this subsection, but shall hold all such funds in an account in the individual’s name. All earnings attributable to an individual’s money must accrue to the individual.
5. No public or private agency or organization, nor any of the public or private agency or organization’s employees may be made representative payee for an individual without the individual’s informed consent.
6. When an individual is discharged, all of the individual’s money, including earnings, must be returned to the individual.
7. A public or private agency or organization licensed by the department to provide services to an individual with a developmental disability shall document any restrictions of these rights in the individual’s person-centered service plan.

25-01.2-07. Medical and dental services — Application to residential institution or facility.

All residents of an institution or facility are entitled to appropriate and adequate medical and dental services, which must be provided by qualified professionals who are licensed to practice or are otherwise authorized to provide medical and dental services pursuant to state and federal law and regulations. This section applies only with respect to an institution or facility that provides residential care.

25-01.2-08. Medication — Chemical restraints.

An individual with a developmental disability receiving services at any institution, facility, or individualized setting from a public or private agency or organization may not be administered at any time any drug or medication, or be chemically restrained or tranquilized in any manner, except upon the written authorization of a licensed physician, physician assistant, or advanced practice registered nurse when necessary and appropriate as an element of the service being received or as a treatment of any medical or physical condition in conformity with accepted standards for that treatment. The nature, amount of, and reasons for the administration of any drug or medication must be promptly recorded in the individual’s medical record. A public or private agency or organization licensed by the department to provide services to an individual with a developmental disability shall document any restrictions of these rights in the individual’s person-centered service plan.

25-01.2-09. Punishment — Seclusion — Restraints — Psychosurgery — Sterilization — Shock treatment.

An individual with a developmental disability receiving services at any institution, facility, or individualized setting from a public or private agency or organization may not at any time:

1. Be subjected to any corporal punishment or shock treatment.
2. Be secluded, except to ensure immediate physical safety of the individual or others.
3. Be restrained, except to ensure immediate physical safety of the individual or others.
4. Be subjected to psychosurgery, sterilization, medical behavioral research, or pharmacological research, except in conformity with an order of a court of competent jurisdiction. Under no circumstances may an individual receiving treatment be subjected to hazardous or intrusive experimental research that is not directly related to the specific goals of that individual’s treatment program.
5. Be subjected to electroconvulsive therapy without that individual’s or guardian’s written and informed consent. If the recipient of services is a minor, the recipient’s parent, custodian, or guardian may provide informed consent for that treatment, which the parent, custodian, or guardian believes to be in the recipient’s best interests.

25-01.2-10. Seclusion or physical restraint — Administrator to be notified.

1. Whenever an individual with a developmental disability receiving services from a public or private agency or organization not licensed by the department, is placed in seclusion or is physically restrained, the public or private agency or organization administrator or the administrator’s representative must be notified and shall determine if the isolation or restraint is necessary. The isolation or restraint may be continued only upon written order of the administrator or the administrator’s representative and for a period of not more than twenty-four hours. Any individual who is in seclusion or who is physically restrained must be checked by an attendant at least once every thirty minutes.
2. A public or private agency or organization licensed by the department to provide services to an individual with a developmental disability may not place an individual in seclusion. In order to use physical restraints, the restraint must be in compliance with the individual’s person-centered service plan or done in accordance with the public or private agency’s or organization’s emergency restraint policy.

25-01.2-11. Psychosurgery, sterilization, or research — Court order required — Hearing — Right to attorney at public expense.

A court of competent jurisdiction may issue the orders required for the procedures or treatments in subsection 4 of section 25-01.2-09 upon application of the party alleging the necessity of the procedure, the individual who is receiving or is entitled to receive the treatment, the parents or custodian of the individual under eighteen years of age, or guardian, following a hearing on the application.

1. The individual receiving or entitled to treatment shall:
   1. Receive prior notice of the hearing;
   2. Have the right and the opportunity to present evidence; and
   3. Have the right to be confronted with and to cross-examine witnesses.
2. If the individual with a developmental disability is indigent, counsel shall be provided at public expense not less than ten days before the hearing.
3. The burden of proof is on the party alleging the necessity of the procedure or treatment.
4. An order allowing the procedure or treatment may not be granted unless the party alleging the necessity of the procedure or treatment proves by clear and convincing evidence that the procedure is in the best interest of the recipient and that no less drastic measures are feasible.

25-01.2-12. Diet.

Every individual with a developmental disability receiving residential services in an institution, facility, or individualized setting, must be allowed access to food at any time and meal choices must be provided. Any public or private agency or organization licensed by the department to provide services to an individual with a developmental disability shall document in the individual’s person-centered service plan any restrictions on access to or choice of food because of health and safety concerns.

25-01.2-13. Education.

Every child with a developmental disability is entitled to a free and appropriate education in the least restrictive appropriate setting in accordance with chapter 15.1-32.

25-01.2-14. Individualized habilitation, person-centered service, or individual education plan — Contents.

Any public or private agency or organization that provides services to an individual with a developmental disability must have a written, individualized habilitation, person-centered service, or individual educational plan developed and put into effect for each individual for whom that public or private agency or organization is primarily responsible for the delivery, or coordinating the delivery, of services. A plan required under this section must:

1. Be developed and put into effect within thirty days following admission of the individual.
2. Be reviewed and updated from time to time, but no less than annually.
3. Include a statement of the long-term habilitation or education goals for the individual and the intermediate objectives relating to the attainment of those goals. The objectives must be stated specifically, in sequence, and in behavioral or other terms that provide measurable indices of progress.
4. State an objective criteria and an evaluation procedure and schedule for determining whether the objectives and goals are being achieved.
5. Describe the personnel necessary for the provision of the services described in the plan.
6. Specify the date of initiation and the anticipated duration of each service to be provided.
7. State whether the individual with a developmental disability appears to need a guardian and determine the type of protection needed by the individual based on the individual’s actual mental and adaptive limitations and other conditions which may warrant the appointment of a guardian. Any member of the individual habilitation, person-centered service, or individual educational plan team may petition, or notify any interested person of the need to petition, for a finding of incapacity and appointment of a guardian.

25-01.2-15. Right to refuse services.

An adult recipient of services, parents or custodian if the recipient is a minor, or the recipient’s guardian, must be given the opportunity to refuse generally accepted behavioral health or developmental disability services, including medication, unless those services are necessary to prevent the recipient from causing serious harm to the recipient or to others. If services are refused, the recipient, guardian, or parent or custodian of a minor must be informed of alternate services available, the risks of those alternate services, and the possible consequences to the recipient of the refusal of generally accepted services.

25-01.2-16. Notice of rights.

Any public or private agency or organization that provides services to an individual with a developmental disability in an institution or facility shall post conspicuously in public areas a summary of the rights that are set out in this chapter. In addition, upon commencement of services or as soon after commencement as the recipient’s condition permits, every recipient who is eighteen years of age or older, the parents or custodian of all recipients under eighteen years of age, and the guardian must be given written notice of the rights guaranteed by this chapter.

25-01.2-17. Enforcement of rights.

Every individual with a developmental disability is entitled to enforce any of the rights guaranteed by this chapter by civil action or any other remedy available by common law or statute. In any proceeding to enforce these rights, the court may, in its discretion, award reasonable attorney’s fees and costs to a successful plaintiff. An individual with a developmental disability who is successful in an administrative proceeding may also be awarded reasonable attorney’s fees and costs. Any award of attorney’s fees and costs must be in addition to any actual or punitive damages to which the individual may be entitled.

25-01.2-18. Authority to adopt rules. [Effective through August 31, 2022]

The director of the state department of human services may adopt, in accordance with chapter 28-32, any rules necessary to implement this chapter. The superintendent of public instruction may adopt rules to implement this chapter in schools. The rules adopted may not restrict or limit the rights guaranteed by this chapter.

25-01.2-18. Authority to adopt rules. [Effective September 1, 2022]

The department of health and human services may adopt, in accordance with chapter 28-32, any rules necessary to implement this chapter. The superintendent of public instruction may adopt rules to implement this chapter in schools. The rules adopted may not restrict or limit the rights guaranteed by this chapter.

25-01.3-01. Definitions.

In sections 25-01.3-01 through 25-01.3-12, unless the context otherwise requires:

1. “Abuse” means:
   1. Willful use of offensive, abusive, or demeaning language by a caretaker that causes mental anguish of any person with developmental disabilities;
   2. Knowing, reckless, or intentional acts or failures to act which cause injury or death to a developmentally disabled or mentally ill person or which placed that person at risk of injury or death;
   3. Rape or sexual assault of a developmentally disabled or mentally ill person;
   4. Corporal punishment or striking of a developmentally disabled or mentally ill person;
   5. Unauthorized use or the use of excessive force in the placement of bodily restraints on a developmentally disabled or mentally ill person; and
   6. Use of bodily or chemical restraints on a developmentally disabled or mentally ill person which is not in compliance with federal or state laws and administrative regulations.
2. “Advocacy” means action to assist or represent a person or group of persons with developmental disabilities or mental illnesses in securing their rights, obtaining needed services, investigating complaints, and removing barriers to identified needs.
3. “Advocate” means an employee of the project.
4. “Caretaker” means a person, organization, association, or facility who has assumed legal responsibility or a contractual obligation for the care of a person with developmental disabilities or mental illness, or a parent, spouse, sibling, other relative, or person who has voluntarily assumed responsibility for the person’s care.
5. “Committee” means the committee on protection and advocacy.
6. “Complaint” means an allegation of a violation of human or legal rights, or a lack of needed services, which is not a report of abuse, neglect, or exploitation.
7. “Developmental disability” is a disability as defined in section 25-01.2-01.
8. “Eligibility for services” means persons eligible for services of the project, including:
   1. An adult with developmental disabilities.
   2. An adult suffering from a mental illness who is an inpatient or resident in a facility rendering care or treatment, even if the location of the person is unknown.
   3. An adult suffering from a mental illness who is in the process of being admitted to a facility rendering care or treatment, including persons being transported to such a facility.
   4. An adult suffering from a mental illness who within the last ninety days was an inpatient or resident of a facility rendering care or treatment.
   5. A child with developmental disabilities or a child with mental illness who meets the criteria of subdivision b, c, or d is eligible for advocacy services.
   6. A child with developmental disabilities or mental illness who is not an abused or neglected child as defined in chapter 50-25.1 is eligible for protective services.
9. “Exploitation”, when committed by a caretaker or relative of, or any person in a fiduciary relationship with, a person with developmental disabilities or mental illness, means:
   1. The taking or misuse of property or resources of a person with developmental disabilities or mental illness by means of undue influence, breach of fiduciary relationship, deception, harassment, criminal coercion, theft, or other unlawful or improper means;
   2. The use of the services of a person with developmental disabilities or mental illness without just compensation; or
   3. The use of a person with developmental disabilities or mental illness for the entertainment or sexual gratification of others under circumstances that cause degradation, humiliation, or mental anguish to the person with developmental disabilities or mental illness.
10. “Facility” means a school, residence center, group home, nursing home, foster home, boarding home, or other facility operated by any public or private agency, organization, or institution, which provides services to a person with developmental disabilities or mental illness.
11. “Individually identifiable health information” and “personal representative” have the meaning set forth in title 45, Code of Federal Regulations, part 160, section 103 and part 164, section 5-02, subsection g, respectively.
12. “Mental health professional” means a mental health professional as defined in section 25-03.1-02.
13. “Mental illness” means significant mental illness or emotional impairment as determined by a mental health professional.
14. “Neglect” means:
    1. Inability of a person with developmental disabilities or mental illness to provide food, shelter, clothing, health care, or services necessary to maintain the mental and physical health of that person;
    2. Failure by any caretaker of a person with developmental disabilities or mental illness to meet, either by commission or omission, any statutory obligation, court order, administrative rule or regulation, policy, procedure, or minimally accepted standard for care of persons with developmental disabilities or mental illnesses;
    3. Negligent act or omission by any caretaker which causes injury or death to a person with developmental disabilities or mental illness or which places that person at risk of injury or death;
    4. Failure by any caretaker, who is required by law or administrative rule, to establish or carry out an appropriate individual program or treatment plan for a person with developmental disabilities or mental illness;
    5. Failure by any caretaker to provide adequate nutrition, clothing, or health care to a person with developmental disabilities or mental illness;
    6. Failure by any caretaker to provide a safe environment for a person with developmental disabilities or mental illness; and
    7. Failure by any caretaker to maintain adequate numbers of appropriately trained staff at a facility providing care and services for persons with developmental disabilities or mental illnesses.
15. “Other appropriate remedies” means remedies achieved through alternative dispute resolution, such as discussion, education, conciliation, and mediation.
16. “Project” means the protection and advocacy project.
17. “Protective services” means actions to assist persons with developmental disabilities or mental illnesses who are unable to manage their own resources or to protect themselves from abuse, neglect, exploitation, or other hazards.
18. “Report” means a verbal or written communication, including an anonymous communication, alleging the abuse, neglect, or exploitation of a person with developmental disabilities or mental illness.

25-01.3-02. Committee on protection and advocacy.

1. The committee on protection and advocacy in its capacity of supervising and directing the project shall operate independently of the governor and any state agency that provides treatment, services, or habilitation to persons with disabilities or mental illnesses.
2. The committee consists of seven members who:
   1. Meet federal eligibility requirements for membership;
   2. Do not provide direct treatment, nonadvocacy services, or habilitation to address a need related to a disability or a mental illness;
   3. Do not hold an interest, whether as an officer, director, employee, or otherwise, in an entity that provides direct treatment, nonadvocacy services, or habilitation to address a need related to a disability or a mental illness; and
   4. 1. Broadly represent persons served by the protection and advocacy project; or
      2. Are knowledgeable about the needs of persons served by the protection and advocacy project.
3. The appointments and terms of committee members are as follows:
   1. The governor shall appoint two committee members for two-year terms, beginning on August first in each even-numbered year.
   2. The legislative management shall appoint one member from each house of the legislative assembly for two-year terms, beginning on August first in each odd-numbered year.
   3. The governing board of the arc of North Dakota shall appoint one committee member for a three-year term, beginning August first in each year that is evenly divisible by three.
   4. The governing board of a North Dakota nonprofit advocacy group for people with disabilities shall appoint one committee member for a three-year term, beginning on August first in each year that is divisible by three with a remainder of one. Whenever an appointment to this position is to be made, the other members of the committee shall select a North Dakota nonprofit advocacy group for people with disabilities to make this appointment.
   5. The governing board of the mental health association in North Dakota shall appoint one committee member for a three-year term, beginning on August first in each year that is divisible by three with a remainder of two.
4. Each committee member appointed by a North Dakota nonprofit advocacy group for people with disabilities must be:
   1. An individual with disabilities who is eligible for services; or
   2. A parent, family member, guardian, advocate, or other authorized representative of an individual with disabilities who is eligible for services.
5. A member may not serve more than six consecutive years.
6. A member’s term ends on July thirty-first in the last year of the term and a member shall serve until a successor has been appointed.
7. If any vacancy occurs on the committee, the appointing authority shall appoint an individual to fill the vacancy for the remainder of the term. If the federal government designates a member ineligible, the appointing body shall fill the vacancy for the remainder of the term. Any vacancy on the committee must be filled within sixty days after the date on which the vacancy occurs.
8. The committee is responsible for and shall adopt rules for the administrative supervision and direction and for the planning, design, implementation, and functioning of the project.
9. The committee shall develop a formal process to review complaints from providers or other persons concerning protection and advocacy activities.
10. The governor, upon compliance with federal law and regulations, may redesignate the agency responsible for carrying out the responsibilities of the project under this chapter.

25-01.3-03. Director — Administrative authority.

The committee shall appoint a director, who serves at the will of the committee. The committee shall set the salary of the director within the limits of the amount appropriated for salaries by the legislative assembly. The director shall employ necessary staff, including advocates, who must be classified under the state personnel merit system. The director and other employees of the project are entitled to reimbursement for expenses incurred in carrying out their duties at the same rate and in the same manner as other state officials and employees. The director, with the advice and consent of the committee, may adopt rules for administration of the project, the conduct of its employees, the performance of its business, and the custody, use, and preservation of the records, documents, and property pertaining to the committee. The director shall submit to the committee bimonthly reports concerning the status of revenue, expenditures, and protection or advocacy efforts engaged in by project personnel.

25-01.3-04. Reporting of abuse, neglect, or exploitation — Immunity for good-faith reports.

1. Every medical, mental health, or developmental disabilities professional, educational professional, police or law enforcement officer, or caretaker having knowledge of or reasonable cause to suspect that an adult with developmental disabilities or mental illness coming before the individual providing services in that individual’s official or professional capacity is abused, neglected, or exploited shall report the circumstances of that abuse, neglect, or exploitation to the project. For the purposes of this section:
   1. “Educational professional” means a professional providing educational services either at a school, academy, or other educational facility, or at a private facility or residence, as a teacher, professor, tutor, aide, administrator, or other education professional.
   2. “Medical, mental health, or developmental disabilities professional” means a professional providing health care or services to persons with developmental disabilities or mental illnesses, on a full-time or part-time basis, on an individual basis or at the request of a caretaker, and includes a physician, medical examiner, coroner, dentist, optometrist, chiropractor, nurse, physical therapist, mental health professional, hospital personnel, nursing home personnel, congregate care personnel, social worker, or any other person providing medical, mental health, or developmental disabilities services.
2. An individual not listed in subsection 1 having knowledge of or reasonable cause to suspect that an adult with developmental disabilities or mental illness is abused, neglected, or exploited may report those circumstances to the committee or the project.
3. An individual other than the alleged perpetrator participating in good faith in the making of a report, assisting an investigator, furnishing information to an advocate or other employee of the committee, or in providing protective services under this section, is immune from any liability, civil or criminal, that otherwise might result from the reporting of the alleged case of abuse, neglect, or exploitation.

25-01.3-05. Retaliation — Presumptions — Penalty.

1. An employer that imposes any form of discipline or retaliation against an employee solely because the employee reported having knowledge of or reasonable cause to suspect that a person with developmental disabilities or mental illness was abused, neglected, or exploited is guilty of a class B misdemeanor.
2. A rebuttable presumption that retaliation has occurred arises when an adverse action is taken within ninety days of the report. For the purpose of this subsection, “adverse action” means any action taken against the reporter or the person with developmental disabilities or mental illness about whom the report was made by a facility or person involved in a report because of the report. Adverse action includes:
   1. Discharge from or termination of the employment of the employee.
   2. Demotion, negative work performance evaluation, reduction of hours worked or benefits or work privileges, or reduction in remuneration for services of the employee.
   3. Restriction or prohibition of access by the employee to a facility or to the residents of the facility.
   4. Discharge or transfer of the person with developmental disabilities or mental illness from or within a facility or from the supervision of a caretaker.
   5. Failure of a facility to perform customary services for the person with developmental disabilities or mental illness.
3. It is a defense to any charge brought under this section that the good faith of the individual making the report, described in subsection 3 of section 25-01.3-04, has been rebutted, but only as to actions taken against the employee.

25-01.3-06. Authority of project — Annual report.

1. Pursuant to rules adopted by the committee, the project, within the limits of legislative appropriations, shall provide advocacy and protective services for persons with developmental disabilities and persons with mental illnesses. The rules adopted by the committee relating to the need for the consent of the client must balance the rights of persons with developmental disabilities or mental illnesses to privacy and to refuse services under section 25-01.3-11 with the committee’s duties to protect the human and legal rights of persons eligible for services and to monitor facilities for compliance with federal and state laws and rules.
2. The project may:
   1. Represent persons with developmental disabilities or mental illnesses so the persons may realize the rights and services to which they are entitled.
   2. Investigate complaints and reports if the alleged incidents are reported to the committee or the project or if there is probable cause to believe the incidents occurred.
   3. Monitor individual habilitation or treatment plans, program plans, educational plans, facilities and programs, and all other services and care provided to persons with developmental disabilities or mental illnesses.
   4. Employ counsel to represent clients to pursue legal, administrative, voluntary compliance, and other appropriate remedies to ensure the protection of the rights of persons with developmental disabilities or mental illnesses, and employ counsel to represent the project or the committee when, in the opinion of the attorney general, a conflict of interest under the North Dakota Rules of Professional Conduct exists between the office of attorney general and the committee or the project, and the conflict cannot be avoided by the appointment of counsel under subsection 3 of section 54-12-01 or section 54-12-08.
   5. Pursue legal, administrative, voluntary compliance, and other appropriate remedies to ensure the protection and the rights of persons with developmental disabilities or mental illnesses. Before instituting legal action in a federal or state court on behalf of a person with developmental disabilities or mental illnesses, the project shall exhaust in a timely manner all administrative remedies if appropriate. If, in pursuing administrative remedies, the project determines a matter with respect to that person will not be resolved within a reasonable time, the project may pursue alternative remedies, including the initiation of a legal action with the consent of the committee. However, exhaustion of administrative remedies is not a prerequisite to initiation of a legal action if that action is instituted to prevent or eliminate imminent serious harm to a person with developmental disabilities or mental illnesses.
   6. Sign a criminal complaint necessary to protect the interests of a person with developmental disabilities or mental illness, or group of persons with developmental disabilities or mental illnesses, who appear to have been victimized by or subjected to criminal conduct.
   7. Review each annual survey report and plan of corrections for cited deficiencies made pursuant to titles XVIII and XIX of the Social Security Act with respect to any facility rendering care or treatment to persons with developmental disabilities or mental illnesses.
   8. Provide the public, on an annual basis, an opportunity to comment on the priorities established by, and the activities of the committee.
   9. Establish a grievance procedure for clients or prospective clients to ensure persons with developmental disabilities or mental illnesses have full access to the services of the committee.
   10. Prepare an annual report to the legislative assembly and the governor describing the priorities, activities, accomplishments, and expenditures of the system.
   11. Provide information on and referral to programs and services addressing the needs of persons with developmental disabilities or mental illnesses.
   12. Accept and administer gifts, grants, or contracts with individuals or organizations, including the federal government, on such terms as may be beneficial to the state.
   13. Contract with any person, public or private, to carry out any responsibilities of the project under this chapter and section 25-01-01.1.
3. The project shall use the report, complaint, and investigation process to assess the opportunity for voluntary compliance and other appropriate remedies.

25-01.3-07. Access to records, facilities, and persons — Rules.

A caretaker shall provide the project access to the person with developmental disabilities or mental illness and to the facility where the person resides. The committee shall adopt rules regarding access to the records of a client for the purpose of investigating complaints or reports and monitoring service delivery systems. Any rules adopted under this section must comply with subsection 4 of section 25-01.2-03, section 25-16-07, 42 U.S.C. 6042, and 42 U.S.C. 10805.

25-01.3-08. Investigation of reports and complaints.

1. Upon receipt of any report of suspected abuse, neglect, exploitation, or a complaint made pursuant to sections 25-01.3-01 through 25-01.3-12, the project shall assess the need for an investigation of the report or complaint. If the project determines the report or complaint is warranted, the project shall investigate or cause the report or complaint to be investigated. For the purpose of investigating a report or a complaint, the project may:
   1. Interview the alleged victim who has developmental disabilities or mental illness at any time of the day or night, with or without notice.
   2. Interview any other individual who may have knowledge of the situation.
   3. Access all locations under the control of the caretaker where records or other information exist, including the residence of the alleged victim.
   4. Coordinate investigations with other agencies, departments, or other entities providing services necessary or advisable for the person with developmental disabilities or mental illness.
   5. Delegate investigatory powers to the extent necessary and appropriate to any individual or entity.
2. This section does not limit the responsibilities of law enforcement agencies to enforce the laws of this state or preclude law enforcement agencies from investigating, as appropriate, any alleged criminal conduct.
3. This section does not prohibit the project from assessing the opportunity for voluntary compliance and other appropriate remedies in the course of investigating a report or complaint.

25-01.3-09. Conflict of interest.

In any situation in which the project is representing, or has been requested to represent, two or more persons with developmental disabilities or mental illnesses, if those persons have conflicting interests in the matter for which the project is requested to act, the project may provide services to the first person making application for services for that purpose. Any additional person, with conflicting interests, may be referred to another agency or individuals for assistance.

25-01.3-10. Confidentiality and privileged information.

1. All information relating to an individual with a disability, including individually identifiable health information, that is in the possession of the committee, project, or any advocate is confidential and is not subject to disclosure, except:
   1. If an authorization for disclosure is given in writing by each individual with a disability who may be identifiable from the information, or that individual’s personal representative;
   2. In a judicial proceeding when ordered by the presiding judge;
   3. To a law enforcement officer for a law enforcement purpose, a health oversight agency, or, at the discretion of the committee, to any other legally constituted board or agency serving the interests of an individual with a disability for any other purpose authorized by this chapter, or any other state or federal law; or
   4. To the parents of a minor who is an eligible person under sections 25-01.3-01 through 25-01.3-12 or legal guardians of the person with a disability except that no information may be disclosed to a person with mental illness who is the subject of the information when such a disclosure is prohibited by state or federal law.
2. Unless ordered by a court of competent jurisdiction, the name of an individual who in good faith makes a report or complaint may not be disclosed by the committee or the project.

25-01.3-11. Refusal of services — Alternatives.

If a person with developmental disabilities or mental illness refuses an offer of services from the project and, in the judgment of the project, the person’s life, safety, or health is seriously jeopardized, the project may petition a court of competent jurisdiction for the appointment of a guardian or conservator. The project may also refer the matter to an appropriate agency, department, or authority for possible civil action on behalf of the person with mental illness or developmental disabilities, or for criminal prosecution of any individual abusing, neglecting, or exploiting a person with mental illness or developmental disabilities.

25-01.3-12. Penalties.

1. A person who permits or allows the unauthorized disclosure of reports or complaints obtained under sections 25-01.3-01 through 25-01.3-12 is guilty of an infraction.
2. A person who willfully fails to report the abuse, neglect, or exploitation of any person with developmental disabilities or mental illness, if required to report pursuant to sections 25-01.3-01 through 25-01.3-12, is guilty of an infraction.

25-02-01. State hospital for the mentally ill — Location — Title — Administration and control. [Effective through August 31, 2022]

An institution for the care of the mentally ill must be maintained at the city of Jamestown and must be known as the state hospital. The department of human services shall administer and control the state hospital.

25-02-01. State hospital for the mentally ill — Location — Title — Administration and control. [Effective September 1, 2022]

An institution for the care of the mentally ill must be maintained at the city of Jamestown and must be known as the state hospital. The department of health and human services shall administer and control the state hospital.

25-02-01.1. Maintenance of state hospital accreditation — Governing body membership — Rulemaking authority. [Effective through August 31, 2022]

1. The department of human services shall seek appropriations and resources sufficient to ensure maintenance of the state hospital’s accreditation by the joint commission and certification by the centers for Medicare and Medicaid services or by similar accrediting and certifying organizations and agencies possessing hospital standards recognized by the health care industry and accepted by the department.
2. The department, in consultation with the state hospital, shall create a state hospital governing body and shall by rules describe the powers and duties of the governing body. The department shall compensate members not employed by the department in the amount of one hundred dollars per day and reimburse members for expenses incurred in attending meetings in the amounts provided by sections 44-08-04 and 54-06-09.
3. The governing body must be composed of the executive director of the department of human services; the director of the division of behavioral health of the department, who shall serve as chairman of the governing body; the state hospital superintendent; the state hospital medical director; a representative of the department’s fiscal administration division; a behavioral health consumer selected by the mental health association; and a legislator selected by the legislative management. The governing body may include other persons as appointed by the governing body.

25-02-01.1. Maintenance of state hospital accreditation — Governing body membership — Rulemaking authority. [Effective September 1, 2022]

1. The department of health and human services shall seek appropriations and resources sufficient to ensure maintenance of the state hospital’s accreditation by the joint commission and certification by the centers for Medicare and Medicaid services or by similar accrediting and certifying organizations and agencies possessing hospital standards recognized by the health care industry and accepted by the department.
2. The department, in consultation with the state hospital, shall create a state hospital governing body and shall by rules describe the powers and duties of the governing body. The department shall compensate members not employed by the department in the amount of one hundred dollars per day and reimburse members for expenses incurred in attending meetings in the amounts provided by sections 44-08-04 and 54-06-09.
3. The governing body must be composed of the executive director of the department of health and human services; the director of the division of behavioral health of the department, who shall serve as chairman of the governing body; the state hospital superintendent; the state hospital medical director; a representative of the department’s fiscal administration division; a behavioral health consumer selected by the mental health association; and a legislator selected by the legislative management. The governing body may include other persons as appointed by the governing body.

25-02-02. Additional hospital for mentally ill located at Rugby. [Repealed]

25-02-03. Object of state hospital. [Effective through August 31, 2022]

The state hospital is an institution for mental diseases serving specialized populations of the mentally ill, including persons suffering from drug addiction or alcoholism. The state hospital is one component of the North Dakota mental health delivery system and serves as a resource to community-based treatment programs. The state hospital shall, pursuant to rules adopted by the department of human services, receive and care for all mentally ill persons, including persons suffering from drug addiction or alcoholism, residing within this state in accordance with this title, and shall furnish to those mentally ill persons all needed food, shelter, treatment, and support that may tend to restore their mental health or to alleviate their illness or suffering.

25-02-03. Object of state hospital. [Effective September 1, 2022]

The state hospital is an institution for mental diseases serving specialized populations of the mentally ill, including persons suffering from drug addiction or alcoholism. The state hospital is one component of the North Dakota mental health delivery system and serves as a resource to community-based treatment programs. The state hospital shall, pursuant to rules adopted by the department of health and human services, receive and care for all mentally ill persons, including persons suffering from drug addiction or alcoholism, residing within this state in accordance with this title, and shall furnish to those mentally ill persons all needed food, shelter, treatment, and support that may tend to restore their mental health or to alleviate their illness or suffering.

25-02-04. Superintendent to possess certain qualifications — Medical director — Employees.

The superintendent of the state hospital must be a skilled health care administrator with professional training and experience relating to the management of facilities for mentally ill and chemically dependent persons and relating to the needs of the mentally ill and chemically dependent persons. The medical director, who must be a licensed physician and board-certified psychiatrist, shall recommend appointment of all physicians and clinical staff, define their qualifications and duties, and have final authority for the organization and delivery of all medical and clinical services delivered to patients at the state hospital. The state hospital governing body has final approval of all physician and clinical staff appointments to the state hospital. The superintendent shall appoint the medical director in consultation with the supervising officer and with the approval of the governing body. If the superintendent is not a licensed physician and board-certified psychiatrist, the medical director, or a qualified designee of the medical director, shall act as the superintendent’s designee in all matters in which the superintendent’s opinion on medical or clinical treatment is required by law. Every physician on the professional staff must have a license issued by the North Dakota board of medicine.

25-02-05. Superintendent to furnish forms and bylaws to county mental health boards. [Repealed]

Repealed by S.L. 1977, ch. 239, § 48.

25-02-05.1. Specialists. [Repealed]

Repealed by S.L. 1957, ch. 196, § 22.

25-02-06. Nonresidents admitted to state hospital.

A resident of another state or territory may be admitted to the state hospital upon payment of the full cost of treatment of such nonresident, but no resident of another state or territory may be received for treatment to the exclusion of any resident of this state.

25-02-06.1. Disposition of nonresidents — Exceptions — Reciprocal agreements.

If a person who has no legal residence in this state or whose residence is unknown is found to be a person requiring treatment in the state hospital, the person must be sent to the state hospital in the same manner, and accompanied by the same documents, as in the case of a resident of this state. The supervising department shall immediately inquire as to the residence of the person, and, if the residence is found to be in another state or country, the supervising department may arrange for transportation of the person to the place of legal residence or legal settlement. The supervising department may enter into reciprocal agreements with other states regarding the mutual exchange, return, and transportation of persons requiring treatment who are within one state but have legal residence or legal settlement in another state. The agreements may not contain any provision conflicting with any law of this state.

25-02-07. Disposition of mentally ill nonresident. [Repealed]

Repealed by S.L. 1961, ch. 211, § 9.

25-02-08. Expense for care of patient. [Repealed]

Repealed by S.L. 1961, ch. 211, § 9.

25-02-09. Care of patients to be impartial.

All patients at the state hospital must be provided with equal care and treatment in accordance with the different degrees or conditions of mental and physical health.

25-02-10. Attorney general to bring action against county. [Repealed]

Repealed by S.L. 1961, ch. 211, § 9.

25-02-11. County mental health board — Members, appointment, term, quorum. [Repealed]

Repealed by S.L. 1977, ch. 239, § 48.

25-02-12. Oath required of appointive members. [Repealed]

Repealed by S.L. 1977, ch. 239, § 48.

25-02-13. Meetings of county mental health board. [Repealed]

Repealed by S.L. 1977, ch. 239, § 48.

25-02-14. Duties of chairman of county mental health board. [Repealed]

Repealed by S.L. 1977, ch. 239, § 48.

25-02-15. Absence of member of county mental health board — Substitute. [Repealed]

Repealed by S.L. 1977, ch. 239, § 48.

25-02-16. Powers of county mental health board. [Repealed]

Repealed by S.L. 1977, ch. 239, § 48.

25-02-17. Compensation and expenses of county mental health board. [Repealed]

Repealed by S.L. 1977, ch. 239, § 48.

25-02-18. Nonliability of certain officers for detention of mentally ill persons. [Repealed]

Repealed by S.L. 1977, ch. 239, § 48.

25-03.1-01. Legislative intent.

The provisions of this chapter are intended by the legislative assembly to:

1. Provide prompt evaluation and treatment of persons with serious mental disorders or a substance use disorder.
2. Safeguard individual rights.
3. Provide continuity of care for persons with serious mental disorders or a substance use disorder.
4. Encourage the full use of all existing agencies, professional personnel, and public funds to prevent duplication of services and unnecessary expenditures.
5. Encourage, whenever appropriate, that services be provided within the community.

25-03.1-02. Definitions. [Effective through August 31, 2022]

In this chapter, unless the context requires otherwise:

1. “Advanced practice registered nurse” means an individual who is licensed as an advanced practice registered nurse under chapter 43-12.1 within the role of certified nurse practitioner or certified clinical nurse specialist, who has completed the requirements for a minimum of a master’s degree in psychiatric and mental health nursing from an accredited program, and who is functioning within the scope of practice in one of the population foci as approved by the state board of nursing. This chapter does not expand the scope of practice of an advanced practice registered nurse beyond the scope of practice established by the state board of nursing.
2. “Alternative treatment order” means an involuntary outpatient order for a treatment program, other than hospitalization, which may include treatment with a prescribed medication.
3. “Consent” means voluntary permission based upon full disclosure of facts necessary to make a decision and which is given by an individual who has the ability to understand those facts.
4. “Court” means, except when otherwise indicated, the district court serving the county in which the respondent resides.
5. “Department” means the department of human services.
6. “Director” means the director of a treatment facility or the director’s designee.
7. “Expert examiner” means a licensed physician, physician assistant, psychiatrist, psychologist trained in a clinical program, advanced practice registered nurse, or licensed addiction counselor appointed by the court to examine the respondent and to provide an evaluation of whether the respondent is a person requiring treatment.
8. “Independent expert examiner” means a licensed physician, physician assistant, psychiatrist, psychologist trained in a clinical program, advanced practice registered nurse, or licensed addiction counselor, chosen at the request of the respondent to provide an independent evaluation of whether the respondent is a person requiring treatment.
9. “Individual with a substance use disorder” means an individual with an illness or disorder characterized by a maladaptive pattern of usage of alcohol or drugs, or a combination thereof, resulting in social, occupational, psychological, or physical problems.
10. “Magistrate” means the judge of the appropriate district or juvenile court or a judge assigned by the presiding judge of the judicial district.
11. “Mental health professional” means:
    1. A psychologist with at least a master’s degree who has been either licensed or approved for exemption by the North Dakota board of psychology examiners.
    2. A social worker with a master’s degree in social work from an accredited program.
    3. An advanced practice registered nurse.
    4. A registered nurse with a minimum of two years of psychiatric clinical experience under the supervision of an expert examiner.
    5. A licensed addiction counselor.
    6. A licensed professional counselor with a master’s degree in counseling from an accredited program who has either successfully completed the advanced training beyond the master’s degree as required by the national academy of mental health counselors or a minimum of two years of clinical experience in a mental health agency or setting under the supervision of a psychiatrist or psychologist.
    7. A physician assistant.
12. “Mentally ill person” or “person who is mentally ill” means an individual with an organic, mental, or emotional disorder that substantially impairs the capacity to use self-control, judgment, and discretion in the conduct of personal affairs and social relations. The term does not include an individual with an intellectual disability of significantly subaverage general intellectual functioning that originates during the developmental period and is associated with impairment in adaptive behavior, although an individual who is intellectually disabled may also be a person who is mentally ill. A substance use disorder does not per se constitute mental illness, although an individual with a substance use disorder may also be a person who is mentally ill.
13. “Person requiring treatment” means a person who is mentally ill or an individual with a substance use disorder, and there is a reasonable expectation that if the individual is not treated for the mental illness or substance use disorder there exists a serious risk of harm to that individual, others, or property.
14. “Physician assistant” means an individual licensed to practice as a physician assistant under chapter 43-17, who is authorized by the North Dakota board of medicine to practice in the field of psychiatry, holds a certification in psychiatry approved by the board, and is practicing under the supervision of a psychiatrist licensed to practice medicine in this state. This chapter does not expand the scope of practice of a physician assistant beyond the scope of practice authorized by the North Dakota board of medicine.
15. “Private treatment facility” means any facility established under chapter 10-19.1 or 10-33 and licensed under chapter 23-16 or 50-31.
16. “Psychiatrist” means a licensed physician who has completed a residency program in psychiatry.
17. “Public treatment facility” means any treatment facility not falling under the definition of a private treatment facility.
18. “Qualified service organization” means a person that provides services to a treatment facility such as data processing, bill collecting, dosage preparation, laboratory analysis, or legal, medical, accounting, or other professional services, and which agrees that in dealing with patient records, that person is bound by the confidentiality restrictions of this chapter, except as otherwise provided for by law.
19. “Respondent” means an individual subject to petition for involuntary treatment.
20. “Serious risk of harm” means a substantial likelihood of:
    1. Suicide, as manifested by suicidal threats, attempts, or significant depression relevant to suicidal potential;
    2. Killing or inflicting serious bodily harm on another individual or inflicting significant property damage, as manifested by acts or threats;
    3. Substantial deterioration in physical health, substantial injury, disease, or death, based upon recent poor self-control or judgment in providing one’s shelter, nutrition, or personal care; or
    4. Substantial deterioration in mental health which would predictably result in danger to that individual, others, or property, based upon:
       1. Evidence of objective facts to establish the loss of cognitive or volitional control over the individual’s thoughts or actions; or
       2. Acts or threats; patterns in the individual’s treatment history; the individual’s current condition; and other relevant factors, including the effect of the individual’s mental condition on the individual’s ability to consent.
21. “Substantial likelihood” may take into account an individual’s history and recent behavior.
22. “Superintendent” means the state hospital superintendent or the superintendent’s designee.
23. “Third-party payer” means a person that pays, or agrees to pay, for diagnosis or treatment furnished to a patient on the basis of a contractual relationship with the patient or a member of the patient’s family, or on the basis of the patient’s eligibility for federal, state, or local governmental benefits, and includes any person providing audit or evaluation activities for the third-party payer.
24. “Treatment facility” or “facility” means any hospital, including the state hospital at Jamestown, or any evaluation and treatment facility that provides directly, or by direct arrangement with other public or private agencies, emergency evaluation and treatment, outpatient care, and inpatient care to a person who is mentally ill or a person who has a substance use disorder.

25-03.1-02. Definitions. [Effective September 1, 2022]

In this chapter, unless the context requires otherwise:

1. “Advanced practice registered nurse” means an individual who is licensed as an advanced practice registered nurse under chapter 43-12.1 within the role of certified nurse practitioner or certified clinical nurse specialist, who has completed the requirements for a minimum of a master’s degree in psychiatric and mental health nursing from an accredited program, and who is functioning within the scope of practice in one of the population foci as approved by the state board of nursing. This chapter does not expand the scope of practice of an advanced practice registered nurse beyond the scope of practice established by the state board of nursing.
2. “Alternative treatment order” means an involuntary outpatient order for a treatment program, other than hospitalization, which may include treatment with a prescribed medication.
3. “Consent” means voluntary permission based upon full disclosure of facts necessary to make a decision and which is given by an individual who has the ability to understand those facts.
4. “Court” means, except when otherwise indicated, the district court serving the county in which the respondent resides.
5. “Department” means the department of health and human services.
6. “Director” means the director of a treatment facility or the director’s designee.
7. “Expert examiner” means a licensed physician, physician assistant, psychiatrist, psychologist trained in a clinical program, advanced practice registered nurse, or licensed addiction counselor appointed by the court to examine the respondent and to provide an evaluation of whether the respondent is a person requiring treatment.
8. “Independent expert examiner” means a licensed physician, physician assistant, psychiatrist, psychologist trained in a clinical program, advanced practice registered nurse, or licensed addiction counselor, chosen at the request of the respondent to provide an independent evaluation of whether the respondent is a person requiring treatment.
9. “Individual with a substance use disorder” means an individual with an illness or disorder characterized by a maladaptive pattern of usage of alcohol or drugs, or a combination thereof, resulting in social, occupational, psychological, or physical problems.
10. “Magistrate” means the judge of the appropriate district or juvenile court or a judge assigned by the presiding judge of the judicial district.
11. “Mental health professional” means:
    1. A psychologist with at least a master’s degree who has been either licensed or approved for exemption by the North Dakota board of psychology examiners.
    2. A social worker with a master’s degree in social work from an accredited program.
    3. An advanced practice registered nurse.
    4. A registered nurse with a minimum of two years of psychiatric clinical experience under the supervision of an expert examiner.
    5. A licensed addiction counselor.
    6. A licensed professional counselor with a master’s degree in counseling from an accredited program who has either successfully completed the advanced training beyond the master’s degree as required by the national academy of mental health counselors or a minimum of two years of clinical experience in a mental health agency or setting under the supervision of a psychiatrist or psychologist.
    7. A physician assistant.
12. “Mentally ill person” or “person who is mentally ill” means an individual with an organic, mental, or emotional disorder that substantially impairs the capacity to use self-control, judgment, and discretion in the conduct of personal affairs and social relations. The term does not include an individual with an intellectual disability of significantly subaverage general intellectual functioning that originates during the developmental period and is associated with impairment in adaptive behavior, although an individual who is intellectually disabled may also be a person who is mentally ill. A substance use disorder does not per se constitute mental illness, although an individual with a substance use disorder may also be a person who is mentally ill.
13. “Person requiring treatment” means a person who is mentally ill or an individual with a substance use disorder, and there is a reasonable expectation that if the individual is not treated for the mental illness or substance use disorder there exists a serious risk of harm to that individual, others, or property.
14. “Physician assistant” means an individual licensed to practice as a physician assistant under chapter 43-17, who is authorized by the North Dakota board of medicine to practice in the field of psychiatry, holds a certification in psychiatry approved by the board, and is practicing under the supervision of a psychiatrist licensed to practice medicine in this state. This chapter does not expand the scope of practice of a physician assistant beyond the scope of practice authorized by the North Dakota board of medicine.
15. “Private treatment facility” means any facility established under chapter 10-19.1 or 10-33 and licensed under chapter 23-16 or 50-31.
16. “Psychiatrist” means a licensed physician who has completed a residency program in psychiatry.
17. “Public treatment facility” means any treatment facility not falling under the definition of a private treatment facility.
18. “Qualified service organization” means a person that provides services to a treatment facility such as data processing, bill collecting, dosage preparation, laboratory analysis, or legal, medical, accounting, or other professional services, and which agrees that in dealing with patient records, that person is bound by the confidentiality restrictions of this chapter, except as otherwise provided for by law.
19. “Respondent” means an individual subject to petition for involuntary treatment.
20. “Serious risk of harm” means a substantial likelihood of:
    1. Suicide, as manifested by suicidal threats, attempts, or significant depression relevant to suicidal potential;
    2. Killing or inflicting serious bodily harm on another individual or inflicting significant property damage, as manifested by acts or threats;
    3. Substantial deterioration in physical health, substantial injury, disease, or death, based upon recent poor self-control or judgment in providing one’s shelter, nutrition, or personal care; or
    4. Substantial deterioration in mental health which would predictably result in danger to that individual, others, or property, based upon:
       1. Evidence of objective facts to establish the loss of cognitive or volitional control over the individual’s thoughts or actions; or
       2. Acts or threats; patterns in the individual’s treatment history; the individual’s current condition; and other relevant factors, including the effect of the individual’s mental condition on the individual’s ability to consent.
21. “Substantial likelihood” may take into account an individual’s history and recent behavior.
22. “Superintendent” means the state hospital superintendent or the superintendent’s designee.
23. “Third-party payer” means a person that pays, or agrees to pay, for diagnosis or treatment furnished to a patient on the basis of a contractual relationship with the patient or a member of the patient’s family, or on the basis of the patient’s eligibility for federal, state, or local governmental benefits, and includes any person providing audit or evaluation activities for the third-party payer.
24. “Treatment facility” or “facility” means any hospital, including the state hospital at Jamestown, or any evaluation and treatment facility that provides directly, or by direct arrangement with other public or private agencies, emergency evaluation and treatment, outpatient care, and inpatient care to a person who is mentally ill or a person who has a substance use disorder.

25-03.1-03. Jurisdiction.

The district courts have original jurisdiction over the proceedings governed by this chapter.

25-03.1-03.1. Disclosure of health information.

A treating facility or mental health professional may disclose individually identifiable health information to a court, regional human service center, state’s attorney, appointed counsel, retained counsel, or other mental health professional, including an expert examiner, and the disclosure is a disclosure for treatment, including the provision, coordination, and management of health care and to carry out the purposes of this chapter.

25-03.1-04. Screening and admission to a public treatment facility.

Under rules adopted by the department, screening of an individual to a public treatment facility for observation, diagnosis, care, or treatment for mental illness or a substance use disorder must be performed, in person when reasonably practicable, by a regional human service center. This screening must be performed in the region where the individual is physically located. Upon the request of a court, a law enforcement official, a mental health professional, the individual’s legal guardian, a minor’s parent or legal custodian, or the individual requesting services, the regional human service center shall conduct a screening. If a request for screening is made by a mental health professional and the individual who is the subject of the screening does not authorize the disclosure of the individual’s protected health information, upon the request of the regional human service center, any mental health professional who treated the individual within the previous six months shall disclose, subject to the requirements of title 42, Code of Federal Regulations, part 2, to the human service center any relevant protected health information regarding that treatment. Upon receipt of the request, the regional human service center shall arrange for a screening of the individual and, if appropriate, shall treat the applicant or refer the applicant to the appropriate treatment facility. Upon admittance to a public treatment facility, the superintendent or director shall immediately designate a tier 1 or tier 2 mental health professional to examine the individual.

25-03.1-05. Discharge of voluntary patients.

Any voluntary patient who has recovered, or whose treatment the superintendent or director determines is no longer advisable, must be discharged. If, upon discharge, it is determined that the individual would benefit from the receipt of further treatment, the superintendent or director shall offer the individual appropriate treatment on a voluntary basis or shall aid the individual to obtain treatment from another source on a voluntary basis. With the patient’s consent, appropriate referrals may be made for the patient.

25-03.1-06. Right to release on application — Exception — Judicial proceedings.

An individual voluntarily admitted for inpatient treatment to a treatment facility or the state hospital must be orally advised of the right to release and must be further advised in writing of the rights under this chapter. A voluntary patient who requests release must be immediately released. However, if the superintendent or the director determines the patient is a person requiring treatment, the release may be postponed until a petition for involuntary commitment has been filed with the clerk of court and judicial proceedings for involuntary treatment have been held in the county in which the hospital or facility is located. The patient must be served the petition within twenty-four hours, exclusive of weekends and holidays, from the time release is requested, unless extended by the magistrate for good cause shown. The treatment hearing must be held within seven days from the time the petition is served.

25-03.1-07. Involuntary admission standards.

An individual may not be involuntarily admitted under this chapter to the state hospital or another treatment facility unless it is determined the individual is a person requiring treatment.

25-03.1-08. Application to state’s attorney or retained attorney — Petition for involuntary treatment — Investigation by mental health professional.

1. An individual eighteen years of age or over shall present, in good faith, the information necessary for the commitment of an individual for involuntary treatment to the state’s attorney of the county in which the respondent is presently located, or which is the respondent’s place of residence, or to an attorney retained by the petitioner to represent the petitioner throughout the proceedings. The attorney shall assist the petitioner in completing the petition. The petition must be verified by affidavit of the petitioner and contain assertions that the respondent is a person requiring the treatment; the facts, in detail, that are the basis of that assertion; the names, telephone numbers, and addresses, if known, of any witnesses to those facts; and, if known, the name, telephone number, and address of the nearest relative or guardian of the respondent, or, if none, of a friend of the respondent.
2. The petition may be accompanied by any of the following:
   1. A written statement supporting the petition from a tier 1 mental health professional or an addiction counselor who is practicing within the professional scope of practice and who has personally examined the respondent within forty-five days of the date of the petition.
   2. One or more supporting affidavits otherwise corroborating the petition.
3. In assisting the petitioner in completing the petition, the state’s attorney may direct a tier 1 or tier 2 mental health professional designated by the regional human service center to investigate and evaluate the specific facts alleged by the petitioner. The investigation must be completed as promptly as possible and include observations of and conversation with the respondent, unless the respondent cannot be found or refuses to meet with the mental health professional. A written report of the results of the investigation must be delivered to the state’s attorney. Copies of the report must be made available upon request to the respondent, the respondent’s counsel, and any expert examiner conducting an examination under section 25-03.1-11. The state’s attorney or retained attorney shall file the petition if the information provided by the petitioner or gathered by investigation provides probable cause to believe the subject of the petition is a person requiring treatment. A state’s attorney who determines there are insufficient grounds for filing a petition may refer the individual to other community resources. A state’s attorney’s decision not to institute proceedings may be reviewed under section 11-16-06.

25-03.1-09. Review of petition for involuntary treatment — Probable cause established — Respondent notified — Rights.

1. Upon the filing of a petition for involuntary treatment, the clerk of court shall immediately notify the magistrate who shall review the petition and accompanying documentation to determine whether it complies with requirements of section 25-03.1-08 and whether it establishes probable cause to believe the respondent is a person requiring treatment. If probable cause has not been so established, the petition must be dismissed unless an amendment would cure the defect.
2. If probable cause has been established, the magistrate shall cause to be served on the respondent and the respondent’s nearest relative or guardian or, if none, a friend of the respondent:
   1. A copy of the petition and supporting documentation.
   2. A notice informing the respondent of the procedures required by this chapter.
   3. A notice of the respondent’s right to a preliminary and a treatment hearing when in custody under section 25-03.1-25 and if mental illness or a combination of mental illness and a substance use disorder of the respondent is alleged in the petition, or, if not in custody or if in custody and a substance use disorder alone is alleged in the petition, the right to a treatment hearing; of the right to be present at the hearings; of the right to have counsel before the hearings and any court-ordered examination; of the right to an independent evaluation; and, if the respondent is indigent, of the right to counsel and to an independent expert examiner, each at the expense of the county which is the respondent’s place of residence.
   4. Notice that if an independent expert examiner is to be appointed, the respondent must be given an opportunity to select that examiner.

25-03.1-10. Involuntary treatment — Court-ordered examination.

If the petition is not accompanied by a written supportive statement of a tier 1 mental health professional or a licensed addiction counselor who has examined the respondent within the last forty-five days, the court shall order the respondent be examined by an expert examiner of the respondent’s own choice or one appointed by the court. The order must state the date and time within which the respondent must appear; the address to which the respondent is to report; a statement that if the respondent fails to appear at the appointed place at or before the ordered date and time, the respondent may be involuntarily taken into custody and transported to the appointed place; and a statement the expert examiner may consult with or request participation in the examination by a mental health professional and may include with the written examination report any findings or observations by that mental health professional. Accompanying the order must be an explanation of the intended uses and possible effects of this examination. The examination may be conducted at a treatment facility, at the respondent’s home, or at any other suitable place in the community. A request for examination at the state hospital must be screened and approved by a regional human service center. The respondent may be accompanied by one or more relatives or friends at the place of the examination. The costs of the court-ordered examination must be borne by the county that is the respondent’s place of residence.

25-03.1-10.1. Use of telemedicine technology authorized.

For purposes of court-ordered examinations conducted under this chapter, an expert examiner may use telemedicine technologies to assist the expert examiner in conducting those examinations.

25-03.1-11. Involuntary treatment — Examination — Report.

1. The respondent must be examined within a reasonable time by an expert examiner as ordered by the court. If the respondent is taken into custody under the emergency treatment provisions of this chapter, the examination must be conducted within the time limitations set forth in section 25-03.1-26. Any expert examiner conducting an examination under this section may consult with or request participation in the examination by any mental health professional and may include with the written examination report any findings or observations by that mental health professional. This examination report, and that of the independent examiner, if one has been requested, must be filed with the court and immediately sent to the petitioner and the respondent. The report must contain:
   1. Evaluations of the respondent’s physical condition and mental status.
   2. A conclusion as to whether the respondent is a person requiring treatment, with a clear explanation of how that conclusion was derived from the evaluation.
   3. If the report concludes the respondent is a person requiring treatment, a list of available forms of care and treatment that may serve as alternatives to involuntary hospitalization.
   4. The signature of the examiner who prepared the report.
2. For purposes of any examination conducted pursuant to this section:
   1. An evaluation of a respondent’s physical condition may be made only by a tier 1b mental health professional.
   2. An evaluation of a respondent’s mental status may be made only by a tier 1 mental health professional.
   3. An evaluation of whether the respondent is an individual with a substance use disorder may be made only by a tier 1 mental health professional or a licensed addiction counselor.
3. If the expert examiner concludes the respondent is not a person requiring treatment, the court may without taking any other additional action terminate the proceedings and dismiss the petition. If the expert examiner concludes the respondent is a person requiring treatment, or makes no conclusion whether the respondent is a person requiring treatment, the court shall set a date for hearing and shall give notice of hearing to the persons designated in section 25-03.1-12. If the respondent is in custody and is alleged to be a person who is mentally ill or a person who is both mentally ill and has a substance use disorder, the preliminary hearing date must be within four days, exclusive of weekends and holidays, of the date the respondent was taken into custody through emergency commitment under section 25-03.1-25 unless a delay or continuance is concurred in by the respondent or unless extended by the magistrate for good cause shown. If a preliminary hearing is not required, the treatment hearing must be held within four days, exclusive of weekends and holidays, of the date the court received the expert examiner’s report, not to exceed fourteen days from the time the petition was served.

25-03.1-11.1. Combination of preliminary and treatment hearings.

With the consent of the court, the parties may waive the preliminary hearing and conduct the treatment hearing within the time period set for the preliminary hearing.

25-03.1-12. Notice of hearings.

The court shall cause notice of a petition and of the time and place of any hearings under this chapter to be given to the respondent; the respondent’s parents, if a minor; the respondent’s attorney; the petitioner; the state’s attorney; the superintendent or the director of any hospital or treatment facility in which the respondent is hospitalized or is being treated; the spouse of the respondent, if the spouse’s whereabouts is known; the guardian, if any, of the respondent; and such other relatives or persons as the court may determine. The notice must be given at the earliest possible time and sufficiently in advance of the hearing date to permit preparation for the hearing.

25-03.1-13. Right to counsel — Indigency — Waiver — Recoupment — Limitations.

1. Every respondent under this chapter is entitled to legal counsel. The counsel has access to the respondent’s medical records upon proof of representation.
2. Unless an appearance has been entered on behalf of the respondent, the court shall, within twenty-four hours, exclusive of weekends or holidays, from the time the petition was filed, appoint counsel to represent the respondent. If a respondent retains counsel, the retained counsel shall immediately notify the court of that fact.
3. If, after consultation with counsel, the respondent wants to waive the right to counsel or the right to any of the hearings provided for under this chapter, the respondent may do so by notifying the court in writing. The notification must clearly state the respondent’s reasons for the waiver and must also be signed by counsel.
4. If the court determines that the respondent is indigent, the court shall order that appointed counsel be compensated from county funds of the county that is the respondent’s place of residence in a reasonable amount based upon time and expenses. After notice and hearing, the court may order a respondent with appointed counsel to reimburse the county for expenditures made on the respondent’s behalf.
5. If the state’s attorney of a county that has expended sums under subsection 4 on behalf of a respondent who is liable to reimburse the county determines that the respondent may have funds or property to reimburse the county, the state’s attorney shall seek civil recovery of those sums. Commencement of the action must occur within six years after the date the sums were paid.

25-03.1-14. Duty of state’s attorney in court proceedings.

Unless the petitioner has retained an attorney, the state’s attorney for the county in which proceedings under this chapter are initiated shall appear and represent the state in all court proceedings and hearings. The state’s attorney or an attorney retained by the petitioner need not appear at proceedings initiated by the state hospital under sections 25-03.1-23 and 25-03.1-26. The county of residence of the respondent shall bear the cost of the state’s attorney in such proceedings in a reasonable amount based upon time and expenses.

25-03.1-15. Respondent’s attendance at hearings.

The respondent must be present at all hearings unless the respondent waives the right to be present either orally or in writing. A respondent’s refusal to attend a hearing is presumed to be a waiver of the right to be present at the hearing. The judge must be notified if the respondent has been medicated within twenty-four hours of the beginning of the hearing or an adjourned session of the hearing, and of the probable effects of the medication.

25-03.1-16. Medication pending treatment order.

A patient who has requested release or an individual who is the subject of a petition for treatment has the right to refuse medication and other forms of treatment before the preliminary or treatment hearing. However, a physician, a physician assistant, or an advanced practice registered nurse may prescribe medication or a less restrictive alternative if it is necessary to prevent bodily harm to the respondent or others or to prevent imminent deterioration of the respondent’s physical or mental condition. The patient has the right to be free of the effects of medication at the preliminary or treatment hearing by discontinuance of medication no later than twenty-four hours before the hearing unless, in the opinion of the prescriber, the need for the medication still exists or discontinuation would hamper the respondent’s preparation for and participation in the proceedings.

25-03.1-17. Involuntary treatment — Right to preliminary hearing.

1. A respondent who is in custody under section 25-03.1-25 and who is alleged to be a mentally ill person or to be a person who is both mentally ill and has a substance use disorder is entitled to a preliminary hearing.
   1. At the preliminary hearing the court shall review the medical report. During the hearing the court shall allow the petitioner and the respondent an opportunity to testify and to present and cross-examine witnesses, and the court may receive the testimony of any other interested person. The court may receive evidence that would otherwise be inadmissible at a treatment hearing.
   2. At the conclusion of the hearing, if the court does not find probable cause to believe the individual is a person requiring treatment, the court shall dismiss the petition and order the respondent be discharged from the treatment facility if the respondent was detained before the hearing.
2. If the court finds probable cause to believe the respondent is a person requiring treatment, the court shall consider less restrictive alternatives to involuntary detention and treatment.
   1. The court may order the respondent to undergo up to fourteen days’ treatment under a less restrictive alternative or, if the court finds alternative treatment is not in the best interests of the respondent or others, the court shall order the respondent detained for up to fourteen days for involuntary treatment in a treatment facility.
   2. The court shall specifically state to the respondent and give written notice that if involuntary treatment beyond the fourteen-day period is to be sought, the respondent will have the right to a treatment hearing as required by this chapter.
3. Except for good cause, the court may not consider medical records relating to the respondent, unless the petitioner and respondent receive the medical records at least twenty-four hours before the hearing.

25-03.1-18. Involuntary treatment — Release.

The superintendent or the director may release a patient subject to a fourteen-day evaluation and treatment order or a seven-day emergency order if, in the superintendent’s or director’s opinion, the respondent does not meet the criteria of a person requiring treatment or, before the expiration of the fourteen-day order, the respondent no longer requires inpatient treatment. The court must be notified of the release and the reasons therefor. If the respondent is released because the respondent does not meet the criteria of a person requiring treatment, the court shall dismiss the petition.

25-03.1-18.1. Court-authorized involuntary treatment with prescribed medication.

1. 1. Upon notice and hearing, a tier 1b mental health professional may request authorization from the court to treat an individual under a mental health treatment order with prescribed medication. The request may be considered by the court in an involuntary treatment hearing. As a part of the request, a psychiatrist or a final year psychiatric resident physician not involved in the current diagnosis or treatment of the patient shall certify:
      1. That the proposed prescribed medication is clinically appropriate and necessary to effectively treat the patient and that the patient is a person requiring treatment;
      2. That the patient was offered that treatment and refused it or that the patient lacks the capacity to make or communicate a responsible decision about that treatment;
      3. That prescribed medication is the least restrictive form of intervention necessary to meet the treatment needs of the patient; and
      4. That the benefits of the treatment outweigh the known risks to the patient.
   2. The court shall inquire whether the patient has had a sufficient opportunity to adequately prepare to meet the issue of involuntary treatment with prescribed medication and, at the request of the patient, the court may continue the involuntary treatment hearing for a period not exceeding seven days or may appoint an independent expert examiner as provided in subsection 4.
2. 1. Evidence of the factors certified under subsection 1 may be presented to the court at an involuntary treatment hearing held pursuant to sections 25-03.1-19 and 25-03.1-22, or at a separate hearing after motion and notice. The court in ruling on the requested authorization for involuntary treatment with prescribed medication shall consider all relevant evidence presented at the hearing, including:
      1. The danger the patient presents to self or others;
      2. The patient’s current condition;
      3. The patient’s treatment history;
      4. The results of previous medication trials;
      5. The efficacy of current or past treatment modalities concerning the patient;
      6. The patient’s prognosis; and
      7. The effect of the patient’s mental condition on the patient’s capacity to consent.
   2. Involuntary treatment with prescribed medication may not be authorized by the court solely for the convenience of facility staff or for the purpose of punishment.
3. If the factors certified under subsection 1 have been demonstrated by clear and convincing evidence, the court may include in its involuntary treatment order a provision, or it may issue a separate order after notice and hearing, authorizing the tier 1b mental health professional to involuntarily treat the patient with prescribed medication on such terms and conditions as are appropriate. The order for involuntary treatment with prescribed medication, however, may not be in effect for more than ninety days.
4. If a patient has requested an examination by an independent expert examiner under this chapter, and if the tier 1b mental health professional has requested authorization for involuntary treatment with prescribed medication, only a psychiatrist or final year psychiatric resident physician may independently examine the patient as to the issue of involuntary treatment with prescribed medication.

25-03.1-18.2. Guardian consent to involuntary treatment with prescribed medication.

Notwithstanding sections 25-03.1-16, 25-03.1-18.1, and 25-03.1-24, if a patient refuses treatment with prescribed medication, a treating physician, physician assistant, psychiatrist, or advanced practice registered nurse may treat the patient with prescribed medication upon consent of the patient’s guardian pursuant to subsection 6 of section 30.1-28-12.

1. The guardian’s consent for involuntary treatment with prescribed medication may not be in effect for more than ninety days without receiving another recommendation and determination pursuant to subsection 6 of section 30.1-28-12.
2. The patient has the right to be free of the effects of medication at the preliminary or treatment hearing by discontinuance of medication no later than twenty-four hours before the hearing unless, in the opinion of the prescriber, the need for the medication still exists or discontinuation would hamper the patient’s preparation for and participation in the proceedings.

25-03.1-19. Involuntary treatment hearing.

1. The involuntary treatment hearing, unless waived by the respondent or the respondent has been released as a person not requiring treatment, must be held within fourteen days of the preliminary hearing. If the preliminary hearing is not required, the involuntary treatment hearing must be held within four days, exclusive of weekends and holidays, of the date the court received the expert examiner’s report, not to exceed fourteen days from the time the petition was served. The court may extend the time for hearing for good cause. The respondent has the right to an examination by an independent expert examiner if so requested. If the respondent is indigent, the county of residence of the respondent shall pay for the cost of the examination and the respondent may choose an independent expert examiner.
2. The hearing must be held in the county of the respondent’s residence or location or the county in which the state hospital or treatment facility treating the respondent is located, if the respondent requests a change of venue. At the hearing, evidence in support of the petition must be presented by the state’s attorney, private counsel, or counsel designated by the court. During the hearing, the petitioner and the respondent must be afforded an opportunity to testify and to present and cross-examine witnesses. The court may receive the testimony of any other interested person. All individuals not necessary for the conduct of the proceeding must be excluded, except that the court may admit individuals having a legitimate interest in the proceeding. The hearing must be conducted in as informal a manner as practical, but the issue must be tried as a civil matter. Discovery and the power of subpoena permitted under the North Dakota Rules of Civil Procedure are available to the respondent. The court shall receive all relevant and material evidence that may be offered as governed by the North Dakota Rules of Evidence. There is a presumption in favor of the respondent, and the burden of proof in support of the petition is upon the petitioner.
3. If, upon completion of the hearing, the court finds the petition has not been sustained by clear and convincing evidence, the court shall deny the petition, terminate the proceeding, and order the respondent be discharged if the respondent has been hospitalized before the hearing.
4. Except for good cause, the court may not consider a medical record or expert examiner’s report relating to the respondent unless the petitioner and respondent receive the medical record or the expert examiner’s report at least twenty-four hours before the hearing.

25-03.1-20. Involuntary treatment hearing — Findings and dispositions.

If an individual is found at the involuntary treatment hearing to be a person requiring treatment, the findings and conclusions must be entered in the record of the proceedings and the court may:

1. Order the individual to undergo a program of treatment other than hospitalization;
2. Order the individual hospitalized in a public institution; or
3. Order the individual hospitalized in any other private hospital if the attending physician agrees. The reason supporting the court’s particular treatment order must be entered in the record.

25-03.1-21. Involuntary treatment order — Alternatives to hospitalization — Noncompliance with alternative treatment order — Emergency detention by certain professionals — Application for continuing treatment order.

1. Before the court makes a decision in an involuntary treatment hearing, the court shall review a report assessing the availability and appropriateness for the respondent of treatment programs other than hospitalization which has been prepared and submitted by the state hospital or treatment facility. If the court finds a treatment program other than hospitalization is adequate to meet the respondent’s treatment needs and is sufficient to prevent serious risk of harm, the court shall order the respondent to receive whatever treatment, other than hospitalization, is appropriate for a period of ninety days.
2. If the respondent is not complying with the alternative treatment order or the alternative treatment has not been sufficient to prevent serious risk of harm, the department, a representative of the treatment program involved in the alternative treatment order, the petitioner’s retained attorney, or the state’s attorney may apply to the court or to the district court of a different judicial district in which the respondent is located to modify the alternative treatment order. The court shall hold a hearing within seven days after the application is filed and served on the respondent. Based upon the evidence presented at the hearing and other available information, the court may:
   1. Continue the alternative treatment order;
   2. Consider other alternatives to hospitalization, modify the court’s original order, and direct the respondent undergo another program of alternative treatment for the remainder of the ninety-day period; or
   3. Enter a new order directing the respondent be hospitalized until discharged from the hospital under section 25-03.1-30. If the respondent refuses to comply with this hospitalization order, the court may direct a peace officer to take the respondent into protective custody and transport the respondent to a treatment facility.
3. If a peace officer, physician either in person or directing an emergency medical services professional, or any mental health professional reasonably believes the respondent is not complying with an order for alternative treatment, that the alternative treatment is not sufficient to prevent serious risk of harm , and that considerations of time and safety do not allow intervention by a court, the designated professional may cause the respondent to be taken into custody and detained at a treatment facility as provided in subsection 3 of section 25-03.1-25 and, within twenty-four hours, shall file a notice with the court stating the circumstances and factors of the case. The state hospital or public treatment facility immediately shall accept, if appropriately screened and medically stable, and a private treatment facility may accept, the respondent on a provisional basis. The superintendent or director shall require an immediate examination of the respondent and, within twenty-four hours after admission, shall release the respondent subject to the conditions of the original order or file a notice with the court stating in detail the circumstances and factors of the case. The court , within forty-eight hours of receipt of the notice of the superintendent or director, after a hearing and based on the evidence presented and other available information, shall:
   1. Release the respondent from hospitalization and continue the alternative treatment order;
   2. Consider other alternatives to hospitalization, modify the original order of the court, and direct the respondent undergo another program of alternative treatment for the remainder of the commitment period; or
   3. Enter a new order directing the respondent remain hospitalized until discharged from the hospital under section 25-03.1-30.
4. If, at the date of expiration of an order of alternative treatment, it is believed an individual continues to require treatment, a petition for a determination that the individual continues to be a person requiring treatment may be filed with the court where the individual is located.

25-03.1-22. Length of involuntary and continuing treatment orders.

1. An order for involuntary treatment following a preliminary hearing may not exceed fourteen days. An order for involuntary treatment following a treatment hearing may not exceed ninety days.
2. If the director or superintendent believes a patient continues to require treatment, the director or superintendent, not less than fourteen days before the expiration of the initial order, shall petition the court where the facility is located for a determination that the patient continues to be a person requiring treatment and for an order of continuing treatment, which order may be for a period not to exceed one year. The court shall set a hearing date that must be within fourteen days after the petition was filed, unless extended for good cause shown.
3. A respondent subject to a continuing treatment order of indefinite duration retains the rights to periodic review and to petition for discharge under section 25-03.1-31 as that section existed on July 31, 1993.

25-03.1-23. Petition for continuing treatment orders.

A petition for an order authorizing continuing treatment must contain a statement setting forth the specific facts that are the basis of the determination the patient continues to be a person requiring treatment; a statement describing the treatment program provided to the patient and the results of that treatment; and a clinical estimate as to how long further treatment will be required. The petition must be accompanied by a certificate executed by a physician, physician assistant, psychiatrist, psychologist, advanced practice registered nurse, or licensed addiction counselor, any of whom is practicing within that individual’s professional scope of practice.

25-03.1-24. Right to treat.

State hospital or treatment facility personnel may treat a patient with prescribed medication or a less restrictive alternative if, in the opinion of a psychiatrist or physician, these treatments are necessary to prevent bodily harm to the patient or others or to prevent imminent deterioration of the respondent’s physical or mental condition and there is not time to obtain a court order. This chapter does not prohibit a hospital from rendering emergency medical care without the need for consultation, if in the exercise of sound medical judgment that care is immediately necessary and delay would endanger the life of or adversely and substantially affect the health of the patient.

25-03.1-25. Detention or hospitalization — Emergency procedure.

1. When a peace officer, physician either in person or directing an emergency medical services professional, psychiatrist, physician assistant, psychologist, advanced practice registered nurse, or mental health professional has reasonable cause to believe that an individual is a person requiring treatment and there exists a serious risk of harm to that individual, others, or property of an immediate nature that considerations of safety do not allow preliminary intervention by a magistrate, the peace officer, physician either in person or directing an emergency medical services professional, psychiatrist, physician assistant, psychologist, advanced practice registered nurse, or mental health professional, using the screening process set forth in section 25-03.1-04, may cause the individual to be taken into custody and detained at a treatment facility as provided in subsection 3, and subject to section 25-03.1-26, except that if emergency conditions exist that prevent the immediate conveyance of the individual to a public treatment facility, a private facility that has adequate resources and capacity to hold that individual may hold the individual in anticipation of conveyance to a public treatment facility for up to twenty-three hours:
   1. Without conducting an immediate examination required under section 25-03.1-26; and
   2. Without following notice and hearing requirements for a transfer to another treatment facility required under subsection 3 of section 25-03.1-34.
2. If a petitioner seeking the involuntary treatment of a respondent requests that the respondent be taken into immediate custody and the magistrate, upon reviewing the petition and accompanying documentation, finds probable cause to believe that the respondent is a person requiring treatment and there exists a serious risk of harm to the respondent, others, or property if allowed to remain at liberty, the magistrate may enter a written order directing that the respondent be taken into immediate custody and be detained as provided in subsection 3 until the preliminary or treatment hearing, which must be held no more than seven days after the date of the order.
3. Detention under this section may be:
   1. In a treatment facility where the director or superintendent must be informed of the reasons why immediate custody has been ordered. The facility may provide treatment that is necessary to preserve the respondent’s life or to appropriately control behavior by the respondent which is likely to result in physical injury to self or to others if allowed to continue, but may not otherwise provide treatment to the respondent without the respondent’s consent; or
   2. In a public or private facility in the community which is suitably equipped and staffed for the purpose. Detention in a jail or other correctional facility may not be ordered except in cases of actual emergency when no other secure facility is accessible, and then only for a period of not more than twenty-four hours and under close supervision.
4. Immediately upon being taken into custody, the individual must be advised of the purpose of custody, of the intended uses and possible effects of any evaluation that the individual undergoes, and of the individual’s rights to counsel and to a preliminary or treatment hearing.
5. Upon arrival at a facility the peace officer, physician, physician assistant, psychiatrist, psychologist, advanced practice registered nurse, or mental health professional who conveyed the individual or who caused the individual to be conveyed shall complete an application for evaluation and shall deliver a detailed written report from the peace officer, physician, physician assistant, psychiatrist, psychologist, advanced practice registered nurse, or the mental health professional who caused the individual to be conveyed. The written report must state the circumstances under which the individual was taken into custody. The report must allege in detail the overt act that constituted the basis for the beliefs that the individual is a person requiring treatment and that, because of that individual’s condition, there exists a serious risk of harm to that individual, others, or property if the individual is not immediately detained.

25-03.1-26. Emergency procedure — Acceptance of petition and individual — Notice — Court hearing set.

1. A public treatment facility immediately shall accept and a private treatment facility may accept on a provisional basis the application and the individual admitted under section 25-03.1-25. The superintendent or director shall require an immediate examination of the subject and, either within twenty-four hours, exclusive of holidays, after admission or within seventy-two hours after admission, exclusive of holidays, if the individual is admitted with a serious physical condition or illness that requires prompt treatment, shall either:
   1. Release the individual if the superintendent or director finds that the subject does not meet the emergency commitment standards; or
   2. File a petition if one has not been filed with the court of the individual’s residence or the court which directed immediate custody under subsection 2 of section 25-03.1-25, giving notice to the court and stating in detail the circumstances and facts of the case.
2. Upon receipt of the petition and notice of the emergency detention, the magistrate shall set a date for a preliminary hearing, if the respondent is alleged to be a person who is mentally ill or a person who is both mentally ill and has a substance use disorder, or a treatment hearing, if the respondent is alleged to be a person who has a substance use disorder, to be held no later than four days, exclusive of weekends and holidays, after detention unless the person has been released as a person not requiring treatment, has been voluntarily admitted for treatment, has requested or agreed to a continuance, or unless the hearing has been extended by the magistrate for good cause shown. The magistrate shall appoint counsel if one has not been retained by the respondent.

25-03.1-27. Notice and statement of rights.

1. If an individual is detained for emergency evaluation and treatment under this chapter, the superintendent or director shall cause both the patient and, if possible, a responsible member of the patient’s immediate family, a guardian, or a friend, if any, to receive:
   1. A copy of the petition that asserted the individual is a person requiring treatment.
   2. A written statement explaining the individual will be examined by an expert examiner within twenty-four hours of hospitalization, excluding holidays.
   3. A written statement in simple terms explaining the rights of the individual alleged to be a person who is mentally ill or a person who is both mentally ill and has a substance use disorder to a preliminary hearing, to be present at the hearing, and to be represented by legal counsel, if the individual is certified by an expert examiner or examiners as a person requiring treatment.
   4. A written statement in simple terms explaining the rights of the individual to a treatment hearing, to be present at the hearing, to be represented by legal counsel, and the right to an independent medical evaluation.
2. If the individual is unable to read or understand the written materials, every reasonable effort must be made to explain the written material in a language the individual understands, and a note of the explanation and by whom made must be entered into the patient record.

25-03.1-28. Records and proceedings.

A record must be made of all court hearings conducted under this chapter and a copy must be provided to the respondent upon request for purposes of appellate review of the proceedings. If the respondent is indigent, the copy must be provided free of charge, with the expense thereof borne by the county of residence of the respondent.

25-03.1-29. Appeal.

1. The respondent has the right to an expedited appeal from an order of involuntary commitment or alternative treatment, an order modifying a treatment order, an alternative treatment order or less restrictive treatment order, a continuing treatment order, an order denying a petition for discharge, or an order of transfer. Upon entry of an appealable order, the court shall notify the respondent of the right of appeal and the right to counsel. The notice of appeal must be filed within thirty days after the order has been entered. Such appeal must be to the supreme court and the hearing must be commenced within fourteen days of filing of the notice of appeal. The hearing must be limited to a review of the procedures, findings, and conclusions of the lower court. The name of the respondent may not appear on the record on appeal.
2. Pending appeal, the order appealed from remains in effect, unless the supreme court determines otherwise. The respondent may not be denied the opportunity to be present at the appeal hearing, and the court conducting the appeal may issue such interim order as will assure this opportunity to the respondent while protecting the interest sought to be served by the order appealed from.

25-03.1-30. Discharge of hospitalized patient — Transfer to alternative treatment — Termination of alternative treatment.

1. The superintendent or director at any time may discharge a voluntarily hospitalized patient who is clinically suitable for discharge.
2. The superintendent or director shall discharge a patient hospitalized by court order if the patient’s mental condition is such that the patient no longer is a person requiring treatment.
3. If a patient discharged under subsection 1 or 2 has been hospitalized by a court order, or if court proceedings are pending, the treatment facility shall notify the court of the discharge.
4. A person responsible for providing treatment, other than hospitalization, to an individual ordered to undergo a program of alternative treatment may terminate the alternative treatment if the patient is clinically suitable for termination of treatment. The person shall terminate the alternative treatment if the patient no longer is a person requiring treatment and shall notify the court upon that termination.
5. If, upon the discharge of a hospitalized patient or the termination of alternative treatment of an individual under this chapter, the individual would benefit from further treatment, the hospital or provider of alternative treatment shall offer appropriate treatment on a voluntary basis or shall aid the individual to obtain treatment from another source on a voluntary basis.
   1. With the individual’s consent, the superintendent or director shall notify the appropriate community agencies or persons of the release and of the suggested release plan. Community agencies include regional mental health centers, state and local counseling services, public and private associations the function of which is to assist persons who are mentally ill or individuals with a substance use disorder, and the individual’s physician.
   2. The agencies and persons notified of the individual’s release shall report to the facility that initial contact with the individual has been accomplished.
6. If, before expiration of an initial treatment order, the superintendent or director determines a less restrictive form of treatment is more appropriate for a patient hospitalized by court order, the superintendent or director may petition the court that last ordered the patient’s hospitalization to modify the order of the court. The petition must contain statements setting forth the reasons for the determination the patient continues to be a person requiring treatment, the reasons for the determination a less restrictive form of treatment is more appropriate for the patient, and describing the recommended treatment program. If the patient consents, without a hearing, the court may modify the treatment order of the court by directing the patient to undergo the agreed treatment program for the remainder of the treatment order. The patient must be given an opportunity to protest the discharge and modification of treatment order and to receive a hearing on the merits of the protest.

25-03.1-31. Procedure to extend continuing treatment orders — Respondent’s right to petition for discharge.

1. If the director or superintendent believes that a respondent continues to be a person requiring treatment, the director or superintendent, not less than thirty days before expiration of the order, shall petition the court where the facility is located for another continuing treatment order in the manner prescribed by section 25-03.1-23. The petition must also contain a notice to the respondent that, unless the respondent waives a hearing on the petition within fifteen days after service of the petition upon the respondent, a hearing will be held by the court. The court shall appoint counsel for the respondent upon receipt of the petition, unless retained counsel has appeared on behalf of the respondent. If retained counsel has appeared, the court shall provide notice of the petition to the attorney. If the hearing is not waived, it must be held within thirty days after the petition was filed, unless extended for good cause shown. The burden of proof is the same as in an involuntary treatment hearing.
2. Every individual subject to an order of continuing treatment has the right to petition the court for discharge once annually. The petition may be presented to the court or a representative of the facility who shall transmit it to the court forthwith. If the patient is indigent or is unable for reasons satisfactory to the court to obtain an independent expert examiner, the court shall appoint an independent expert examiner to examine the patient and to furnish a report to the court. The court shall set a hearing date which must be within fourteen days of receipt of the examiner’s report. At the hearing, the burden of proof is the same as in an involuntary treatment hearing.

25-03.1-32. Periodic hearing and petition for discharge — Continuing hospitalization. [Repealed]

Repealed by S.L. 1979, ch. 334, § 33.

25-03.1-33. Legal incompetence — Presumption — Finding — Adjudication negated.

1. No determination that a person requires treatment, no court order authorizing hospitalization or alternative treatment, nor any form of admission to a hospital gives rise to a presumption of, constitutes a finding of, or operates as an adjudication of legal incompetence, or of the inability to give or withhold consent.
2. No order of commitment under any previous statute of this state, in the absence of a concomitant appointment of a guardian, constitutes a finding of or operates as an adjudication of legal incompetence, or of the inability to give or withhold consent.

25-03.1-34. Transfer of patients.

1. The superintendent or director of a treatment facility may transfer, or authorize the transfer of, an involuntary patient from a hospital to another facility if the superintendent or director determines it would be consistent with the medical needs of the patient to do so. Due consideration must be given to the relationship of the patient to family, legal guardian, or friends, so as to maintain relationships and encourage visits beneficial to the patient. If a treatment facility licensed by any state for the care and treatment of persons who are mentally ill or individuals with a substance use disorder agrees with the patient or patient’s guardian to accept the patient for treatment, the superintendent or director of the treatment facility shall release the patient to the other facility.
2. Upon receipt of notice from an agency of the United States that facilities are available for the care or treatment of any individual ordered hospitalized who is eligible for care or treatment in a treatment facility of that agency, the superintendent or director of the treatment facility may cause the individual’s transfer to that agency of the United States for treatment. An individual may not be transferred to any agency of the United States if the individual is confined pursuant to conviction of any felony or misdemeanor or the individual has been acquitted of the charge solely on the ground of mental illness unless the court originally ordering confinement of the individual enters an order for transfer after appropriate motion and hearing. An individual transferred under this section to an agency of the United States is deemed committed to that agency under the original order of treatment.
3. A facility may not transfer a patient to another hospital or agency without first notifying the patient and the patient’s legal guardian, spouse, or next of kin, if known, or a chosen friend of the patient and the court that ordered treatment. The patient must be given an opportunity to protest the transfer and to receive a hearing on the protest. The patient’s objection to the transfer must be presented to the court where the facility is located or to a representative of the facility within seven days after the notice of transfer was received. If the objection is presented to a representative of the facility, the representative shall transmit the objection to the court. The court shall set a hearing date, which must be within fourteen days of the date of receipt of the objection. If an objection has not been filed or the patient consents to a transfer, the court may enter an ex parte order authorizing transfer.

25-03.1-34.1. Exchange of individuals with a substance use disorder. [Effective through August 31, 2022]

The director of the department of human services, a county, a city, or a local law enforcement agency may enter into reciprocal agreements with the appropriate authorities of any other state regarding the mutual exchange, return, and transportation of individuals with a mental illness or substance use disorder who are treated or confined in hospitals of one state for treatment of a substance use disorder or mental illness but who have legal residence in another state.

25-03.1-34.1. Exchange of individuals with a substance use disorder. [Effective September 1, 2022]

The director of the department of health and human services, a county, a city, or a local law enforcement agency may enter into reciprocal agreements with the appropriate authorities of any other state regarding the mutual exchange, return, and transportation of individuals with a mental illness or substance use disorder who are treated or confined in hospitals of one state for treatment of a substance use disorder or mental illness but who have legal residence in another state.

25-03.1-34.2. Interstate contracts for treatment of mental illness or a substance use disorder.

1. For purposes of this section, “bordering state” means Minnesota, Montana, or South Dakota.
2. Unless prohibited by another law and subject to the exceptions in subsection 3, the department may contract with any appropriate treatment or detoxification facility in a bordering state for the treatment of mental illness or substance use disorders or for providing substance use disorder detoxification services for residents of North Dakota. The department may also contract with any public or private agency or facility to provide treatment of mental illness or substance use disorders or to provide substance use disorder detoxification services in North Dakota to residents of a bordering state. An individual who receives treatment for mental illness or a substance use disorder or who receives substance use disorder detoxification services in another state under this section is subject to the laws of the state in which treatment or detoxification is provided. An individual who receives treatment or detoxification in another state under this section must be informed of the consequences of receiving treatment or detoxification in another state, including the implications of the differences in state laws.
3. A contract may not be entered under this section for treatment or detoxification to individuals who:
   1. Are serving a sentence after conviction of a criminal offense;
   2. Are on probation or parole;
   3. Are the subject of a presentence investigation; or
   4. Have been committed involuntarily in North Dakota under chapter 25-03.1 for treatment of mental illness or a substance use disorder, except as provided under subsection 5.
4. Contracts entered under this section must, at a minimum:
   1. Describe the services to be provided;
   2. Establish responsibility for the costs of services;
   3. Establish responsibility for the costs of transporting individuals receiving services under this section;
   4. Specify the duration of the contract;
   5. Specify the means of terminating the contract;
   6. Specify the terms and conditions for refusal to admit or retain an individual; and
   7. Identify the goals to be accomplished by the placement of an individual under this section.
5. The department may enter negotiations with appropriate personnel of a bordering state to develop an agreement that conforms to the requirements of this section. An agreement with a bordering state may enable the placement in North Dakota of individuals who require detoxification services, are on emergency holds, or who have been involuntarily committed as mentally ill or having a substance use disorder in a bordering state and enable the temporary placement in a bordering state of patients who require detoxification services or who are on emergency holds in North Dakota under chapter 25-03.1. An agreement with a bordering state must provide that the North Dakota courts retain jurisdiction over North Dakota residents, and that the bordering state affords to North Dakota residents the rights afforded to the residents under North Dakota law. Individuals committed by a court of a bordering state and placed in North Dakota facilities continue to be in the legal custody of the bordering state. The bordering state’s laws governing length of commitment, re-examinations, and extension of commitment must continue to apply to these residents. In all other respects, residents of a bordering state placed in North Dakota facilities are subject to North Dakota laws. An agreement with a bordering state must specify that responsibility for payment for the cost of care of a resident of a bordering state remains with the bordering state of which that individual is a resident and the cost of care of a North Dakota resident remains with the state of North Dakota. This section applies to detoxification services regardless of whether the services are provided on a voluntary or involuntary basis.

25-03.1-35. Treatment by an agency of the United States.

1. If a respondent under this chapter is eligible for treatment by any agency of the United States, the court, upon receipt of notice from that agency showing that facilities are available and that the individual is eligible for care or treatment therein, may order the respondent placed in the custody of the agency for treatment. Any individual admitted under the order of the court to any treatment facility operated by any agency of the United States within or without the state is subject to the rules and regulations of the agency. The chief officer of any treatment facility operated by an agency has the same powers as the heads of treatment facilities within this state with respect to detention, custody, transfer, conditional release, or discharge of patients. Jurisdiction is retained in the committing court of this state at any time to inquire into the mental condition of an individual so transferred or placed and to determine the necessity for continuance of treatment.
2. An order of a court of competent jurisdiction of another state or of the District of Columbia authorizing treatment of an individual by any agency of the United States has the same force and effect as to the individual while in this state as in the geographical jurisdiction of the court entering the order; and the courts of the state or district issuing the order retain jurisdiction of the individual for the purposes of inquiring into the individual’s mental condition and of determining the necessity for continuance of treatment. Consent is hereby given to the application of the law of the state or district in which the court issuing the order for treatment is located with respect to the authority of the chief officer of any treatment facility operated in this state by any agency of the United States to retain custody, transfer, conditionally release, or discharge the individual being treated.

25-03.1-36. Escape of patient from treatment facility.

If any patient escapes from a treatment facility, the superintendent or director may cause an immediate search to be made. If the patient cannot be found, the superintendent or director shall cause notice of the escape to be given forthwith to the court of the county of residence of the patient and to such health officials or officers of the law as may be of assistance in locating the patient. If the patient is found in the county of residence, the court, at the request of the superintendent or director, shall cause the patient to be returned to the treatment facility and shall issue its order to that effect. The patient must thereupon be transported to the treatment facility as provided in other cases. Should the patient be found other than in the county of the patient’s residence, the patient may be transported at the request of the superintendent to the state hospital as directed and at the expense of the state hospital.

25-03.1-37. Reports to and additional powers of department.

The superintendent or director of a treatment facility, by means of nonidentifying data, shall notify the department of all admissions under this chapter to the state hospital or facility. In addition to the specific authority granted under the provisions of this chapter, the department shall have authority to require nonidentifying statistical data from the head of any hospital relating to the admission, examination, diagnosis, release, or discharge of any mentally ill patient.

25-03.1-38. Expenses of district court serving Stutsman County.

All expenses of the district court serving Stutsman County involving patients in residence at the state hospital must be paid by the state hospital under the direction of the department.

25-03.1-39. Transportation — Expenses.

Whenever an individual is about to be involuntarily hospitalized under the provisions of this chapter, an official or person designated by the court shall arrange for the individual’s transportation to the treatment facility with suitable medical or nursing attendants and by such means as may be suitable for the individual’s medical condition. Whenever practicable, the individual to be hospitalized must be permitted to be accompanied by one or more of the individual’s friends or relatives, and when practicable shall not be transported by police officers or in police vehicles. If the proposed patient is unable to pay for expenses of transportation, and friends or relatives do not oblige themselves to pay such expenses, the court may direct that such expenses be paid by the county of the patient’s residence.

25-03.1-40. Rights of patients.

Each patient of a treatment facility retains the following rights, subject only to the limitations and restrictions authorized by section 25-03.1-41. A patient has the right:

1. To receive appropriate treatment for mental and physical ailments and for the prevention of illness or disability.
2. To the least restrictive conditions necessary to achieve the purposes of treatment.
3. To be treated with dignity and respect.
4. To be free from unnecessary restraint and isolation.
5. To visitation and telephone communications.
6. To send and receive sealed mail.
7. To keep and use personal clothing and possessions.
8. To regular opportunities for outdoor physical exercise.
9. To be free to exercise religious faith of choice.
10. To be free from unnecessary medication.
11. To exercise all civil rights, including the right of habeas corpus.
12. Not to be subjected to experimental research without the express and informed written consent of the patient or of the patient’s guardian.
13. Not to be subjected to psychosurgery or electroconvulsive treatment without the express and informed written consent of the patient or of the patient’s guardian.
14. In a manner appropriate to the patient’s capabilities, to ongoing participation in the planning of services.
15. Not to be required to participate in the development of an individual treatment plan.
16. To be free from aversive reinforcement conditioning.

25-03.1-41. Limitations and restrictions of patient’s rights.

The rights enumerated in subsections 5, 6, 7, and 8 of section 25-03.1-40 may be limited or restricted by the treating physician, physician assistant, psychiatrist, advanced practice registered nurse, or psychologist trained in a clinical program, if in that individual’s professional judgment to do so would be in the best interests of the patient and the rights are restricted or limited in the manner authorized by the rules adopted pursuant to section 25-03.1-46. When a physician, physician assistant, psychiatrist, advanced practice registered nurse, or psychologist trained in a clinical program responsible for treatment of a particular patient imposes a special restriction on the rights of the patient as authorized by the rules, a written order specifying the restriction and the reasons for the restriction must be signed by the physician, physician assistant, psychiatrist, advanced practice registered nurse, or psychologist trained in a clinical program and attached to the patient’s chart. These restrictions must be reviewed at intervals of not more than fourteen days and may be renewed by following the procedure set out in this section.

25-03.1-42. Limitation of liability — Penalty for false petition.

1. A person acting in good faith upon either actual knowledge or reliable information which makes the petition for involuntary treatment of an individual under this chapter is not subject to civil or criminal liability.
2. A physician, physician assistant, psychiatrist, psychologist, advanced practice registered nurse, mental health professional, employee of a treatment facility, state’s attorney, or peace officer who in good faith exercises professional judgment in fulfilling an obligation or discretionary responsibility under this chapter is not subject to civil or criminal liability for acting unless it can be shown that it was done in a negligent manner.
3. A person that makes a petition for involuntary treatment of an individual without having good cause to believe the individual is a person who is both mentally ill and has a substance use disorder and as a result is likely to cause serious harm to self or others is guilty of a class A misdemeanor.

25-03.1-43. Confidential records.

All information and records obtained in the course of an investigation, an evaluation, an examination, or treatment under this chapter and the presence or past presence of a patient in a treatment facility are confidential, but the information and records may be disclosed to and be used by a court as required to carry out the purposes of this chapter, and as authorized under title 45, Code of Federal Regulations, part 164. Courts also may release nonclinical identifying information of persons subject to proceedings under this chapter for the purposes of section 62.1-02-01.2. Any information disclosed to a court remains confidential information, except as provided in section 62.1-02-01.2.

25-03.1-44. Records of disclosure. [Repealed]

Repealed by S.L. 2003, ch. 225, § 6.

25-03.1-45. Expungement of records.

Following the discharge of a respondent from a treatment facility or the state hospital or the issuance of a court order denying a petition for commitment, a respondent may at any time move to have all court records pertaining to the proceedings expunged on condition that the respondent file a full release of all claims of whatever nature arising out of the proceedings.

25-03.1-46. Rules and regulations — Preparation of forms.

The department shall, under chapter 28-32, adopt and enforce such rules as may be necessary for the implementation of this chapter. The supreme court, in consultation with the department, the associations of district judges and state’s attorneys, and other affected organizations, is responsible for the preparation and the department is responsible for distribution of the necessary and appropriate forms to enable compliance with this chapter.

25-03.2-01. Definitions. [Effective through August 31, 2022]

In this chapter, unless the context otherwise requires:

1. “Child” or “children” means a person or persons under the age of twenty-one.
2. “Clinical supervision” means the oversight responsibility for individual treatment plans and individual service delivery.
3. “Department” means the department of human services.
4. “Diagnostic assessment” means a written summary of the history, diagnosis, and individual treatment needs of a mentally ill person using diagnostic, interview, and other relevant assessment techniques.
5. “Individual treatment plan” means a written plan of intervention, treatment, and services for a mentally ill person that is developed under the clinical supervision of a mental health professional on the basis of a diagnostic assessment.
6. “Mentally ill person” has the same meaning provided for in section 25-03.1-02.
7. “Psychiatric residential treatment facility for children” means a facility or a distinct part of a facility that provides to children a total, twenty-four hour, therapeutic environment integrating group living, educational services, and a clinical program based upon a comprehensive, interdisciplinary clinical assessment, and an individualized treatment plan that meets the needs of the child and family. The services are available to children in need of and able to respond to active psychotherapeutic intervention and who cannot be effectively treated in their own family, in another home, or in a less restrictive setting. The facility must meet the requirements of a psychiatric residential treatment facility as set out in title 42, Code of Federal Regulations, part 483.352.
8. “Residential treatment” means a twenty-four hour a day program under the clinical supervision of a mental health professional, in a community residential setting other than an acute care hospital, for the active treatment of mentally ill persons.

25-03.2-01. Definitions. [Effective September 1, 2022]

In this chapter, unless the context otherwise requires:

1. “Child” or “children” means a person or persons under the age of twenty-one.
2. “Clinical supervision” means the oversight responsibility for individual treatment plans and individual service delivery.
3. “Department” means the department of health and human services.
4. “Diagnostic assessment” means a written summary of the history, diagnosis, and individual treatment needs of a mentally ill person using diagnostic, interview, and other relevant assessment techniques.
5. “Individual treatment plan” means a written plan of intervention, treatment, and services for a mentally ill person that is developed under the clinical supervision of a mental health professional on the basis of a diagnostic assessment.
6. “Mentally ill person” has the same meaning provided for in section 25-03.1-02.
7. “Psychiatric residential treatment facility for children” means a facility or a distinct part of a facility that provides to children a total, twenty-four hour, therapeutic environment integrating group living, educational services, and a clinical program based upon a comprehensive, interdisciplinary clinical assessment, and an individualized treatment plan that meets the needs of the child and family. The services are available to children in need of and able to respond to active psychotherapeutic intervention and who cannot be effectively treated in their own family, in another home, or in a less restrictive setting. The facility must meet the requirements of a psychiatric residential treatment facility as set out in title 42, Code of Federal Regulations, part 483.352.
8. “Residential treatment” means a twenty-four hour a day program under the clinical supervision of a mental health professional, in a community residential setting other than an acute care hospital, for the active treatment of mentally ill persons.

25-03.2-02. License required.

The operator of a publicly or privately operated psychiatric residential treatment facility for children shall meet the requirements for licensure and shall secure a license from the department.

25-03.2-03. Requirements for license.

The department shall issue a license for the operation of a psychiatric residential treatment facility for children upon a showing that:

1. The premises to be used are in fit, safe, and sanitary condition and properly equipped to provide good care and treatment;
2. The program director of the facility holds, at a minimum, a master’s degree in social work, psychology, or in a related field with at least two years of professional experience in the treatment of children suffering from mental illnesses or emotional disturbances. The executive director of the facility must have, at a minimum, a bachelor’s degree in a behavioral science or a bachelor’s degree in any field and two years of experience in administration;
3. The staff employed by the facility is supervised by the program director and qualified by training and experience to provide services to children suffering from mental illnesses or emotional disturbances. The facility annually must provide training to staff which is relevant to the needs of the client population;
4. The health, safety, and well-being of the children cared for and treated in the facility will be properly safeguarded;
5. There are sufficient treatment, educational, recreational and leisure, and physical facilities and services available to the children in the facility;
6. The facility will provide for a medical and psychological examination of each child within seventy-two hours of admission and thereafter as needed by the child;
7. An interdisciplinary team will review each individual treatment plan at least monthly and update or amend the plan to meet the needs of the child;
8. The facility develops postdischarge plans and coordinates facility services and related community services with partial discharge plans with each child’s family, school, and community upon discharge to ensure continuity of care; and
9. The facility is in compliance with requirements for psychiatric residential treatment facilities under 42 U.S.C. 1396d [Pub. L. 89-97; 79 Stat. 351] and title 42, Code of Federal Regulations, part 441, and with this chapter and rules adopted under this chapter.

25-03.2-03.1. Moratorium on expansion of psychiatric residential treatment facility for children bed capacity — Exchange of bed capacity.

1. Notwithstanding sections 25-03.2-03 and 25-03.2-08, unless a needs assessment conducted by the department indicates a need for the licensing of additional bed capacity, the department may not issue a license under this chapter for any additional bed capacity for a psychiatric residential treatment facility for children above the state’s gross number of beds licensed as of June 30, 2003. This subsection does not apply to nor prohibit the department from licensing additional bed capacity for a new psychiatric residential treatment facility for children if the additional beds are designated for the care of children and adolescents who are residents of other states.
2. Notwithstanding subsection 1, the department may develop a policy to:
   1. Exchange qualified residential treatment program bed capacity licensed under chapter 50-11 with psychiatric residential treatment facility bed capacity; or
   2. Exchange psychiatric residential treatment facility bed capacity with qualified residential treatment program bed capacity licensed under chapter 50-11.

25-03.2-04. Conviction not bar to licensure — Exceptions.

Conviction of an offense by an owner or operator of a facility does not disqualify the center from licensure unless the department determines that the offense has a direct bearing upon a person’s ability to serve the public as an owner or operator of a psychiatric residential treatment facility for children, or that, following conviction of any offense, the person is not sufficiently rehabilitated under section 12.1-33-02.1.

25-03.2-05. Content of license.

The license to operate a psychiatric residential treatment facility for children must specify:

1. The name of the licensee.
2. The premises to which the license is applicable.
3. The number of children who may be received in the premises at any one time.
4. The date of expiration of the license.

25-03.2-06. Admission criteria.

A child may be admitted to a psychiatric residential treatment facility for children if, the child has been diagnosed by a psychiatrist or psychologist as suffering from a mental illness or emotional disturbance and the child is in need of and able to respond to active psychotherapeutic intervention and cannot be effectively treated in the child’s family, in another home, or in a less restrictive setting. The facility must take into account the age and diagnosis of the child in order to provide an environment that is safe and therapeutic for all children.

25-03.2-07. Method of providing service.

A psychiatric residential treatment facility for children shall provide for the development of an individual treatment plan, based upon a comprehensive interdisciplinary diagnostic assessment, which includes the role of the family, identifies the goals and objectives of the therapeutic activities and treatment, provides a schedule for accomplishing the therapeutic activities and treatment goals and objectives, and identifies the individuals responsible for providing services, consistent with the individual treatment plan, to children. Clinical supervision of the individual treatment plan must be accomplished as set forth by the department in rules. Clinical supervision must be documented in individual treatment plans and by entries in the child’s record regarding supervisory activity.

25-03.2-08. Revocation or denial of license.

The department may revoke a license or deny an application for a license under this chapter if:

1. Any requirement and condition of this chapter for the issuance of a license is not met, or has ceased to be met;
2. The license was issued or requested upon fraudulent or untrue representations;
3. The owner or operator has violated any rule of the department; or
4. The owner, operator, or an employee of the facility is or has been found guilty of an offense determined by the department to have a direct bearing on the person’s ability to serve as an owner, operator, or employee, or the department determines, following conviction of an offense, that the person is not sufficiently rehabilitated under section 12.1-33-02.1.

25-03.2-09. Hearing on denial or revocation of license.

In any case in which the department determines that a license should be revoked or an application for a license should be denied, written reasons for the revocation or denial must be provided to the licensee or applicant. The licensee or applicant is entitled to a hearing before the department if a hearing is requested within ten days after the charges are provided.

25-03.2-10. Department may adopt rules.

The department may adopt rules for the conduct of psychiatric residential treatment facilities for children and shall adopt rules defining which professionals may provide clinical supervision and review, and may develop, update, and sign an individual treatment plan within a psychiatric residential treatment facility for children.

25-03.3-01. Definitions. [Effective through August 31, 2022]

In this chapter, unless the context otherwise requires:

1. “Committed individual” means an individual committed for custody and treatment pursuant to this chapter.
2. “Executive director” means the executive director of the department of human services or the executive director’s designee.
3. “Intellectual disability” means mental retardation as defined in the “Diagnostic and Statistical Manual of Mental Disorders”, American psychiatric association, (4th edition, text revision 2000).
4. “Qualified expert” means an individual who has an expertise in sexual offender evaluations and who is a psychiatrist or psychologist trained in a clinical program and licensed pursuant to this state’s law or a psychologist approved for exemption by the North Dakota board of psychologist examiners. For purposes of evaluating an individual with an intellectual disability, the qualified expert must have specialized knowledge in sexual offender evaluations of individuals with an intellectual disability.
5. “Respondent” means an individual subject to a commitment proceeding pursuant to this chapter.
6. “Sexual act” means sexual contact between human beings, including contact between the penis and the vulva, the penis and the anus, the mouth and the penis, the mouth and the vulva, or the vulva and the vulva; or the use of an object that comes in contact with the victim’s anus, vulva, or penis. Sexual contact between the penis and the vulva, or between the penis and the anus, or an object and the anus, vulva, or penis of the victim, occurs upon penetration, however slight. Emission is not required.
7. “Sexual contact” means any touching of the sexual or other intimate parts of an individual for the purpose of arousing or satisfying sexual or aggressive desires.
8. “Sexually dangerous individual” means an individual who is shown to have engaged in sexually predatory conduct and who has a congenital or acquired condition that is manifested by a sexual disorder, a personality disorder, or other mental disorder or dysfunction that makes that individual likely to engage in further acts of sexually predatory conduct which constitute a danger to the physical or mental health or safety of others. It is a rebuttable presumption that sexually predatory conduct creates a danger to the physical or mental health or safety of the victim of the conduct. For these purposes, intellectual disability is not a sexual disorder, personality disorder, or other mental disorder or dysfunction.
9. “Sexually predatory conduct” means:
   1. Engaging or attempting to engage in a sexual act or sexual contact with another individual, or causing or attempting to cause another individual to engage in a sexual act or sexual contact, if:
      1. The victim is compelled to submit by force or by threat of imminent death, serious bodily injury, or kidnapping directed toward the victim or any human being, or the victim is compelled to submit by any threat or coercion that would render a person reasonably incapable of resisting;
      2. The victim’s power to appraise or control the victim’s conduct has been substantially impaired by the administration or employment, without the victim’s knowledge, of intoxicants or other means for purposes of preventing resistance;
      3. The actor knows or should have known that the victim is unaware that a sexual act is being committed upon the victim;
      4. The victim is less than fifteen years old;
      5. The actor knows or should have known that the victim has a disability that substantially impairs the victim’s understanding of the nature of the sexual act or contact;
      6. The victim is in official custody or detained in a treatment facility, health care facility, correctional facility, or other institution and is under the supervisory authority, disciplinary control, or care of the actor;
      7. The victim is a minor and the actor is an adult; or
      8. The other individual is a person related to the actor within a degree of consanguinity within which marriages are declared incestuous and void by section 14-03-03 and the actor knows that; or
   2. Engaging in or attempting to engage in sexual contact with another individual or causing or attempting to cause another individual to have sexual contact, if:
      1. The actor knows or should have known that the contact is offensive to the victim; or
      2. The victim is a minor, fifteen years of age or older, and the actor is the minor’s parent, guardian, or is otherwise responsible for general supervision of the victim’s welfare.
10. “Should have known” means a reasonable individual without a congenital or acquired condition that is manifested by a sexual disorder, a personality disorder, or other mental disorder or dysfunction in the actor’s circumstances would have known.
11. “Superintendent” means the superintendent of the state hospital or the superintendent’s designee.
12. “Treatment facility” means any hospital, including the state hospital, or any treatment facility, including the life skills and transition center, which can provide directly, or by direct arrangement with other public or private agencies, evaluation and treatment of sexually dangerous individuals.

25-03.3-01. Definitions. [Effective September 1, 2022]

In this chapter, unless the context otherwise requires:

1. “Committed individual” means an individual committed for custody and treatment pursuant to this chapter.
2. “Executive director” means the executive director of the department of health and human services or the executive director’s designee.
3. “Intellectual disability” means mental retardation as defined in the “Diagnostic and Statistical Manual of Mental Disorders”, American psychiatric association, (4th edition, text revision 2000).
4. “Qualified expert” means an individual who has an expertise in sexual offender evaluations and who is a psychiatrist or psychologist trained in a clinical program and licensed pursuant to this state’s law or a psychologist approved for exemption by the North Dakota board of psychologist examiners. For purposes of evaluating an individual with an intellectual disability, the qualified expert must have specialized knowledge in sexual offender evaluations of individuals with an intellectual disability.
5. “Respondent” means an individual subject to a commitment proceeding pursuant to this chapter.
6. “Sexual act” means sexual contact between human beings, including contact between the penis and the vulva, the penis and the anus, the mouth and the penis, the mouth and the vulva, or the vulva and the vulva; or the use of an object that comes in contact with the victim’s anus, vulva, or penis. Sexual contact between the penis and the vulva, or between the penis and the anus, or an object and the anus, vulva, or penis of the victim, occurs upon penetration, however slight. Emission is not required.
7. “Sexual contact” means any touching of the sexual or other intimate parts of an individual for the purpose of arousing or satisfying sexual or aggressive desires.
8. “Sexually dangerous individual” means an individual who is shown to have engaged in sexually predatory conduct and who has a congenital or acquired condition that is manifested by a sexual disorder, a personality disorder, or other mental disorder or dysfunction that makes that individual likely to engage in further acts of sexually predatory conduct which constitute a danger to the physical or mental health or safety of others. It is a rebuttable presumption that sexually predatory conduct creates a danger to the physical or mental health or safety of the victim of the conduct. For these purposes, intellectual disability is not a sexual disorder, personality disorder, or other mental disorder or dysfunction.
9. “Sexually predatory conduct” means:
   1. Engaging or attempting to engage in a sexual act or sexual contact with another individual, or causing or attempting to cause another individual to engage in a sexual act or sexual contact, if:
      1. The victim is compelled to submit by force or by threat of imminent death, serious bodily injury, or kidnapping directed toward the victim or any human being, or the victim is compelled to submit by any threat or coercion that would render a person reasonably incapable of resisting;
      2. The victim’s power to appraise or control the victim’s conduct has been substantially impaired by the administration or employment, without the victim’s knowledge, of intoxicants or other means for purposes of preventing resistance;
      3. The actor knows or should have known that the victim is unaware that a sexual act is being committed upon the victim;
      4. The victim is less than fifteen years old;
      5. The actor knows or should have known that the victim has a disability that substantially impairs the victim’s understanding of the nature of the sexual act or contact;
      6. The victim is in official custody or detained in a treatment facility, health care facility, correctional facility, or other institution and is under the supervisory authority, disciplinary control, or care of the actor;
      7. The victim is a minor and the actor is an adult; or
      8. The other individual is a person related to the actor within a degree of consanguinity within which marriages are declared incestuous and void by section 14-03-03 and the actor knows that; or
   2. Engaging in or attempting to engage in sexual contact with another individual or causing or attempting to cause another individual to have sexual contact, if:
      1. The actor knows or should have known that the contact is offensive to the victim; or
      2. The victim is a minor, fifteen years of age or older, and the actor is the minor’s parent, guardian, or is otherwise responsible for general supervision of the victim’s welfare.
10. “Should have known” means a reasonable individual without a congenital or acquired condition that is manifested by a sexual disorder, a personality disorder, or other mental disorder or dysfunction in the actor’s circumstances would have known.
11. “Superintendent” means the superintendent of the state hospital or the superintendent’s designee.
12. “Treatment facility” means any hospital, including the state hospital, or any treatment facility, including the life skills and transition center, which can provide directly, or by direct arrangement with other public or private agencies, evaluation and treatment of sexually dangerous individuals.

25-03.3-02. Jurisdiction and venue.

The district court has original jurisdiction over the proceedings governed by this chapter. A proceeding pursuant to this chapter may be tried in any county in which the respondent resides or is located, or has committed any sexually predatory conduct, or if the respondent is an inmate, any of the foregoing venues or a county to which the respondent has indicated an intent to relocate upon release from the correctional facility.

25-03.3-03. Sexually dangerous individual — Petition.

1. If it appears that an individual is a sexually dangerous individual, the state’s attorney may file a petition in the district court alleging that the individual is a sexually dangerous individual and stating sufficient facts to support the allegation.
2. The petition and any proceeding under section 25-03.3-11 are confidential and are not public records or proceedings under sections 44-04-18 and 44-04-19 and sections 5 and 6 of article XI of the Constitution of North Dakota. The court may permit access to a respondent’s records or proceedings under this chapter to the respondent’s guardian, guardian ad litem, or other similarly situated individual. The court may permit access to information in the respondent’s records to other individuals who require the information for use in performing official governmental duties. Notwithstanding any other provision of law, proceedings under section 25-03.3-13 and any evidence introduced or presented to the court for any such proceeding are required to be open to the public, with the exception of a proceeding involving an individual who has not been convicted of a sexual act as defined in section 25-03.3-01. The protections of subsection 10 of section 12.1-34-02 and section 12.1-35-03 apply to any records or proceedings under this chapter.

25-03.3-03.1. Referral of inmates to state’s attorneys — Immunity.

1. The department of corrections and rehabilitation shall maintain treatment records for any inmate who has been convicted of an offense that includes sexually predatory conduct. Approximately six months before the projected release date of the inmate, the department shall complete an assessment of the inmate to determine whether a recommendation is to be made to a state’s attorney for civil commitment of the inmate under this chapter. The assessment must be based on actuarial and clinical evaluations or any other information determined by the director to be relevant, including inmate behavior and whether the inmate participated in sexual offender treatment while incarcerated.
2. If, upon the completion of the assessment, the department determines the inmate may meet the definition of a sexually dangerous individual, the department shall refer the inmate to a state’s attorney of an appropriate county as provided for in section 25-03.3-02. The department may make a referral of an inmate to more than one county.
3. Any referral from the department must include a summary of the factors considered material to the determination that the inmate is appropriate for referral. The department shall provide a copy of the referral and summary to the attorney general and the superintendent of the life skills and transition center and the state hospital.
4. Following the receipt of a referral, but at least sixty days before the release date of the inmate, the state’s attorney shall notify the department and the attorney general of the state’s attorney’s intended disposition of the referral.
5. Any person participating in good faith in the assessment and referral of an inmate is immune from any civil or criminal liability. For the purpose of any civil or criminal proceeding, the good faith of any person required to participate in the assessment and referral of an inmate is presumed.

25-03.3-04. Retention of records.

Notwithstanding any other provision of law, all adult and juvenile case files and court records of an alleged offense defined by chapters 12.1-20 and 12.1-27.2 must be retained for twenty-five years and made available to any state’s attorney for purposes of investigation or proceedings pursuant to this chapter. If the subject of a case file or court record has died before the expiration of the twenty-five-year period, the official, department, or agency possessing the case files and records shall maintain the case files and records in accordance with the case file and records retention policies of that official, department, or agency. For purposes of this section, “adult and juvenile case files” mean the subject’s medical, psychological, and treatment clinical assessments, evaluations, and progress reports; offenses in custody records; case notes; and criminal investigation reports and records.

25-03.3-05. Abrogation of confidentiality statutes and privileges.

1. Notwithstanding any other provision of law requiring confidentiality of information about individuals receiving care, custody, education, treatment, or any other services from the state or any political subdivision, any confidential information about a respondent or committed individual must be released to a state’s attorney for proceedings pursuant to this chapter unless release results in the loss of federal funds. The physician-patient privilege and psychotherapist-patient privilege do not apply to communications relevant to an issue in proceedings to commit an individual as a sexually dangerous person if the physician or psychotherapist in the course of diagnosis or treatment determines the patient is in need of commitment and to communications with a committed individual. The provision of any confidential or privileged information to the state’s attorney does not render the state, any political subdivision, or any state or political subdivision official or employee, or other person liable pursuant to any criminal or civil law relating to confidentiality or privilege.
2. For purposes of this chapter, the disclosure of individually identifiable health information by a treating facility or mental health professional to the state hospital or a mental health professional, including an expert examiner, is a disclosure for treatment. A retained or appointed counsel has the right to obtain individually identifiable health information regarding a respondent in a proceeding under this chapter. In any other case, the right of an inmate or a patient to obtain protected health information must be in accordance with title 45, Code of Federal Regulations, part 164.

25-03.3-06. Use of confidential records.

Upon request, any confidential records provided to the state’s attorney pursuant to this chapter must be made available to the respondent or committed individual, the attorney of the respondent or committed individual, a qualified expert charged with examining the respondent or committed individual, the court, and any treatment facility in which the respondent or committed individual is being evaluated or treated pursuant to this chapter.

25-03.3-07. Appointment of guardian ad litem. [Effective through August 31, 2022]

At any stage of a proceeding under this chapter, on application of any individual or on its own motion, the court may appoint a guardian ad litem for a minor or an individual with an intellectual disability who is a respondent or witness or otherwise involved in the proceeding, if the minor or an individual with an intellectual disability has no parent, guardian, or custodian appearing on behalf of the minor or the individual with an intellectual disability or the interests of those persons conflict with those of the minor or an individual with an intellectual disability. The department of human services shall pay the expense of the guardian ad litem fee as established by the court.

25-03.3-07. Appointment of guardian ad litem. [Effective September 1, 2022]

At any stage of a proceeding under this chapter, on application of any individual or on its own motion, the court may appoint a guardian ad litem for a minor or an individual with an intellectual disability who is a respondent or witness or otherwise involved in the proceeding, if the minor or an individual with an intellectual disability has no parent, guardian, or custodian appearing on behalf of the minor or the individual with an intellectual disability or the interests of those persons conflict with those of the minor or an individual with an intellectual disability. The department of health and human services shall pay the expense of the guardian ad litem fee as established by the court.

25-03.3-08. Sexually dangerous individual — Procedure on petition — Detention. [Effective through August 31, 2022]

1. Upon the filing of a petition pursuant to this chapter, the court shall determine whether to issue an order for detention of the respondent named in the petition. The petition may be heard ex parte. The court shall issue an order for detention if there is cause to believe that the respondent is a sexually dangerous individual. If the court issues an order for detention, the order must direct that the respondent be taken into custody and transferred to an appropriate treatment facility or local correctional facility to be held for subsequent hearing pursuant to this chapter. Under this section, the department of human services shall pay for any expense incurred in the detention or evaluation of the respondent.
2. If the state’s attorney knows or believes the respondent named in the petition is an individual with an intellectual disability, the state’s attorney shall notify the court in the petition and shall advise the court of the name of the legal guardian of the respondent or, if none is known, the court may appoint a guardian ad litem for the respondent. Before service of the notice required in section 25-03.3-10, the court shall appoint an attorney for the respondent. An individual with an intellectual disability may be detained in a correctional facility before the probable cause hearing only when no other secure facility is accessible, and then only under close supervision.

25-03.3-08. Sexually dangerous individual — Procedure on petition — Detention. [Effective September 1, 2022]

1. Upon the filing of a petition pursuant to this chapter, the court shall determine whether to issue an order for detention of the respondent named in the petition. The petition may be heard ex parte. The court shall issue an order for detention if there is cause to believe that the respondent is a sexually dangerous individual. If the court issues an order for detention, the order must direct that the respondent be taken into custody and transferred to an appropriate treatment facility or local correctional facility to be held for subsequent hearing pursuant to this chapter. Under this section, the department of health and human services shall pay for any expense incurred in the detention or evaluation of the respondent.
2. If the state’s attorney knows or believes the respondent named in the petition is an individual with an intellectual disability, the state’s attorney shall notify the court in the petition and shall advise the court of the name of the legal guardian of the respondent or, if none is known, the court may appoint a guardian ad litem for the respondent. Before service of the notice required in section 25-03.3-10, the court shall appoint an attorney for the respondent. An individual with an intellectual disability may be detained in a correctional facility before the probable cause hearing only when no other secure facility is accessible, and then only under close supervision.

25-03.3-09. Right to counsel — Waiver.

1. Every respondent is entitled to legal counsel. Unless an appearance has been entered on behalf of the respondent, the court, within twenty-four hours from the time the petition was filed, exclusive of weekends or holidays, shall appoint counsel to represent the respondent. If a respondent retains counsel, the retained counsel immediately shall notify the court of that fact.
2. After consultation with counsel, the respondent may waive the right to counsel or the right to any hearing provided pursuant to this chapter by notifying the court in writing. The notification must clearly state the respondent’s reasons for the waiver and the respondent’s counsel shall separately certify that counsel has explained to the respondent the proceedings, the legal and factual issues, potential defenses, the burden of proof, and possible outcomes of the proceedings. No guardian, guardian ad litem, attorney, or other individual may waive the right to counsel on behalf of an individual with an intellectual disability.
3. If the court determines that the respondent is indigent, the court shall appoint counsel and order that appointed counsel be compensated by the county that is the respondent’s place of residence in a reasonable amount based upon time and expenses.
4. The state’s attorney of a county that has expended sums pursuant to subsection 3 may seek civil recovery of those sums from property of the respondent. Commencement of the action must occur within six years after the date the sums were paid. After notice and hearing, the court may order an individual to reimburse the county for expenditures made on that individual’s behalf pursuant to this chapter.

25-03.3-10. Notice.

If a respondent is detained pursuant to section 25-03.3-08, the state’s attorney shall provide the respondent, or the respondent’s guardian, if appropriate, with a copy of the petition filed with the court. The state’s attorney shall provide the respondent with written notice of the respondent’s right to a preliminary hearing and a commitment hearing, if probable cause is found to exist; the right to counsel and that counsel will be appointed for the respondent, if the respondent is indigent; and the right to have an expert of the respondent’s choosing conduct an evaluation and testify on the respondent’s behalf or, if the respondent is indigent, that the court will appoint a qualified expert for the respondent. The notice must state the date, time, and place for the preliminary hearing. If notice is given to a respondent who the state’s attorney knows or believes is an individual with an intellectual disability, the state’s attorney also shall give notice to the respondent’s attorney, guardian, and guardian ad litem, if any.

25-03.3-11. Preliminary hearing — Probable cause.

The respondent is entitled to a preliminary hearing within seventy-two hours of being taken into custody pursuant to an order of the court, excluding weekends and holidays, unless the respondent knowingly waives the preliminary hearing pursuant to section 25-03.3-09. The respondent has a right to be present, to testify, and to present and cross-examine witnesses at any preliminary hearing. The court may receive evidence that would otherwise be inadmissible at a commitment hearing. If the court determines after a preliminary hearing that there is probable cause to believe the respondent is a sexually dangerous individual, the court shall order that the respondent be transferred to an appropriate treatment facility for an evaluation as to whether the respondent has a congenital or acquired condition that is manifested by a sexual disorder, a personality disorder, or other mental disorder or dysfunction that makes the respondent likely to engage in further acts of sexually predatory conduct. If the court determines that probable cause does not exist to believe that the respondent is a sexually dangerous individual, the court shall dismiss the petition. If the respondent waives the preliminary hearing, then the respondent must be immediately transferred to an appropriate treatment facility for an evaluation as to whether the respondent has a congenital or acquired condition that is manifested by a sexual disorder, a personality disorder, or other mental disorder or dysfunction that makes the respondent likely to engage in further acts of sexually predatory conduct. An individual with an intellectual disability may be evaluated under this chapter at a facility only if that facility provides care and treatment to individuals with an intellectual disability.

25-03.3-12. Sexually dangerous individual — Evaluation. [Effective through August 31, 2022]

The evaluation must be conducted by one or more experts chosen by the executive director. Whenever a respondent is subject to an evaluation pursuant to this chapter, the respondent may retain an expert to perform an evaluation or testify on the respondent’s behalf. When the respondent is an adult with an intellectual disability and a guardian or guardian ad litem has not been appointed for the respondent, the court shall appoint an expert to perform an evaluation on behalf of the respondent. In the case of a respondent who is indigent, the court shall appoint a qualified expert to perform an examination or participate in the commitment proceeding on the respondent’s behalf. The department of human services shall compensate any qualified expert appointed by the court on behalf of an indigent respondent in a reasonable amount based on time and expenses. An expert retained on behalf of the respondent must have reasonable access to the respondent for the purpose of the examination and to all relevant medical, psychological, and court records and reports.

25-03.3-12. Sexually dangerous individual — Evaluation. [Effective September 1, 2022]

The evaluation must be conducted by one or more experts chosen by the executive director. Whenever a respondent is subject to an evaluation pursuant to this chapter, the respondent may retain an expert to perform an evaluation or testify on the respondent’s behalf. When the respondent is an adult with an intellectual disability and a guardian or guardian ad litem has not been appointed for the respondent, the court shall appoint an expert to perform an evaluation on behalf of the respondent. In the case of a respondent who is indigent, the court shall appoint a qualified expert to perform an examination or participate in the commitment proceeding on the respondent’s behalf. The department of health and human services shall compensate any qualified expert appointed by the court on behalf of an indigent respondent in a reasonable amount based on time and expenses. An expert retained on behalf of the respondent must have reasonable access to the respondent for the purpose of the examination and to all relevant medical, psychological, and court records and reports.

25-03.3-13. Sexually dangerous individual — Commitment proceeding — Report of findings.

Within sixty days after the finding of probable cause, the court shall conduct a commitment proceeding to determine whether the respondent is a sexually dangerous individual. The court may extend the time for good cause. At the commitment proceeding, any testimony and reports of an expert who conducted an examination are admissible, including risk assessment evaluations. Any proceeding pursuant to this chapter must be tried to the court and not a jury. At the commitment proceeding, the state’s attorney shall present evidence in support of the petition and the burden is on the state to show by clear and convincing evidence that the respondent is a sexually dangerous individual. An individual may not be committed unless expert evidence is admitted establishing that the individual has a congenital or acquired condition that is manifested by a sexual disorder, a personality disorder, or other mental disorder or dysfunction that makes that individual likely to engage in further acts of sexually predatory conduct. The respondent has a right to be present, to testify, and to present and cross-examine witnesses. If the respondent is found to be a sexually dangerous individual, the court shall commit the respondent to the care, custody, and control of the executive director. The executive director shall place the respondent in an appropriate facility or program at which treatment is available. The appropriate treatment facility or program must be the least restrictive available treatment facility or program necessary to achieve the purposes of this chapter. The executive director may not be required to create a less restrictive treatment facility or treatment program specifically for the respondent or committed individual. Unless the respondent has been committed to the legal and physical custody of the department of corrections and rehabilitation, the respondent may not be placed at and the treatment program for the respondent may not be provided at the state penitentiary or an affiliated penal facility. If the respondent is found not to be a sexually dangerous individual, the court shall discharge the respondent.

25-03.3-14. Interagency placement.

If a committed individual also has been committed to the legal and physical custody of the department of corrections and rehabilitation, the director of the department of corrections and rehabilitation and the executive director may consult one another and determine the appropriate placement of the individual and may transfer the individual between placements.

25-03.3-15. Evidence of prior acts.

Notwithstanding any other provision of law, in any proceeding pursuant to this chapter, evidence of prior sexually predatory conduct or criminal conduct, including a record of the juvenile court, is admissible.

25-03.3-16. Limitation on findings as evidence in criminal proceedings.

Any determination made pursuant to this chapter regarding whether a respondent is a sexually dangerous individual or has a congenital or acquired condition that is manifested by a sexual disorder, a personality disorder, or other mental disorder or dysfunction is inadmissible in any criminal proceeding against the respondent, including any criminal proceeding to determine whether the respondent is fit to stand trial, incapable of forming requisite intent, or not guilty by reason of lack of responsibility because of mental disease or defect.

25-03.3-17. Postcommitment proceeding, discharge, and further disposition. [Effective through August 31, 2022]

1. A committed individual must remain in the care, custody, and control of the executive director until, in the opinion of the executive director, the individual is safe to be at large.
2. Each committed individual must have an examination of that individual’s mental condition at least once a year. A report regarding the examination must be provided to the court that committed the individual. At the time of the annual examination, the committed individual has the right to have an expert examine the individual, and, upon the request of an indigent committed individual, the court shall appoint a qualified expert to examine the committed individual and report to the court. The department of human services shall compensate a qualified expert appointed by the court in a reasonable amount based on time and expenses. That expert must have reasonable access to the committed individual and to all records relating to the committed individual, including confidential records.
3. If a committed individual has been committed to an out-of-state facility by the executive director for purposes of treatment, an expert from that state may be appointed by the court as a qualified expert for an indigent committed individual for any postcommitment proceeding.
4. After any report pursuant to this section is provided to the court, the court may order further examination and investigation of the committed individual as the court considers necessary. The court may set the matter for a hearing. At the hearing, the committed individual is entitled to be present and to the benefit of the protections afforded at the commitment proceeding. The state’s attorney shall represent the state at the hearing. After the hearing, the court shall determine whether the committed individual is to be discharged or to be retained as a sexually dangerous individual in the care, custody, and control of the executive director.
5. The executive director may only discharge a sexually dangerous individual from commitment pursuant to a court order. The executive director may petition the committing court at any time for the discharge of the committed individual. The executive director shall give the state’s attorney notice of any petition for discharge the executive director files with the court. Before the petition is granted, the state’s attorney has the right to be heard by the court on the petition. The state’s attorney may waive this right.
6. If the executive director moves a committed individual from a placement in the community to a placement in a secure treatment facility that is more restrictive, the committed individual may challenge the move at a hearing to be held within thirty days after the move in accordance with procedures established by the department of human services.

25-03.3-17. Postcommitment proceeding, discharge, and further disposition. [Effective September 1, 2022]

1. A committed individual must remain in the care, custody, and control of the executive director until, in the opinion of the executive director, the individual is safe to be at large.
2. Each committed individual must have an examination of that individual’s mental condition at least once a year. A report regarding the examination must be provided to the court that committed the individual. At the time of the annual examination, the committed individual has the right to have an expert examine the individual, and, upon the request of an indigent committed individual, the court shall appoint a qualified expert to examine the committed individual and report to the court. The department of health and human services shall compensate a qualified expert appointed by the court in a reasonable amount based on time and expenses. That expert must have reasonable access to the committed individual and to all records relating to the committed individual, including confidential records.
3. If a committed individual has been committed to an out-of-state facility by the executive director for purposes of treatment, an expert from that state may be appointed by the court as a qualified expert for an indigent committed individual for any postcommitment proceeding.
4. After any report pursuant to this section is provided to the court, the court may order further examination and investigation of the committed individual as the court considers necessary. The court may set the matter for a hearing. At the hearing, the committed individual is entitled to be present and to the benefit of the protections afforded at the commitment proceeding. The state’s attorney shall represent the state at the hearing. After the hearing, the court shall determine whether the committed individual is to be discharged or to be retained as a sexually dangerous individual in the care, custody, and control of the executive director.
5. The executive director may only discharge a sexually dangerous individual from commitment pursuant to a court order. The executive director may petition the committing court at any time for the discharge of the committed individual. The executive director shall give the state’s attorney notice of any petition for discharge the executive director files with the court. Before the petition is granted, the state’s attorney has the right to be heard by the court on the petition. The state’s attorney may waive this right.
6. If the executive director moves a committed individual from a placement in the community to a placement in a secure treatment facility that is more restrictive, the committed individual may challenge the move at a hearing to be held within thirty days after the move in accordance with procedures established by the department of health and human services.

25-03.3-18. Petition for discharge — Notice. [Effective through August 31, 2022]

1. Annually, the executive director shall provide the committed individual with written notice that the individual has a right to petition the court for discharge. The notice must explain to the committed person when the committed person has a right to a hearing on the petition. The notice must inform the committed person of the rights this chapter affords the committed person at a discharge hearing. The executive director shall forward a copy of the notice to the committing court. If the committed individual is an individual with an intellectual disability, the executive director shall also provide the written notice to the individual’s attorney, guardian, and guardian ad litem, if any.
2. If the committed individual files a petition for discharge and has not had a hearing pursuant to section 25-03.3-17 or this section during the preceding twelve months, the committed individual has a right to a hearing on the petition.
3. At the hearing on the petition for discharge, the committed individual is entitled to be present and to the benefit of the protections afforded at the commitment proceeding. The state’s attorney shall represent the state and may have the committed individual evaluated by experts chosen by the state. The committed individual is entitled to have an expert of the committed individual’s choice conduct an evaluation. The court shall appoint a qualified expert if the committed individual is indigent and requests an appointment. The department of human services shall compensate a qualified expert appointed by the court in a reasonable amount based on time and expenses. That expert must have reasonable access to the committed individual and to all records relating to the committed individual, including confidential records.
4. At any hearing held pursuant to a petition for discharge, the burden of proof is on the state to show by clear and convincing evidence that the committed individual remains a sexually dangerous individual.

25-03.3-18. Petition for discharge — Notice. [Effective September 1, 2022]

1. Annually, the executive director shall provide the committed individual with written notice that the individual has a right to petition the court for discharge. The notice must explain to the committed person when the committed person has a right to a hearing on the petition. The notice must inform the committed person of the rights this chapter affords the committed person at a discharge hearing. The executive director shall forward a copy of the notice to the committing court. If the committed individual is an individual with an intellectual disability, the executive director shall also provide the written notice to the individual’s attorney, guardian, and guardian ad litem, if any.
2. If the committed individual files a petition for discharge and has not had a hearing pursuant to section 25-03.3-17 or this section during the preceding twelve months, the committed individual has a right to a hearing on the petition.
3. At the hearing on the petition for discharge, the committed individual is entitled to be present and to the benefit of the protections afforded at the commitment proceeding. The state’s attorney shall represent the state and may have the committed individual evaluated by experts chosen by the state. The committed individual is entitled to have an expert of the committed individual’s choice conduct an evaluation. The court shall appoint a qualified expert if the committed individual is indigent and requests an appointment. The department of health and human services shall compensate a qualified expert appointed by the court in a reasonable amount based on time and expenses. That expert must have reasonable access to the committed individual and to all records relating to the committed individual, including confidential records.
4. At any hearing held pursuant to a petition for discharge, the burden of proof is on the state to show by clear and convincing evidence that the committed individual remains a sexually dangerous individual.

25-03.3-18.1. Annual review — Petition for discharge — Inapplicability during periods of imprisonment.

Sections 25-03.3-17 and 25-03.3-18 do not apply if a respondent, during a period of commitment under this chapter, is transferred to the custody of the department of corrections and rehabilitation in accordance with section 29-27-07 or is serving a term of imprisonment in a county jail or regional corrections center. Upon release from imprisonment, the respondent must be retransferred to the care, custody, and control of the executive director. Upon retransfer, the respondent is entitled to a review to determine whether continued commitment under this chapter is warranted.

25-03.3-19. Appeal.

The respondent has the right to an appeal from an order of commitment or an order denying a petition for discharge. Upon entry of an appealable order, the court shall notify the respondent of the right to appeal and the right to counsel. The notice of appeal must be filed within thirty days after entry of the order. The appeal must be limited to a review of the procedures, findings, and conclusions of the committing court. Pending a decision on appeal, the order appealed from remains in effect. If the respondent is an individual with an intellectual disability, the court shall provide notice of the right to appeal to the respondent’s attorney, the respondent’s guardian, and guardian ad litem.

25-03.3-20. Limitation of liability.

A person acting in good faith upon either actual knowledge or reliable information, who provides information to the state’s attorney or the court pursuant to this chapter, is not subject to civil or criminal liability.

25-03.3-21. Recovery of expense. [Effective through August 31, 2022]

The department of human services, to the extent it has expended sums or provided services pursuant to this title, may seek civil recovery from the property of the respondent or committed individual. The department of human services must commence the action within six years after the department paid the sums or provided the services to the respondent or committed individual. After notice and hearing, the court may order an individual to reimburse the department of human services for all or part of the expenditures made for that individual pursuant to this chapter. In establishing the amount of reimbursement ordered under this section, the court shall consider the ability of the respondent or committed individual to pay.

25-03.3-21. Recovery of expense. [Effective September 1, 2022]

The department of health and human services, to the extent it has expended sums or provided services pursuant to this title, may seek civil recovery from the property of the respondent or committed individual. The department of health and human services must commence the action within six years after the department paid the sums or provided the services to the respondent or committed individual. After notice and hearing, the court may order an individual to reimburse the department of health and human services for all or part of the expenditures made for that individual pursuant to this chapter. In establishing the amount of reimbursement ordered under this section, the court shall consider the ability of the respondent or committed individual to pay.

25-03.3-22. Rules. [Effective through August 31, 2022]

The department of human services may adopt rules under chapter 28-32 to implement this chapter, but the rules may not restrict or limit the rights guaranteed by this chapter.

25-03.3-22. Rules. [Effective September 1, 2022]

The department of health and human services may adopt rules under chapter 28-32 to implement this chapter, but the rules may not restrict or limit the rights guaranteed by this chapter.

25-03.3-23. Individual rights.

For so long as a committed individual is placed in and resides at a treatment facility, the committed individual has the same rights as other residents of the facility, subject to the following limitations and restrictions:

1. The individual’s rights are subordinate to legitimate safety precautions and to the terms of the applicable individualized habilitation or treatment plan.
2. If an individual’s rights are inconsistent with this chapter in a particular situation, the specific provisions of this chapter prevail.

25-03.3-24. Postcommitment community placement — Penalty.

1. Following commitment of a sexually dangerous individual, the executive director may conduct a risk management assessment of the committed individual for the purpose of determining whether the individual may be treated safely in the community on an outpatient basis. The executive director may place a committed individual in the community for treatment on an outpatient basis only pursuant to a court order. The executive director may petition the court at any time for community placement. The executive director shall give the state’s attorney of the county of community placement notice of any petition for community placement the executive director files with the court. Before the petition is granted, the state’s attorney has the right to be heard by the court. The state’s attorney may waive this right. At any hearing held pursuant to a petition by the executive director for the community placement of a committed individual, the burden of proof required of the executive director is a preponderance of the evidence. The court’s order of community placement must contain appropriate restrictions and requirements for the committed individual, including:
   1. Participation and compliance with a specific course of treatment;
   2. Submission to electronic monitoring and any other appropriate supervision;
   3. Prohibition of the individual changing place of residency or leaving the state without prior authorization of the court;
   4. Establishment of safety zones, and compliance by the committed individual with those safety zones;
   5. Requirement that the committed individual notify the court within twenty-four hours of any change in the individual’s status that affects proper treatment or supervision;
   6. Contact with victims is prohibited independent of a supervised treatment plan; and
   7. Any other restriction or requirement deemed necessary by the court to assure public safety and proper treatment of the committed individual.
2. Violation by a committed individual of a court order issued pursuant to this section is a class C felony.

25-04-00.1. Definitions.

For the purposes of this chapter:

1. “Nonresident patient at the life skills and transition center” includes:
   1. Any patient at the life skills and transition center who is under eighteen years old and whose responsible relative is not a bona fide resident of this state.
   2. Any Indian patients for whom the United States government has, through its statutes and regulations, a responsibility for their care.
2. “Nonresident responsible relative” includes the patient’s nonresident spouse, father, or mother. It includes the bureau of Indian affairs in those cases involving Indian patients for whom the United States government has, through its statutes and regulations, a responsibility for their care.

25-04-01. Life skills and transition center — Name — Administration and control. [Effective through August 31, 2022]

A facility for individuals with developmental disabilities must be maintained at or near the city of Grafton in Walsh County. The facility must also be available for an individual who is determined to be an individual who may benefit from the facility’s services. The facility must be known and designated as the life skills and transition center. The department of human services has administrative authority and control of the life skills and transition center.

25-04-01. Life skills and transition center — Name — Administration and control. [Effective September 1, 2022]

A facility for individuals with developmental disabilities must be maintained at or near the city of Grafton in Walsh County. The facility must also be available for an individual who is determined to be an individual who may benefit from the facility’s services. The facility must be known and designated as the life skills and transition center. The department of health and human services has administrative authority and control of the life skills and transition center.

25-04-01.1. Life skills and transition center to be substituted for developmental center at westwood park, Grafton.

The legislative council shall delete, where appropriate, “developmental center at westwood park, Grafton”, “developmental center”, or any derivatives of those terms, which when used in context indicate an intention to refer to those terms, wherever they appear in the North Dakota Century Code, in supplements to the North Dakota Century Code, and in the North Dakota Administrative Code, and to insert in lieu of each deletion “life skills and transition center” or an appropriate derivative of that phrase. These changes are to be made when any volume or supplement of the North Dakota Century Code is being reprinted. Life skills and transition center is to be substituted for, shall take any action previously to be taken by, and shall perform any duties previously to be performed by the developmental center at westwood park, Grafton.

25-04-02. Purpose of life skills and transition center. [Effective through August 31, 2022]

1. The life skills and transition center must be maintained for the relief, instruction, care, and custody of individuals with developmental disabilities or other individuals who may benefit from the services offered at the center. For this purpose the department of human services may introduce and establish such trades and manual industries as in its judgment will best prepare the residents for future self-support.
2. The department may provide onsite and offsite additional services and effectuate its powers and duties to best serve individuals with developmental disabilities and other individuals who may benefit from those activities. The services provided and the duties effectuated need not be accredited by the accreditation council on services for people with developmental disabilities or certified by the health care financing administration, or any other similar accrediting or certifying organization, if the service or duty is not provided to individuals with developmental disabilities or if such accrediting or certifying organization does not accredit or certify the service or duty.

25-04-02. Purpose of life skills and transition center. [Effective September 1, 2022]

1. The life skills and transition center must be maintained for the relief, instruction, care, and custody of individuals with developmental disabilities or other individuals who may benefit from the services offered at the center. For this purpose the department of health and human services may introduce and establish such trades and manual industries as in its judgment will best prepare the residents for future self-support.
2. The department may provide onsite and offsite additional services and effectuate its powers and duties to best serve individuals with developmental disabilities and other individuals who may benefit from those activities. The services provided and the duties effectuated need not be accredited by the accreditation council on services for people with developmental disabilities or certified by the health care financing administration, or any other similar accrediting or certifying organization, if the service or duty is not provided to individuals with developmental disabilities or if such accrediting or certifying organization does not accredit or certify the service or duty.

25-04-02.1. Accreditation of life skills and transition center. [Effective through August 31, 2022]

The department of human services shall request appropriations and resources sufficient to ensure maintenance of the life skills and transition center’s accreditation by the accreditation council on services for people with developmental disabilities and certification by the health care financing administration and, if deemed necessary, by similar accrediting and certifying organizations and agencies possessing standards applicable to an individual with a developmental disability and disciplines needed to provide quality services to individuals served.

25-04-02.1. Accreditation of life skills and transition center. [Effective September 1, 2022]

The department of health and human services shall request appropriations and resources sufficient to ensure maintenance of the life skills and transition center’s accreditation by the accreditation council on services for people with developmental disabilities and certification by the health care financing administration and, if deemed necessary, by similar accrediting and certifying organizations and agencies possessing standards applicable to an individual with a developmental disability and disciplines needed to provide quality services to individuals served.

25-04-02.2. Institutional sale of services — Budget section approval.

Subject to approval of the legislative assembly or the budget section if the legislative assembly is not in session, the life skills and transition center may provide any service not otherwise authorized by law under contract with a governmental or nongovernmental person. The life skills and transition center shall determine the rates for services provided. The legislative assembly or the budget section may approve the provision of a service under this section only after determining the service is not otherwise being provided by either the private or public sector. Any request considered by the budget section must comply with section 54-35-02.9.

25-04-03. Qualifications of superintendent.

The superintendent of the life skills and transition center must be a skilled administrator with professional training and experience relating to the needs of individuals with developmental disabilities. All employees must be appointed and removed by the superintendent or by the superintendent’s designee. The salaries of all employees shall be fixed by the superintendent or the superintendent’s designee within the limits of the legislative appropriations made for such purpose.

25-04-03.1. Biennial report — Assistant superintendent. [Repealed]

Repealed by S.L. 1989, ch. 338, § 6.

25-04-04. Who may receive benefits of life skills and transition center. [Effective through August 31, 2022]

Subject to this chapter and to any rules adopted by the department of human services, the benefits of the life skills and transition center may be received by:

1. Individuals with developmental disabilities and other individuals who may benefit from services provided at the life skills and transition center who, in the opinion of the superintendent of the life skills and transition center are of suitable age and capacity to receive instruction in the center and whose deficiencies prevent them from receiving proper training and instruction in the public schools;
2. Individuals with developmental disabilities and other individuals who may benefit from services provided at the life skills and transition center who cannot be properly cared for in their homes or other available facilities; or
3. Individuals with developmental disabilities and other individuals who may benefit from onsite and offsite services provided or duties effectuated by the life skills and transition center.

Residents and nonresidents of this state may receive the benefits of the life skills and transition center. Priority, however, must be given to residents of this state and first priority must be given to individuals with developmental disabilities.

25-04-04. Who may receive benefits of life skills and transition center. [Effective September 1, 2022]

Subject to this chapter and to any rules adopted by the department of health and human services, the benefits of the life skills and transition center may be received by:

1. Individuals with developmental disabilities and other individuals who may benefit from services provided at the life skills and transition center who, in the opinion of the superintendent of the life skills and transition center are of suitable age and capacity to receive instruction in the center and whose deficiencies prevent them from receiving proper training and instruction in the public schools;
2. Individuals with developmental disabilities and other individuals who may benefit from services provided at the life skills and transition center who cannot be properly cared for in their homes or other available facilities; or
3. Individuals with developmental disabilities and other individuals who may benefit from onsite and offsite services provided or duties effectuated by the life skills and transition center.

Residents and nonresidents of this state may receive the benefits of the life skills and transition center. Priority, however, must be given to residents of this state and first priority must be given to individuals with developmental disabilities.

25-04-04.1. Program management for a resident.

The department shall ensure active program management is maintained for eligible individuals residing at the life skills and transition center.

25-04-05. Qualifications for admission to state facility — Screening required prior to admission or readmission — Educational or related services without charge for persons twenty-one years of age and under. [Effective through August 31, 2022]

1. The superintendent may admit a person to the life skills and transition center when all of the following conditions have been met:
   1. Application for admission has been made on behalf of the person by a parent or guardian or the person or agency having legal custody, or by the person seeking admission, in accordance with procedures established by the department of human services.
   2. A comprehensive evaluation of the person has been made within three months of the date of application, a report of which has been filed with the superintendent and which, together with such other information or reviews as the department of human services may require, indicates to the superintendent’s satisfaction that the person is eligible for admission to the life skills and transition center.
   3. The person may be admitted without exceeding the resident capacity of the facility as specified in the professional standards adopted by the department of human services.
2. No person may be admitted or readmitted to the life skills and transition center unless that person has undergone a screening process at the life skills and transition center to determine whether the admission or readmission is appropriate. Length of stay criteria may be established under rules as the department of human services may adopt. Any person who is suspected of being able to benefit from the services offered at the center may be screened to ascertain whether or not that person is actually a proper case for care, treatment, and training at the life skills and transition center. If in the opinion of the superintendent the person screened under this subsection is a proper subject for institutional care, treatment, and training at the life skills and transition center, that person may remain as a voluntary resident at the center at the discretion of the superintendent if all other conditions for admission required by this section are met.
3. Notwithstanding any other provision of this chapter, no handicapped patient, twenty-one years of age or under, or the estate or the parent of such patient, may be charged for educational or related services provided at the life skills and transition center. Except as provided in subsection 4, the department of human services has prior claim on all benefits accruing to such patients for medical and medically related services under entitlement from the federal government, medical or hospital insurance contracts, workforce safety and insurance, or medical care and disability programs. For purposes of this subsection, “related services” means transportation and such developmental, corrective, and other supportive services, as determined by the department of public instruction, as are required to assist a handicapped patient to benefit from special education. The cost of related services other than medical and medically related services must be paid by the life skills and transition center, the school district of residence of the handicapped child, and other appropriate state agencies and political subdivisions of this state. The department of public instruction, the department of human services, the school district of residence, and other appropriate state agencies and political subdivisions, as determined by the department of public instruction, shall determine and agree to that portion of related services, other than medical and medically related services, for which each agency and political subdivision is liable. The department of public instruction may adopt rules necessary to implement this section.
4. Parents of an individual with a developmental disability, who is twenty-one years of age or under, are not required to file, assist in filing, agree to filing, or assign an insurance claim when filing the claim would pose a realistic threat that the parents would suffer a financial loss not incurred by similarly situated parents of children with disabilities. Financial losses do not include incidental costs such as the time needed to file or assist in filing an insurance claim or the postage needed to mail the claim. Financial losses include:
   1. A decrease in available lifetime coverage or any other benefit under an insurance policy.
   2. An increase in premiums or the discontinuation of a policy.
   3. An out-of-pocket expense such as the payment of a deductible amount incurred in filing a claim unless the life skills and transition center pays or waives the out-of-pocket expense.

25-04-05. Qualifications for admission to state facility — Screening required prior to admission or readmission — Educational or related services without charge for persons twenty-one years of age and under. [Effective September 1, 2022]

1. The superintendent may admit a person to the life skills and transition center when all of the following conditions have been met:
   1. Application for admission has been made on behalf of the person by a parent or guardian or the person or agency having legal custody, or by the person seeking admission, in accordance with procedures established by the department of health and human services.
   2. A comprehensive evaluation of the person has been made within three months of the date of application, a report of which has been filed with the superintendent and which, together with such other information or reviews as the department of health and human services may require, indicates to the superintendent’s satisfaction that the person is eligible for admission to the life skills and transition center.
   3. The person may be admitted without exceeding the resident capacity of the facility as specified in the professional standards adopted by the department of health and human services.
2. No person may be admitted or readmitted to the life skills and transition center unless that person has undergone a screening process at the life skills and transition center to determine whether the admission or readmission is appropriate. Length of stay criteria may be established under rules as the department of health and human services may adopt. Any person who is suspected of being able to benefit from the services offered at the center may be screened to ascertain whether or not that person is actually a proper case for care, treatment, and training at the life skills and transition center. If in the opinion of the superintendent the person screened under this subsection is a proper subject for institutional care, treatment, and training at the life skills and transition center, that person may remain as a voluntary resident at the center at the discretion of the superintendent if all other conditions for admission required by this section are met.
3. Notwithstanding any other provision of this chapter, no handicapped patient, twenty-one years of age or under, or the estate or the parent of such patient, may be charged for educational or related services provided at the life skills and transition center. Except as provided in subsection 4, the department of health and human services has prior claim on all benefits accruing to such patients for medical and medically related services under entitlement from the federal government, medical or hospital insurance contracts, workforce safety and insurance, or medical care and disability programs. For purposes of this subsection, “related services” means transportation and such developmental, corrective, and other supportive services, as determined by the department of public instruction, as are required to assist a handicapped patient to benefit from special education. The cost of related services other than medical and medically related services must be paid by the life skills and transition center, the school district of residence of the handicapped child, and other appropriate state agencies and political subdivisions of this state. The department of public instruction, the department of health and human services, the school district of residence, and other appropriate state agencies and political subdivisions, as determined by the department of public instruction, shall determine and agree to that portion of related services, other than medical and medically related services, for which each agency and political subdivision is liable. The department of public instruction may adopt rules necessary to implement this section.
4. Parents of an individual with a developmental disability, who is twenty-one years of age or under, are not required to file, assist in filing, agree to filing, or assign an insurance claim when filing the claim would pose a realistic threat that the parents would suffer a financial loss not incurred by similarly situated parents of children with disabilities. Financial losses do not include incidental costs such as the time needed to file or assist in filing an insurance claim or the postage needed to mail the claim. Financial losses include:
   1. A decrease in available lifetime coverage or any other benefit under an insurance policy.
   2. An increase in premiums or the discontinuation of a policy.
   3. An out-of-pocket expense such as the payment of a deductible amount incurred in filing a claim unless the life skills and transition center pays or waives the out-of-pocket expense.

25-04-05.1. Transfer of residents — Visiting privileges — Release and placement of patients. [Effective through August 31, 2022]

1. The superintendent shall have the right of temporary transfer of any resident of the life skills and transition center to an appropriate hospital or other specialized facility when in the superintendent’s opinion the immediate health and safety of the resident requires the transfer. The superintendent shall also have the right and responsibility of indefinite transfer of a resident from one state facility for individuals with developmental disabilities to another when the best interest of the resident will be served thereby, or when the transfer is required in conformity with the policies of the department of human services; provided, however, that no transfer may be effected until all reasonable efforts have been made to consult with the resident’s parent or guardian of the person.
2. Subject to reasonable rules for the orderly operation of the life skills and transition center or other state facility for individuals with developmental disabilities, any parent or guardian of the person of a resident shall have the right of visiting and communicating with a child or ward and authorizing visits and communications with others.
3. The superintendent may authorize the temporary release of any resident to the custody of the resident’s parent or guardian of the person, or to another person designated by the parent or such guardian. In the absence of such authorization, any parent or guardian of the person of any resident may formally request, in writing, the resident’s temporary release. The release must be granted at the earliest reasonable opportunity, but not more than thirty days after receipt of a written application. If a release is, or would be, effected contrary to the advice of the superintendent based on a recent comprehensive evaluation of the individual, the superintendent shall so advise the parent or such guardian in writing.
4. The superintendent may arrange for the suitable placement of a resident outside the life skills and transition center or other state facility and to release the resident on placement, provided placement has been preceded by a comprehensive evaluation. No such placement may be effected until all reasonable efforts have been made to consult with the resident’s parent or guardian of the person.

25-04-05.1. Transfer of residents — Visiting privileges — Release and placement of patients. [Effective September 1, 2022]

1. The superintendent shall have the right of temporary transfer of any resident of the life skills and transition center to an appropriate hospital or other specialized facility when in the superintendent’s opinion the immediate health and safety of the resident requires the transfer. The superintendent shall also have the right and responsibility of indefinite transfer of a resident from one state facility for individuals with developmental disabilities to another when the best interest of the resident will be served thereby, or when the transfer is required in conformity with the policies of the department of health and human services; provided, however, that no transfer may be effected until all reasonable efforts have been made to consult with the resident’s parent or guardian of the person.
2. Subject to reasonable rules for the orderly operation of the life skills and transition center or other state facility for individuals with developmental disabilities, any parent or guardian of the person of a resident shall have the right of visiting and communicating with a child or ward and authorizing visits and communications with others.
3. The superintendent may authorize the temporary release of any resident to the custody of the resident’s parent or guardian of the person, or to another person designated by the parent or such guardian. In the absence of such authorization, any parent or guardian of the person of any resident may formally request, in writing, the resident’s temporary release. The release must be granted at the earliest reasonable opportunity, but not more than thirty days after receipt of a written application. If a release is, or would be, effected contrary to the advice of the superintendent based on a recent comprehensive evaluation of the individual, the superintendent shall so advise the parent or such guardian in writing.
4. The superintendent may arrange for the suitable placement of a resident outside the life skills and transition center or other state facility and to release the resident on placement, provided placement has been preceded by a comprehensive evaluation. No such placement may be effected until all reasonable efforts have been made to consult with the resident’s parent or guardian of the person.

25-04-05.2. San haven — Transportation costs — Payment limited. [Repealed]

Repealed by S.L. 1989, ch. 338, § 6.

25-04-06. Juvenile court commitment of dependent, neglected, or delinquent mentally deficient — Commitment for observation — Appeal.

In any proceeding instituted in juvenile court, the court may make an order committing the child to the life skills and transition center whenever it appears to the satisfaction of the court that the child involved in the proceeding is:

1. Dependent and a candidate for services at the life skills and transition center;
2. Neglected and a candidate for services at the life skills and transition center; or
3. Delinquent and a candidate for services at the life skills and transition center.

If the court is in doubt as to whether the child is a candidate for services offered at the life skills and transition center, the court may make an order committing the child to the life skills and transition center for observation only by the authorities of such institution. If it is ascertained as a result of such observation that the child is a candidate for services offered at the life skills and transition center, a report to such effect must be made by the authorities of the life skills and transition center to the court. The court thereupon shall make an order fixing a time for a hearing upon the report showing the child to be in need of these services. Notice of the hearing must be given to the parents, custodian, or guardian of such child in the manner prescribed by law for the giving of notice in other proceedings in juvenile court. Upon such hearing, the court shall make such order as it may deem proper. Any parent, custodian, guardian, or other person charged with the control of such child may take an appeal from the order made by the court in the manner now prescribed by law for the taking of appeals from decisions of the juvenile court. The procedure provided in this section is not exclusive but is in addition to other procedures provided in this chapter for the commitment of children to the life skills and transition center.

25-04-07. Disabled defendants. [Repealed]

Repealed by S.L. 1991, ch. 121, § 5.

25-04-08. Discharge of resident from institution. [Effective through August 31, 2022]

A person who has been admitted as a resident must be permanently discharged within thirty days under any one of the following conditions:

1. The superintendent, on the basis of a comprehensive evaluation, finds that the care, treatment, training, rehabilitation, and supervision offered by the state are no longer required.
2. The parent or guardian who voluntarily committed the parent’s child or the guardian’s ward as a resident and who retains legal custody makes a written request for discharge.
3. The person is admitted on indefinite transfer to a hospital, school, or other facility, or a protective service under the jurisdiction of another state, or another agency or department of this state; provided, however, that if such admission be by contractual arrangement made by the department of human services, the person must be placed on nonresident release status, but not discharged.
4. A court of competent jurisdiction orders the discharge of the person.

Any person who is to be discharged under subsection 2 or 4 shall first receive a comprehensive evaluation unless such evaluation is not completed within thirty days of the request for discharge.

25-04-08. Discharge of resident from institution. [Effective September 1, 2022]

A person who has been admitted as a resident must be permanently discharged within thirty days under any one of the following conditions:

1. The superintendent, on the basis of a comprehensive evaluation, finds that the care, treatment, training, rehabilitation, and supervision offered by the state are no longer required.
2. The parent or guardian who voluntarily committed the parent’s child or the guardian’s ward as a resident and who retains legal custody makes a written request for discharge.
3. The person is admitted on indefinite transfer to a hospital, school, or other facility, or a protective service under the jurisdiction of another state, or another agency or department of this state; provided, however, that if such admission be by contractual arrangement made by the department of health and human services, the person must be placed on nonresident release status, but not discharged.
4. A court of competent jurisdiction orders the discharge of the person.

Any person who is to be discharged under subsection 2 or 4 shall first receive a comprehensive evaluation unless such evaluation is not completed within thirty days of the request for discharge.

25-04-08.1. Notification before discharge. [Effective through August 31, 2022]

Before discharge the superintendent shall consult with the parent or guardian of the person to be discharged, or with the court that ordered the commitment, and shall notify the director of the county social service board or human service zone of the county in which it is proposed that such person will assume residence and also shall notify the executive director of the department of human services.

25-04-08.1. Notification before discharge. [Effective September 1, 2022]

Before discharge the superintendent shall consult with the parent or guardian of the person to be discharged, or with the court that ordered the commitment, and shall notify the director of the county social service board or human service zone of the county in which it is proposed that such person will assume residence and also shall notify the executive director of the department of health and human services.

25-04-09. Expense for care of inmates to be charge upon county — County to remit to state treasurer. [Repealed]

Repealed by S.L. 1961, ch. 211, § 9.

25-04-10. Transfer of inmate of state school when person legally responsible for support moves to another state. [Repealed]

Repealed by S.L. 1961, ch. 211, § 9.

25-04-11. Disposition of person who is not a legal resident. [Effective through August 31, 2022]

If a person who has no legal residence in this state is subject to admission to the life skills and transition center or other appropriate state facility, by order of a court of competent jurisdiction, such person must be sent, at the expense of the county or human service zone, to the life skills and transition center in the same manner as a resident of this state who is found to be in need of services offered at the life skills and transition center, and the superintendent of the life skills and transition center shall then arrange for the transportation of such person to the place where the person belongs. The department of human services shall ascertain the place where such person belongs when the same conveniently can be done.

25-04-11. Disposition of person who is not a legal resident. [Effective September 1, 2022]

If a person who has no legal residence in this state is subject to admission to the life skills and transition center or other appropriate state facility, by order of a court of competent jurisdiction, such person must be sent, at the expense of the county or human service zone, to the life skills and transition center in the same manner as a resident of this state who is found to be in need of services offered at the life skills and transition center, and the superintendent of the life skills and transition center shall then arrange for the transportation of such person to the place where the person belongs. The department of health and human services shall ascertain the place where such person belongs when the same conveniently can be done.

25-04-11.1. Disposition of nonresidents — Exceptions — Reciprocal agreements.

If a person who has no legal residence in this state or whose residence is unknown is found to be a person requiring care and treatment in the life skills and transition center, the person must be sent to the life skills and transition center in the same manner, and accompanied by the same documents, as in the case of a resident of this state. The supervising department shall immediately inquire as to the residence of the person or the person’s responsible relatives, and, if the residence is found to be in another state or country, the supervising department shall arrange for transportation of the person to the place of legal residence or legal settlement unless the person can be accommodated at the life skills and transition center without depriving a North Dakota resident of care and treatment at the life skills and transition center and adequate costs of care are paid for within a reasonable time, or unless a reciprocal agreement has been entered into with another state regarding the care and commitment of the nonresident. The supervising department may enter into reciprocal agreements with other states regarding the mutual exchange, return, and transportation of persons who are within one state but have legal residence or legal settlement in another state. The agreements may not contain any provision conflicting with any law of this state.

25-04-11.2. Liability for care and treatment of nonresident patients.

Nonresident patients at the life skills and transition center and nonresident responsible relatives of patients are liable for the chargeable costs of care and treatment at the life skills and transition center.

25-04-12. Electric power may be furnished to city of Dunseith from state school power plant. [Repealed]

Repealed by S.L. 1961, ch. 209, § 5.

25-04-13. Guardianship of person and estate — Superintendent and director of institutions to act as guardians in lieu of court appointment or assumption by parent. [Repealed]

Repealed by S.L. 1973, ch. 257, § 82.

25-04-13.1. Guardianship — Superintendent to act as guardian. [Repealed]

Repealed by S.L. 1987, ch. 326, § 2.

25-04-14. Expenses chargeable against patient or patient’s estate — Filing claims. [Effective through August 31, 2022]

Expenses for care and treatment of each patient at the life skills and transition center must, if practicable, be in accordance with the cost of providing care and treatment for the different degrees or conditions of mental and physical health and charges may be adjusted in accordance with the patient’s ability to pay which must include an estimate of potential future receipts, including amounts from estates. The supervising department shall recover from the patient or from a discharged patient expenses chargeable for care and treatment. If any patient is receiving social security benefits or is a veteran or a dependent of a veteran who has received, is receiving, or is entitled to receive compensation or pension from the veterans’ administration, the expenses are a current claim against the patient and may be recovered monthly by the supervising department except that any amount required by the payer of the benefits to be paid directly to the patient must, upon approval of the department of human services, be credited to the patient’s personal account from any money thus received.

25-04-14. Expenses chargeable against patient or patient’s estate — Filing claims. [Effective September 1, 2022]

Expenses for care and treatment of each patient at the life skills and transition center must, if practicable, be in accordance with the cost of providing care and treatment for the different degrees or conditions of mental and physical health and charges may be adjusted in accordance with the patient’s ability to pay which must include an estimate of potential future receipts, including amounts from estates. The supervising department shall recover from the patient or from a discharged patient expenses chargeable for care and treatment. If any patient is receiving social security benefits or is a veteran or a dependent of a veteran who has received, is receiving, or is entitled to receive compensation or pension from the veterans’ administration, the expenses are a current claim against the patient and may be recovered monthly by the supervising department except that any amount required by the payer of the benefits to be paid directly to the patient must, upon approval of the department of health and human services, be credited to the patient’s personal account from any money thus received.

25-04-15. Expenses chargeable against guardianship estate of patient — Restrictions. [Effective through August 31, 2022]

The expenses chargeable by the state for the care and treatment of any patient over twenty-one years of age at the life skills and transition center must be charged against the guardianship estate of such patient, if the patient has such an estate, subject to the following restrictions:

1. No part of the estate may be taken for such purpose if the patient has dependents within the United States dependent upon the estate for support and the taking of all or a portion of the estate would result in undue hardship to those dependents.
2. No real property belonging to the estate may be sold during the lifetime of the patient except for the maintenance and support of the patient’s dependents, unless it is shown that the sale of the property will not result in undue hardship to those dependents, and it may be sold only upon the order of the district court having jurisdiction of the estate, with the consent of the department of human services.
3. No personal property belonging to the estate may be sold within five years from the date upon which the patient was sent to the life skills and transition center unless the property is ordered sold by the district court having jurisdiction of the estate for the reason that the property is likely to deteriorate in value during the time herein specified.
4. No claim may be made to recover from the estate of a former resident of the life skills and transition center who has left the life skills and transition center and married and leaves a spouse or issue dependent upon such estate.

25-04-15. Expenses chargeable against guardianship estate of patient — Restrictions. [Effective September 1, 2022]

The expenses chargeable by the state for the care and treatment of any patient over twenty-one years of age at the life skills and transition center must be charged against the guardianship estate of such patient, if the patient has such an estate, subject to the following restrictions:

1. No part of the estate may be taken for such purpose if the patient has dependents within the United States dependent upon the estate for support and the taking of all or a portion of the estate would result in undue hardship to those dependents.
2. No real property belonging to the estate may be sold during the lifetime of the patient except for the maintenance and support of the patient’s dependents, unless it is shown that the sale of the property will not result in undue hardship to those dependents, and it may be sold only upon the order of the district court having jurisdiction of the estate, with the consent of the department of health and human services.
3. No personal property belonging to the estate may be sold within five years from the date upon which the patient was sent to the life skills and transition center unless the property is ordered sold by the district court having jurisdiction of the estate for the reason that the property is likely to deteriorate in value during the time herein specified.
4. No claim may be made to recover from the estate of a former resident of the life skills and transition center who has left the life skills and transition center and married and leaves a spouse or issue dependent upon such estate.

25-04-15.1. Statute of limitations not bar to recovery.

No statute of limitations or similar statute or the doctrine of laches may bar the recovery of costs of care furnished under this chapter. It is not necessary to bill currently any person for those accounts determined to be inactive, currently uncollectible, or for which it has been determined as provided by law that there is no present ability to pay. Current billings may be made for amounts chargeable by law or for which it has been determined the responsible party presently has an ability to pay, but the manner of billing may not affect the total amount due. This section applies to claims for the cost of care furnished on or after July 1, 1961.

25-04-16. Waiver of payment — Use of income tax data — Confidentiality — Definition. [Effective through August 31, 2022]

1. Except with respect to services provided and duties effectuated for persons other than residents of the life skills and transition center who are developmentally disabled, and except with respect to services provided and duties effectuated under subsection 2 of section 25-04-02, the resident, former resident, parent of a resident or former resident under age eighteen, personal representative, or guardian may make application to the supervising department to pay less than the costs or none of the costs incurred by the state for the resident’s care and treatment at the life skills and transition center. An application from a resident, former resident, personal representative, or guardian must be accompanied by proof of the resident’s or the estate of the resident’s inability to pay. An application from a parent of a resident or former resident must be accompanied by proof that the parent has applied for or cooperated fully in an application for medical and medically related services under entitlement from the federal government, medical or hospital insurance contracts, workforce safety and insurance, or medical care and disability programs for provision of services to the resident, and has assured the contribution of those services, compensation, and contract and program benefits to meet the cost of care provided to the resident by the life skills and transition center. A waiver must be granted upon receipt of an application from such a parent, which is complete and supported by the required proofs and is effective for so long as the parent continues to apply for or cooperate fully in applications for services, compensation, and contract and program benefits, and continues to assure the contribution of those services, compensation, and benefits to meet the costs of care. A waiver, once granted with respect to a resident under age eighteen, extinguishes any debt that would otherwise be owed by the resident, the resident’s parents, or the resident’s estate with respect to care and treatment furnished during times the waiver is effective.
2. Upon receipt of such application, the supervising department shall direct the human service zone of the county from which the patient was admitted to determine whether the application is complete and supported by the required proofs. The supervising department shall approve, reject, or amend the determination made by the human service zone. The determination made by the supervising department may be appealed to the district court of the county of residence of the patient.
3. Any patient, former patient, parent of a patient or former patient, guardian, or personal representative who seeks relief from the payment of the cost of care and treatment by filing an application for relief of payment shall do so with the understanding that the supervising department may, in its discretion, and to its satisfaction, verify any statement made in such application for relief of payment by a request for information from financial institutions, including commercial banks, and from other sources likely to possess verifying information. Notwithstanding the provisions of section 57-38-57, this verification may include a review of such applicant’s state income tax return or any other document or report submitted to or held by any office or department of the state of North Dakota or any of its political subdivisions.
4. When any official or employee of the life skills and transition center who, pursuant to subsection 1, obtains income tax information or other tax information from the state tax commissioner the confidentiality of which is protected by law, such official or employee may not divulge such information except to the extent necessary for the administration of this chapter or when otherwise directed by judicial order or when otherwise provided by law.
5. As used in this chapter, “supervising department” means the department of human services.

25-04-16. Waiver of payment — Use of income tax data — Confidentiality — Definition. [Effective September 1, 2022]

1. Except with respect to services provided and duties effectuated for persons other than residents of the life skills and transition center who are developmentally disabled, and except with respect to services provided and duties effectuated under subsection 2 of section 25-04-02, the resident, former resident, parent of a resident or former resident under age eighteen, personal representative, or guardian may make application to the supervising department to pay less than the costs or none of the costs incurred by the state for the resident’s care and treatment at the life skills and transition center. An application from a resident, former resident, personal representative, or guardian must be accompanied by proof of the resident’s or the estate of the resident’s inability to pay. An application from a parent of a resident or former resident must be accompanied by proof that the parent has applied for or cooperated fully in an application for medical and medically related services under entitlement from the federal government, medical or hospital insurance contracts, workforce safety and insurance, or medical care and disability programs for provision of services to the resident, and has assured the contribution of those services, compensation, and contract and program benefits to meet the cost of care provided to the resident by the life skills and transition center. A waiver must be granted upon receipt of an application from such a parent, which is complete and supported by the required proofs and is effective for so long as the parent continues to apply for or cooperate fully in applications for services, compensation, and contract and program benefits, and continues to assure the contribution of those services, compensation, and benefits to meet the costs of care. A waiver, once granted with respect to a resident under age eighteen, extinguishes any debt that would otherwise be owed by the resident, the resident’s parents, or the resident’s estate with respect to care and treatment furnished during times the waiver is effective.
2. Upon receipt of such application, the supervising department shall direct the human service zone of the county from which the patient was admitted to determine whether the application is complete and supported by the required proofs. The supervising department shall approve, reject, or amend the determination made by the human service zone. The determination made by the supervising department may be appealed to the district court of the county of residence of the patient.
3. Any patient, former patient, parent of a patient or former patient, guardian, or personal representative who seeks relief from the payment of the cost of care and treatment by filing an application for relief of payment shall do so with the understanding that the supervising department may, in its discretion, and to its satisfaction, verify any statement made in such application for relief of payment by a request for information from financial institutions, including commercial banks, and from other sources likely to possess verifying information. Notwithstanding the provisions of section 57-38-57, this verification may include a review of such applicant’s state income tax return or any other document or report submitted to or held by any office or department of the state of North Dakota or any of its political subdivisions.
4. When any official or employee of the life skills and transition center who, pursuant to subsection 1, obtains income tax information or other tax information from the state tax commissioner the confidentiality of which is protected by law, such official or employee may not divulge such information except to the extent necessary for the administration of this chapter or when otherwise directed by judicial order or when otherwise provided by law.
5. As used in this chapter, “supervising department” means the department of health and human services.

25-04-17. Reduction or writeoff of accounts — Report to legislative audit and fiscal review committee.

The supervising department may authorize the reduction or writeoff of a patient’s past-due account from the life skills and transition center’s financial records upon determining that the account is not collectible. The supervising department, by September first after the close of each fiscal year, shall present a detailed report to the legislative audit and fiscal review committee on the status of accounts receivable for that fiscal year. The report must include:

1. An aging by patient classification of accounts remaining unpaid.
2. The amounts by patient classification by which accounts were reduced or written off for reasons other than payment during that fiscal year.

25-04-18. Limitations of this chapter.

The provisions of this chapter may not be construed to limit or broaden the plaintiff class as defined by order of the United States district court for the district of North Dakota entered on January 13, 1981, in civil number A1-80-141.

25-04-19. Quality assurance review committees — Reports — Immunity.

Any information, data, report, or record made available to an internal quality assurance review committee of the life skills and transition center is confidential and may be used by the committee and the members thereof only in the exercise of the proper functions of the committee. The proceedings and records of the committee are not subject to subpoena or discovery or introduction into evidence in any civil action arising out of any matter under consideration by the committee. Any information, document, or record otherwise available from original sources is not immune from discovery or use in any civil action merely because it was presented during the proceedings of the committee, nor may any person who testified before the committee or who is a member of it be prevented from testifying as to matters within that person’s knowledge, but a witness cannot be asked about that witness’s testimony before the committee. This section does not relieve any person of any liability incurred as a result of furnishing health care to the resident. No person furnishing information, data, reports, or records to the committee with respect to any resident of the life skills and transition center is, by reason of furnishing the information, data, reports, or records, liable in damages to any resident, or answerable for willful violation of a privileged or confidential communication. No member of the committee is liable in damages to any person for any action taken or recommendation made within the scope of the functions of the committee if the committee member acts without malice and in the reasonable belief that the action or recommendation is warranted by the facts known to the member.

25-04-20. Westwood park assets management committee. [Repealed]

Repealed by S.L. 1999, ch. 34, § 39.

25-06-01. North Dakota vision services — school for the blind — Maintained — Location.

There must be maintained at Grand Forks, in Grand Forks County, a statewide service, resource, and referral center for the education and training of all residents of this state who are blind or have a visual impairment and to serve as the national instructional materials access center authorized user for the purpose of facilitating access to and conversion of accessible instructional materials in alternate formats for use by blind individuals, individuals with visual impairment, and students with other print disabilities, which must be known as the North Dakota vision services — school for the blind.

25-06-01.1. Definitions.

For purposes of this chapter:

1. An individual who is blind means an individual who is totally blind or whose central visual acuity does not exceed twenty/two hundred in the better eye with corrective lenses, or the widest diameter of the visual field is no greater than twenty degrees;
2. An individual with a visual impairment means an individual with an impairment in vision which, even with correction, adversely affects the individual’s functional ability; and
3. A student with print disabilities means a student enrolled in elementary or secondary school who has an individualized education program, which includes documentation of either an inability to read or use standard printed material as a result of physical limitations or a reading disability resulting from an organic dysfunction that has been certified by competent authority to be of sufficient severity to prevent reading of printed material in a normal manner.

25-06-02. Duties and responsibilities of North Dakota vision services — school for the blind.

Within the limits of legislative appropriation, North Dakota vision services — school for the blind shall:

1. Provide vision-specific services that include consultations, evaluations, information, training, and educational services, including instruction in orientation, mobility, braille, braille music, daily living skills, technology, career and technical education training, and recreation.
2. Collect and distribute information on vision services and resources available in the state.
3. Coordinate loans of adaptive devices, equipment, and materials.
4. Maintain a database of residents who are blind or have a visual impairment.
5. Facilitate collaboration with agencies and programs providing services to individuals who are blind or have a visual impairment.
6. Assist residents to access appropriate services, including services available from the vocational rehabilitation division, independent living centers, infant development programs, developmental disabilities programs, the state library, local education programs, and advocacy programs.
7. Serve as the national instructional materials access center authorized user for the purpose of facilitating access to and conversion of accessible instructional materials in alternate formats for use by blind individuals, individuals with visual impairment, and students with other print disabilities.

25-06-02.1. North Dakota vision services — school for the blind — Appointment of superintendent, budget, staff, and reporting structure.

The superintendent of the North Dakota vision services — school for the blind is appointed by and reports to the superintendent of public instruction. The North Dakota vision services — school for the blind must have a separate budget and separate staff from the department of public instruction.

25-06-02.2. Superintendent — Special duties.

The superintendent of the North Dakota vision services — school for the blind may also be the superintendent of the school for the deaf.

25-06-03. Superintendent to possess certain qualifications.

The superintendent of the North Dakota vision services — school for the blind must possess those qualifications, educational and otherwise, as in the opinion of the superintendent of public instruction may qualify that person to instruct and minister to the needs of blind persons.

25-06-03.1. Criminal history record checks.

The school for the blind may require any employee, final applicant for employment, or any individual otherwise providing services to the school to submit to a statewide and nationwide criminal history record check. The nationwide criminal history record check must be conducted in the manner provided in section 12-60-24. The school for the blind may assess all costs associated with obtaining a criminal history record check to the individual upon whom the criminal history record check is conducted.

25-06-04. Qualifications for admission to school for the blind — Residents of state entitled to free education. [Repealed]

Repealed by S.L. 2001, ch. 257, § 5.

25-06-05. Services to nonresidents.

Individuals who are blind or have a visual impairment who are not residents of this state may receive services from North Dakota vision services — school for the blind if the individuals pay the cost of the services as determined by the superintendent of public instruction. Nonresidents may not receive services to the exclusion of residents of this state.

25-06-06. Transportation of indigent persons. [Repealed]

Repealed by S.L. 1979, ch. 336, § 3.

25-06-07. Instruction at school for the blind. [Repealed]

Repealed by S.L. 2001, ch. 257, § 5.

25-06-08. Accounts for clothing — How collected. [Repealed]

Repealed by S.L. 1997, ch. 244, § 4.

25-06-09. Blind persons — Duty to report. [Repealed]

Repealed by S.L. 2001, ch. 257, § 5.

25-06-10. Purchase and resale of vision-specific adaptive aids, devices, and appliances — Revolving fund — Continuing appropriation.

A revolving vision aids, devices, and appliances fund is hereby established in the state treasury to be used by the North Dakota vision services — school for the blind to purchase and resell vision-specific adaptive aids, devices, and appliances to be used by blind and visually impaired persons resident in this state. The North Dakota vision services — school for the blind may apply service charges when needed to cover the cost of purchasing, invoicing, and shipping, and all revenue from the sale of aids, appliances, devices, and shipping and postage fees must be deposited in the fund. The North Dakota vision services — school for the blind may receive gifts, grants, and donations for deposit in and use by the fund. All moneys in the revolving fund are hereby appropriated to the North Dakota vision services — school for the blind on a continuing basis for expenditure for the purposes of this section.

25-06-11. School for the blind fund.

The school for the blind fund is a special fund in the state treasury. All moneys received pursuant to section 2 of article IX of the Constitution of North Dakota, revenues received from services and leases, and contributions must be deposited in the fund. Moneys in the fund are to be used pursuant to legislative appropriation for the provision of services under this chapter.

25-07-01. School for the deaf — Maintained — Location — Purpose.

There must be maintained at Devils Lake, in Ramsey County, a school for the deaf, which may provide education and training and serve as a resource and referral center for individuals who are deaf or hearing impaired.

25-07-01.1. School for the deaf — Appointment of superintendent, budget, staff, and reporting structure.

The superintendent of the school for the deaf is appointed by and reports to the superintendent of public instruction. The school for the deaf must have a separate budget and separate staff from the department of public instruction.

25-07-02. Superintendent — Special duties.

The superintendent of the school for the deaf may also act as superintendent of the North Dakota vision services — school for the blind.

25-07-02.1. Criminal history record checks.

The school for the deaf may require any employee, final applicant for employment, or any individual otherwise providing services to the school to submit to a statewide and nationwide criminal history record check. The nationwide criminal history record check must be conducted in the manner provided in section 12-60-24. The school for the deaf may assess all costs associated with obtaining a criminal history record check to the individual upon whom the criminal history record check is conducted.

25-07-03. Matron — Duties. [Repealed]

Repealed by S.L. 1971, ch. 274, § 3.

25-07-04. Qualifications for admission to school for the deaf — Residents of state entitled to free education.

1. A child who is a resident of this state and who, because of deafness or a hearing impairment, is unable to receive an education in the public schools, is entitled to attend the school for the deaf at the expense of the state. A child is entitled to attend the school at any age up to twenty-one.
2. The school for the deaf shall provide application forms upon request. A child may not be admitted to the school until the child’s application is completed and approved.
3. The school for the deaf shall provide transportation to any child who has been admitted, in accordance with the child’s individual education plan.
4. Any child who is a resident of this state and who is deaf or hearing impaired is entitled to receive special education and related services in accordance with the child’s individual education program. Each individual education program must address the child’s academic, recreational, and leisure needs, as well as the acquisition of independent living skills and career and technical education opportunities.

25-07-05. Admission of nonresidents.

A child who is deaf or hearing-impaired but who is not a resident of this state may be admitted to the school for the deaf, provided the annual cost of the child’s education, as determined by the superintendent of public instruction, is paid on behalf of the child in advance of the child’s admission and on a yearly basis thereafter. The school may not admit a child who is not a resident of this state to the exclusion of a child who is a resident of this state.

25-07-06. Instruction at school for the deaf.

The superintendent of the school for the deaf shall provide special education and related services designed to meet the unique needs of each child who is deaf or hearing impaired, in accordance with the child’s individual education program.

25-07-07. Transportation of indigent children to and from school for deaf. [Repealed]

Repealed by S.L. 1979, ch. 336, § 3.

25-07-08. Clothing may be furnished when necessary — Accounts for clothing.

The school for the deaf shall provide clothing to a child who is enrolled in the school if the child does not have suitable clothing. If the child is a minor, the school shall charge the child’s parent or legal guardian for any clothing provided to the child under this section and shall charge the individual for any clothing provided to the individual under this section if the individual has reached the age of majority. If the superintendent certifies any charges under this section as being correct, the charges are presumed correct in all courts.

25-07-09. Collection of clothing account. [Repealed]

Repealed by S.L. 1999, ch. 106, § 18.

25-07-10. Deaf persons — Duty to report.

It is the duty of every public school superintendent, physician, otologist, audiologist, nurse, clinic, hospital, and social and welfare agency in this state to report in writing to the superintendent of the North Dakota school for the deaf the name, age, and residence of persons under the age of twenty-one years who are deaf or hard of hearing, and in such cases to furnish such additional pertinent information as the superintendent of the North Dakota school for the deaf may request. All reports must be forwarded to said superintendent of the school for the deaf within thirty days after diagnosis, examination, or discovery.

25-07-11. Home intervention program.

The school for the deaf may provide a home intervention program for children who are under the age of five and who are deaf or hearing impaired. The program must include information, counseling services, auditory training, and basic language development instruction for the parents of such children. This home intervention program must be carried out by college or university trained teachers of the deaf, speech pathologists, or audiologists.

25-07-12. Provision of services — Collaboration — Competition.

The school for the deaf may collaborate with public and private entities for the provision of services to individuals who are deaf or hearing impaired. The school for the deaf may not compete with any public or private entity offering the same services within a region.

25-07-13. School for the deaf fund.

The school for the deaf fund is a special fund in the state treasury. All moneys received pursuant to section 2 of article IX of the Constitution of North Dakota and all revenues received from the lease of buildings and the provision of meals and services, including interpreter services, must be deposited in the fund. Moneys in the fund are to be used pursuant to legislative appropriation for provision of services under this chapter.

25-10-01. Mental health services. [Repealed]

25-10-01.1. Unified mental health delivery system. [Repealed]

25-10-02. Psychiatric clinic. [Repealed]

Repealed by S.L. 1987, ch. 570, § 45.

25-10-03. Mental health coordinating committee — Membership — Purpose. [Repealed]

Repealed by S.L. 1971, ch. 276, § 1.

25-10-04. Transfer of institutions under the director of institutions. [Repealed]

Repealed by S.L. 1985, ch. 82, § 162.

25-10-05. Mental health and retardation service units. [Repealed]

Repealed by S.L. 1981, ch. 486, § 37.

25-11-01. Enactment of interstate compact on mental health.

The interstate compact on mental health is hereby enacted into law and entered into by this state with all other states legally joined therein in the form substantially as follows:

25-11-02. Compact administrator — Powers. [Effective through August 31, 2022]

Pursuant to said compact, the executive director of the department of human services must be the compact administrator and who, acting jointly with like officers of other party states, may adopt rules to carry out more effectively the terms of the compact. The compact administrator shall cooperate with all departments, agencies, and officers of and in the government of this state and its subdivisions in facilitating the proper administration of the compact or any supplementary agreement or agreements entered into by this state thereunder.

25-11-02. Compact administrator — Powers. [Effective September 1, 2022]

Pursuant to said compact, the executive director of the department of health and human services must be the compact administrator and who, acting jointly with like officers of other party states, may adopt rules to carry out more effectively the terms of the compact. The compact administrator shall cooperate with all departments, agencies, and officers of and in the government of this state and its subdivisions in facilitating the proper administration of the compact or any supplementary agreement or agreements entered into by this state thereunder.

25-11-03. Power to make supplementary agreements — Limitation.

The compact administrator is hereby authorized and empowered to enter into supplementary agreements with appropriate officials of other states pursuant to articles VII and XI of the compact. In the event that such supplementary agreements require or contemplate the use of any institution or facility of this state or require or contemplate the provision of any service by this state, no such agreement may have force or effect until approved by the head of the department or agency under whose jurisdiction said institution or facility is operated or whose department or agency will be charged with the rendering of such service.

25-11-04. Discharge of financial obligations.

The compact administrator, subject to the approval of the state treasurer, may make or arrange for any payments necessary to discharge any financial obligations imposed upon this state by the compact or by any supplementary agreement entered into thereunder.

25-11-05. Transfer of patients — Approval of court.

The compact administrator is hereby directed to consult with the immediate family of any proposed transferee and, in the case of a proposed transferee from an institution in this state to an institution in another party state, to take no final action without approval of the district court which committed the patient, or if such patient was not committed, then without approval of the district court serving Stutsman County.

25-11-06. Transmission of copies of chapter.

Duly authorized copies of this chapter must, upon its approval, be transmitted by the secretary of state to the governor of each state, the attorney general and the administrator of general services of the United States, and the council of state governments.

25-13-01. Legislative policy.

It is the policy of this state to encourage and enable the blind, the visually handicapped, and the otherwise physically disabled to participate fully in the social and economic life of the state and to engage in remunerative employment.

25-13-01.1. Definitions.

For purposes of this chapter “service animal” means any dog trained to do work, perform tasks, or provide assistance for the benefit of an individual with a disability. The term includes a dog trained to provide assistance to an individual with a disability, pull a wheelchair, lend balance support, retrieve dropped objects, or provide assistance in a medical crisis.

25-13-02. Individual with a disability — Service animal — Admission to public places.

An individual with a disability is entitled to be accompanied by a service animal in places of public accommodations, common carriers, facilities of a health care provider, and all places to which the public is generally invited, without being required to pay an extra charge for the animal; provided, that the individual is liable for any damage done to the premises or facility by the animal.

25-13-02.1. Trainer and a service animal in training — Admission to public places.

1. A trainer with a service animal in training may enter any place of public accommodation, common carrier, facility of a health care provider, and any place to which the public is generally invited, without being required to pay an extra charge for the service animal in training, provided:
   1. The trainer notifies an onsite manager that a service animal in training is being brought onto the premises;
   2. The trainer wears a photo identification card issued by a nationally recognized service animal training program; and
   3. The trainer is liable for any damage done to the premises or facility by the service animal in training.
2. Upon receiving notice as provided in subsection 1, the onsite manager may not deny admission to the trainer and the service animal in training without good cause.

25-13-02.2. Service animal — Misrepresentation — Penalty.

An individual is guilty of an infraction if the individual, in an attempt to gain admission to a public place under this chapter or obtain a reasonable housing accommodation under section 47-16-07.5, knowingly makes a false claim that a pet is a service animal.

25-13-03. Driver of motor vehicle — Precaution — Individual with service animal.

If the driver of a motor vehicle approaches an individual who is blind or visually impaired and who is carrying a cane predominately white or metallic in color, with or without a red tip, or who is accompanied by a service animal, the driver shall take all reasonable precautions to avoid injury to the individual and the service animal. Any driver who fails to take reasonable precautions is liable to the individual for any injury caused. An individual who is blind or visually impaired and not carrying a cane or an individual with a disability who is not accompanied by a service animal has all of the rights and privileges conferred by law upon other individuals. The failure of an individual who is blind or visually impaired to carry a cane or the failure of an individual with a disability to be accompanied by a service animal is not by itself evidence of fault.

25-13-04. Penalty for interfering or denying use of facilities.

Any person who denies or interferes with admittance to or enjoyment of the public places or facilities enumerated in section 25-13-02 or otherwise interferes with the rights of an individual who is blind or visually impaired, or with the rights of an individual who is accompanied by a service animal, is guilty of a class A misdemeanor. This section does not apply to a denial of admission under section 25-13-02.1.

25-13-05. State employment of individuals who are blind or otherwise disabled.

It is the policy of this state that individuals who are blind, visually impaired, or otherwise disabled shall be employed in the state service, the service of the political subdivisions of the state, the public schools, and all other employment supported in whole or in part by public funds on the same terms and conditions as individuals who are not disabled, unless the particular disability prevents the performance of the work involved.

25-13-06. Killing or injury of service animal — Penalty.

1. A person is guilty of a class C felony and is subject to a civil penalty of up to ten thousand dollars if that person willfully and unjustifiably kills, shoots, tortures, torments, beats, kicks, strikes, mutilates, disables, or otherwise injures a service animal.
2. A person is guilty of a class A misdemeanor and is subject to a civil penalty of up to five thousand dollars if that person willfully:
   1. Harasses, taunts, or provokes a service animal; or
   2. Interferes with a service animal while the animal is working.
3. This section does not apply to a veterinarian who terminates the life of a service animal to relieve the animal of undue suffering and pain.

25-14-01. Enactment of interstate compact on mentally disordered offenders.

The interstate compact on mentally disordered offenders, hereinafter called “the compact”, is hereby enacted and entered into with all other jurisdictions legally joining therein. The provisions of said compact are as follows:

25-14-02. State health officer shall administer compact. [Effective through August 31, 2022]

The state health officer is hereby authorized to negotiate and enter into contracts on behalf of the state pursuant to article III of the compact and may perform such contracts; provided that no funds, personnel, facilities, equipment, supplies, or materials shall be pledged, committed, or used on account of any such contract unless legally available therefor.

25-14-02. Department of health and human services shall administer compact. [Effective September 1, 2022]

The department of health and human services may negotiate and enter contracts on behalf of the state pursuant to article III of the compact and may perform such contracts; provided that no funds, personnel, facilities, equipment, supplies, or materials shall be pledged, committed, or used on account of any such contract unless legally available therefor.

25-16-01. Definitions. [Effective through August 31, 2022]

In this chapter unless the context or subject matter otherwise requires:

1. “Department” means the department of human services.
2. “Treatment or care center” means an entity providing services to individuals with developmental disabilities and licensed by the department to provide services.

25-16-01. Definitions. [Effective September 1, 2022]

In this chapter unless the context or subject matter otherwise requires:

1. “Department” means the department of health and human services.
2. “Treatment or care center” means an entity providing services to individuals with developmental disabilities and licensed by the department to provide services.

25-16-02. License required.

The operator of a treatment or care center for individuals with a developmental disability shall secure annually from the department a license as required by rules adopted under this chapter.

25-16-03. Requirements for license.

The department shall issue a license for the operation of a treatment or care center for individuals with a developmental disability upon a showing that:

1. The premises to be used are in fit, safe, sanitary condition and properly equipped to provide good care and treatment;
2. The persons in active charge of the center and their assistants are qualified by training and experience to carry on efficiently the duties required of them;
3. The health, safety, and well-being of the residents cared for and treated therein will be properly safeguarded;
4. There is sufficient entertainment, treatment, educational, and physical facilities and services available to the residents therein;
5. Appropriate arrangements are made for a medical and psychological examination of each resident; and
6. The provider is in compliance with rules adopted by the department under this chapter.

25-16-03.1. Conviction not bar to licensure — Exceptions.

Conviction of an offense does not disqualify a person from licensure under this chapter unless the division determines that the offense has a direct bearing upon a person’s ability to serve the public as an owner or operator of a treatment or care center for individuals with a developmental disability, or that, following conviction of any offense, the person is not sufficiently rehabilitated under section 12.1-33-02.1.

25-16-04. Inspection and report by department.

The department may inspect the facilities and premises of the applicant to determine the premises are fit, safe, and sanitary to provide quality care and treatment.

25-16-05. Content of license.

The license to operate a treatment or care center for individuals with a developmental disability issued under the provisions of this chapter must specify:

1. The name of the licensee.
2. The premises to which the license is applicable.
3. The number of residents who may be received in such premises at any one time.
4. The date of expiration of the license.

25-16-06. Department to prescribe forms — Rules.

The department may prescribe forms for the registration and record of the persons residing in treatment or care centers for individuals with a developmental disability and may adopt reasonable rules for the conduct of such centers as are necessary to carry out the purposes of this chapter.

25-16-07. Records of treatment or care center confidential. [Effective through August 31, 2022]

Except as otherwise authorized by law, an agent of the department of human services or the superintendent of the life skills and transition center or the licensee or their agents or employees may not disclose the contents of the individual records of a treatment or care center for individuals with a developmental disability, nor of the reports received from those records, except:

1. In a judicial proceeding when ordered by the presiding judge;
2. To a law enforcement official for a law enforcement purpose or any other legally constituted boards or agencies serving the interests of the residents for treatment, payment, or health care operations, to arrange, facilitate, or coordinate service to any such person;
3. To the parents or legal guardians of the resident;
4. To a physician to aid in the treatment of an individual within the fourth degree of consanguinity of a deceased resident, if the disclosure is limited to genetic health information that has a direct bearing on the health of the relative, the relative’s child, or the relative’s decision to have a child; or
5. To an individual who is within the fourth degree of consanguinity of a deceased resident, if the disclosure is limited to information about a resident needed to establish a family’s genealogy.

25-16-07. Records of treatment or care center confidential. [Effective September 1, 2022]

Except as otherwise authorized by law, an agent of the department or the superintendent of the life skills and transition center or the licensee or their agents or employees may not disclose the contents of the individual records of a treatment or care center for individuals with a developmental disability, nor of the reports received from those records, except:

1. In a judicial proceeding when ordered by the presiding judge;
2. To a law enforcement official for a law enforcement purpose or any other legally constituted boards or agencies serving the interests of the residents for treatment, payment, or health care operations, to arrange, facilitate, or coordinate service to any such person;
3. To the parents or legal guardians of the resident;
4. To a physician to aid in the treatment of an individual within the fourth degree of consanguinity of a deceased resident, if the disclosure is limited to genetic health information that has a direct bearing on the health of the relative, the relative’s child, or the relative’s decision to have a child; or
5. To an individual who is within the fourth degree of consanguinity of a deceased resident, if the disclosure is limited to information about a resident needed to establish a family’s genealogy.

25-16-08. Revocation of license.

The department may revoke a license of a treatment or care center for individuals with a developmental disability upon a proper showing that:

1. Any of the conditions set forth in section 25-16-03 as requirements for the issuance of the license no longer exists;
2. The license was issued upon fraudulent or untrue representations;
3. The owner or operator has violated any of the rules of the department; or
4. The owner or operator of the center has been guilty of an offense determined by the department to have a direct bearing upon a person’s ability to serve the public as an owner or operator, or the department determines, following conviction of an offense, that the person is not sufficiently rehabilitated under section 12.1-33-02.1.

25-16-09. Hearing on denial or revocation of license.

Before any application for a license to conduct a treatment or care center for individuals with a developmental disability is denied or before the revocation of such license by the department, written charges as to the reasons for the revocation or denial must be served upon the applicant or licensee, who has a right to a hearing before the department, if a hearing is requested within ten days after service of written charges.

25-16-10. Purchase of services. [Repealed]

Repealed by S.L. 2003, ch. 231, § 2.

Note.

Section 3 of chapter 231, S.L. 2003, repealed this section effective July 1, 2003.

25-16-10.1. Maximum annual return on investment. [Repealed]

Repealed by S.L. 2003, ch. 231, § 3.

25-16-11. Funds of state department of human services for purchasing residential care, custody, treatment, and education for developmentally disabled persons. [Repealed]

Repealed by S.L. 2001, ch. 259, § 1.

25-16-12. Efforts to obtain private and governmental grants. [Effective through August 31, 2022]

The department of human services and the duly licensed treatment or care centers for individuals with a developmental disability may exert all possible efforts to obtain grants, both private and governmental, for the care, custody, treatment, training, and education of individuals with a developmental disability.

25-16-12. Efforts to obtain private and governmental grants. [Effective September 1, 2022]

The department and the duly licensed treatment or care centers for individuals with a developmental disability may exert all possible efforts to obtain grants, both private and governmental, for the care, custody, treatment, training, and education of individuals with a developmental disability.

25-16-13. Expenses chargeable against patient, patient’s estate, or responsible relatives.

This chapter does not relieve the responsibility of the patient, the patient’s estate, or responsible relatives of the expenses for care and treatment as provided in chapter 25-04 or 50-06.3. The provisions of chapter 25-04 or 50-06.3 applicable to the expenses of care and treatment of patients apply to this chapter.

25-16-14. Definitions — Group homes for individuals with developmental disabilities — Zoning.

1. For the purposes of this section:
   1. “Group home” means any community residential facility, foster home, family care facility, or other similar home for individuals with a developmental disability.
   2. “Individual with a developmental disability” means an individual with a severe, chronic disability which:
      1. Is attributable to a mental or physical impairment or combination of mental and physical impairments;
      2. Is manifested before the individual attains age twenty-two;
      3. Is likely to continue indefinitely;
      4. Results in substantial functional limitations in three or more of the following areas of major life activity:
         1. Self-care;
         2. Receptive and expressive language;
         3. Learning;
         4. Mobility;
         5. Self-direction;
         6. Capacity for independent living; and
         7. Economic sufficiency; and
      5. Reflects the individual’s needs for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services which are lifelong or extended duration and are individually planned and coordinated.
2. Notwithstanding the provisions in chapter 11-33, 40-47, or 58-03, or any other provisions authorizing any political subdivision to establish or enforce zoning regulations, a licensed group home serving six or fewer individuals with a developmental disability must be considered a permitted use in a single-family or equivalent least-density residential zone, and a licensed group home serving eight or fewer individuals with a developmental disability must be considered a permitted use in any area zoned for residential use of greater density than single-family use.

25-16-15. Depreciation recapture on the sale of fixed assets. [Repealed]

Repealed by S.L. 2003, ch. 231, § 2.

Note.

Section 3 of chapter 231, S.L. 2003, repealed this section effective July 1, 2003.

25-16-16. Owner compensation for services provided. [Repealed]

Repealed by S.L. 2003, ch. 231, § 3.

25-16.1-01. Definitions. [Effective through August 31, 2022]

In this chapter, unless the context or subject matter otherwise requires:

1. “Department” means the department of human services.
2. “Treatment or care center” means an entity providing services to individuals with developmental disabilities and licensed by the department to provide services.

25-16.1-01. Definitions. [Effective September 1, 2022]

In this chapter, unless the context or subject matter otherwise requires:

1. “Department” means the department of health and human services.
2. “Treatment or care center” means an entity providing services to individuals with developmental disabilities and licensed by the department to provide services.

25-16.1-02. Conditions for appointment of receiver.

When the department has revoked the license of a treatment or care center, or when the operator of a center has requested, the department may file a petition with the district court to place the center under the control of a receiver if necessary to protect the health or safety of clients at the center. The court may grant the petition upon a finding that the health or safety of the clients at the center would be seriously threatened if a condition existing at the time the petition was filed is permitted to continue. Such a finding may be based upon evidence concerning the physical plant, the program and services offered by the center, but not solely upon evidence that a center:

1. Has been denied a license to operate as a center, or has had a previously issued license revoked; or
2. Has been denied certification as an intermediate care facility for individuals with intellectual disabilities, or has lost or had revoked such certification.

25-16.1-03. Appointment of receiver.

The court shall appoint, as receiver, the executive director of the department who shall designate a qualified individual not employed by this state or its political subdivisions, or a nonprofit organization to execute the receivership. The receiver appointed by the court shall use the income and assets of the treatment or care center to maintain and operate the center and to attempt to correct the conditions which constitute a threat to the clients. The receiver may not liquidate the assets of the treatment or care center.

25-16.1-04. Termination of receivership.

The receivership shall be terminated when the receiver and the court certify that the conditions which prompted the appointment have been corrected, when the license is restored, when a new license is issued, or, in the case of an election by the owner or owners to discontinue operation, when the clients are safely placed or provided services in other centers.

25-16.1-05. Accounting.

Upon the termination of the receivership, the receiver shall render a complete accounting to the court and shall dispose of surplus funds as the court directs.

25-16.2-01. Work activity center — Definition. [Effective through August 31, 2022]

As used in this chapter “work activity center” means a facility, licensed by the department of human services, which is located in the state and operated by a nonprofit corporation organized for the primary purpose of employing and providing rehabilitative activities for individuals with physical disabilities, developmental disabilities, or chronic mental illnesses.

25-16.2-01. Work activity center — Definition. [Effective September 1, 2022]

As used in this chapter “work activity center” means a facility, licensed by the department of health and human services, which is located in the state and operated by a nonprofit corporation organized for the primary purpose of employing and providing rehabilitative activities for individuals with physical disabilities, developmental disabilities, or chronic mental illnesses.

25-16.2-01.1. Purpose.

It is in the public interest to advance employment opportunities to individuals with disabilities so that those individuals may acquire job skills and training and gain greater independence and quality of life. This state is committed to promoting self-sufficiency, integrating individuals with disabilities into our communities, and maximizing the earning potential of individuals with disabilities.

25-16.2-02. Direct bidding with work activity centers for highway grade stakes.

Unless no work activity center bids on the contract, the office of management and budget or the department of transportation, whichever may be authorized to purchase highway grade stakes, shall award any contract for the purchase of highway grade stakes to work activity centers. The office of management and budget or the department of transportation shall request bids from work activity centers and shall award any contract for the purchase of highway grade stakes on the basis of these factors:

1. Whether the product contracted for is supplied by the work activity center at a fair market price.
2. Whether the product to be supplied by the work activity center meets the specifications of the department of transportation.
3. The ability, capacity, and skill of the work activity center to perform the contract required.
4. The character, integrity, reputation, judgment, experience, and efficiency of the work activity center.
5. Whether the work activity center can perform the contract within the time specified.
6. The quality of performance of previous contracts negotiated with the work activity center.
7. The previous and existing compliance by the work activity center with laws relating to the contract.

25-16.2-03. Contract requirement.

Any contract awarded pursuant to this chapter must be in writing and must be made available by the purchasing party to any person upon request. The contract must include the purchase price, the quantity of commodity or service purchased, and the time period for which the commodity or service will be provided.

25-16.2-04. Direct purchase from work activity centers.

If acceptable commodities or services are produced or provided by a work activity center at fair market price, any state entity or political subdivision may enter a contract to purchase directly from the work activity center without obtaining competition.

25-17-00.1. Definitions. [Effective through August 31, 2022]

As used in this chapter, unless the context otherwise requires:

1. “Confirmatory-diagnostic testing” means testing to prove or disprove the presence of a specific metabolic disease or genetic disease.
2. “Confirmatory-diagnostic testing laboratory” means a laboratory performing confirmatory-diagnostic testing.
3. “Department” means the state department of health.
4. “Licensed clinician” means a currently licensed physician, physician assistant, or advanced practice registered nurse.
5. “Low-protein modified food product” means a food product that is specially formulated to have less than one gram of protein per serving and is intended to be used under the direction of a licensed clinician for the dietary treatment of a metabolic disease. The term does not include a natural food that is naturally low in protein.
6. “Medical food” means a food that is intended for the dietary treatment of a disease or condition for which nutritional requirements are established by medical evaluation and is formulated to be consumed or administered under the direction of a licensed clinician.
7. “Metabolic disease” and “genetic disease” mean a disease as designated by rule of the state health council for which early identification and timely intervention will lead to a significant reduction in mortality, morbidity, and associated disabilities.
8. “Newborn screening program” means a program facilitating access to appropriate testing, followup, diagnosis, intervention, management, evaluation, and education regarding metabolic diseases and genetic diseases identified in newborns.
9. “Out-of-range screening result” means a screening result that is outside of the expected range of testing results established for a particular disease.
10. “Responsible clinician” means the licensed clinician, midwife, naturopath, or birth attendant attending a newborn.
11. “Screening” means initial testing of a newborn for the possible presence of metabolic disease or genetic disease.
12. “Screening laboratory” means the laboratory the department selects to perform screening.

25-17-00.1. Definitions. [Effective September 1, 2022]

As used in this chapter, unless the context otherwise requires:

1. “Confirmatory-diagnostic testing” means testing to prove or disprove the presence of a specific metabolic disease or genetic disease.
2. “Confirmatory-diagnostic testing laboratory” means a laboratory performing confirmatory-diagnostic testing.
3. “Department” means the department of health and human services.
4. “Licensed clinician” means a currently licensed physician, physician assistant, or advanced practice registered nurse.
5. “Low-protein modified food product” means a food product that is specially formulated to have less than one gram of protein per serving and is intended to be used under the direction of a licensed clinician for the dietary treatment of a metabolic disease. The term does not include a natural food that is naturally low in protein.
6. “Medical food” means a food that is intended for the dietary treatment of a disease or condition for which nutritional requirements are established by medical evaluation and is formulated to be consumed or administered under the direction of a licensed clinician.
7. “Metabolic disease” and “genetic disease” mean a disease as designated by rule of the department for which early identification and timely intervention will lead to a significant reduction in mortality, morbidity, and associated disabilities.
8. “Newborn screening program” means a program facilitating access to appropriate testing, followup, diagnosis, intervention, management, evaluation, and education regarding metabolic diseases and genetic diseases identified in newborns.
9. “Out-of-range screening result” means a screening result that is outside of the expected range of testing results established for a particular disease.
10. “Responsible clinician” means the licensed clinician, midwife, naturopath, or birth attendant attending a newborn.
11. “Screening” means initial testing of a newborn for the possible presence of metabolic disease or genetic disease.
12. “Screening laboratory” means the laboratory the department selects to perform screening.

25-17-01. Newborn screening education programs and tests. [Effective through August 31, 2022]

The state department of health shall:

1. Develop and implement a metabolic disease and genetic disease educational program among licensed clinicians, hospital staffs, public health nurses, and the citizens of this state. This educational program must include information about the nature of the diseases and about screening for the early detection of these diseases so that proper measures may be taken to reduce mortality, morbidity, and associated disabilities.
2. Provide, on a statewide basis, a newborn screening program.
3. Coordinate with or refer individuals to public and private health care service providers for long-term followup services for metabolic diseases and genetic diseases.
4. Select a screening laboratory.
5. Store, maintain, and dispose of blood spots used for screening.

25-17-01. Newborn screening education programs and tests. [Effective September 1, 2022]

The department shall:

1. Develop and implement a metabolic disease and genetic disease educational program among licensed clinicians, hospital staffs, public health nurses, and the citizens of this state. This educational program must include information about the nature of the diseases and about screening for the early detection of these diseases so that proper measures may be taken to reduce mortality, morbidity, and associated disabilities.
2. Provide, on a statewide basis, a newborn screening program.
3. Coordinate with or refer individuals to public and private health care service providers for long-term followup services for metabolic diseases and genetic diseases.
4. Select a screening laboratory.
5. Store, maintain, and dispose of blood spots used for screening.

25-17-02. Rulemaking requirement. [Effective through August 31, 2022]

The state health council shall adopt rules necessary to implement this chapter.

25-17-02. Rulemaking requirement. [Effective September 1, 2022]

The department shall adopt rules necessary to implement this chapter.

25-17-02.1. Testing and reporting requirements.

1. A responsible clinician shall provide the parents and guardians of a newborn written information on the nature of newborn screening and confirmatory-diagnostic testing. The parents or guardians of a newborn may object to screening after receiving the written information. A newborn may not be subject to screening to which the newborn’s parents or guardians object. In the case of an objection, the responsible clinician shall record the objection in a document signed by the parents or guardians and shall submit the document to the department.
2. The responsible clinician attending a newborn shall cause that newborn to be subjected to screening in the manner prescribed by the department.
3. The screening laboratory shall provide to the department screening results and any blood spots used in screening.
4. If screening shows an out-of-range screening result, the responsible clinician shall cause the newborn to be subjected to appropriate clinical followup by a licensed clinician which may include confirmatory-diagnostic testing. The responsible clinician shall ensure the department receives any confirmatory-diagnostic testing results.
5. A licensed clinician attending a patient with a metabolic disease or genetic disease that was not detected by the state’s newborn screening program shall report the case to the department.

History. S.L. 2015, ch. 204, § 4, eff August 1, 2015.

25-17-03. Treatment for positive diagnosis — Registry of cases. [Effective through August 31, 2022]

The state department of health shall:

1. Notify responsible clinicians regarding cases with out-of-range screening results or positive confirmatory-diagnostic testing results in order to facilitate access to appropriate treatment. If the responsible clinician is not a licensed clinician, the responsible clinician shall refer the patient to a licensed clinician for appropriate followup care.
2. Refer every diagnosed case of a metabolic disease or genetic disease to a licensed clinician for necessary treatment.
3. Maintain a registry of cases of metabolic diseases and genetic diseases.
4. Provide medical food at no cost to males under age twenty-six and females under age forty-five who are diagnosed with phenylketonuria or maple syrup urine disease, regardless of income. If treatment services under this subsection are provided to an individual by the department, the department may seek reimbursement from any government program that provides coverage to that individual for the treatment services provided by the department.
5. Offer for sale at cost medical food to females age forty-five and over and to males age twenty-six and over who are diagnosed with phenylketonuria or maple syrup urine disease, regardless of income. These individuals are responsible for payment to the department for the cost of medical food.
6. Provide low-protein modified food products, if medically necessary as determined by a qualified health care provider, to females under age forty-five and males under age twenty-six who are receiving medical assistance and are diagnosed with phenylketonuria or maple syrup urine disease.

25-17-03. Treatment for positive diagnosis — Registry of cases. [Effective September 1, 2022]

The department shall:

1. Notify responsible clinicians regarding cases with out-of-range screening results or positive confirmatory-diagnostic testing results in order to facilitate access to appropriate treatment. If the responsible clinician is not a licensed clinician, the responsible clinician shall refer the patient to a licensed clinician for appropriate followup care.
2. Refer every diagnosed case of a metabolic disease or genetic disease to a licensed clinician for necessary treatment.
3. Maintain a registry of cases of metabolic diseases and genetic diseases.
4. Provide medical food at no cost to males under age twenty-six and females under age forty-five who are diagnosed with phenylketonuria or maple syrup urine disease, regardless of income. If treatment services under this subsection are provided to an individual by the department, the department may seek reimbursement from any government program that provides coverage to that individual for the treatment services provided by the department.
5. Offer for sale at cost medical food to females age forty-five and over and to males age twenty-six and over who are diagnosed with phenylketonuria or maple syrup urine disease, regardless of income. These individuals are responsible for payment to the department for the cost of medical food.
6. Provide low-protein modified food products, if medically necessary as determined by a qualified health care provider, to females under age forty-five and males under age twenty-six who are receiving medical assistance and are diagnosed with phenylketonuria or maple syrup urine disease.

25-17-04. Testing and reporting requirements. [Repealed]

25-17-05. Testing charges.

A screening and confirmatory-diagnostic testing laboratory may charge fees for necessary services.

25-17-06. Pulse oximetry screening for critical congenital heart defects — Exception. [Effective through August 31, 2022]

Before discharge of a newborn child born in a hospital with a birthing center, the newborn child must receive a pulse oximetry screening for critical congenital heart defects. The screening requirement of this section does not apply if the parents or guardians of a newborn child object to the screening. The state department of health shall provide medical staff and facilities that provide birthing services with notice regarding this screening requirement. For purposes of this chapter, pulse oximetry screening is not a test under section 25-17-05 and a congenital heart defect detected by screening under this section is not a metabolic disease or genetic disease as those terms are used under this chapter.

25-17-06. Pulse oximetry screening for critical congenital heart defects — Exception. [Effective September 1, 2022]

Before discharge of a newborn child born in a hospital with a birthing center, the newborn child must receive a pulse oximetry screening for critical congenital heart defects. The screening requirement of this section does not apply if the parents or guardians of a newborn child object to the screening. The department shall provide medical staff and facilities that provide birthing services with notice regarding this screening requirement. For purposes of this chapter, pulse oximetry screening is not a test under section 25-17-05 and a congenital heart defect detected by screening under this section is not a metabolic disease or genetic disease as those terms are used under this chapter.

25-17-07. Institutional review board.

A person that conducts research on blood spots, other specimens, or registry data that is maintained by the department shall follow institutional review board processes for human research which must include obtaining parent or guardian authorization.

History. S.L. 2015, ch. 204, § 8, eff August 1, 2015.

25-18-01. Definitions. [Effective through August 31, 2022]

In this chapter, unless the context or subject matter otherwise requires:

1. “Department” means the department of human services.
2. “Treatment or care center” means an entity providing services to individuals with developmental disabilities and licensed by the department to provide services.

25-18-01. Definitions. [Effective September 1, 2022]

In this chapter, unless the context or subject matter otherwise requires:

1. “Department” means the department of health and human services.
2. “Treatment or care center” means an entity providing services to individuals with developmental disabilities and licensed by the department to provide services.

25-18-02. Workgroup — Membership — Facilitator. [Repealed]

Repealed by S.L. 2005, ch. 252, § 4.

25-18-03. Purchase of services.

The department may purchase, from funds appropriated to it for that purpose, residential care, custody, treatment, training, and education for individuals with developmental disabilities from any treatment or care center licensed in this state.

25-18-04. Fee-for-service system — Fee determination. [Repealed]

Repealed by S.L. 2005, ch. 252, § 4.

25-18-05. Limitation on owner compensation for services provided.

For-profit treatment or care centers may compensate working owners and their families for time worked on behalf of the treatment or care center. The amount of total annual compensation allowed for an owner acting in an executive or administrative capacity must be limited as follows:

Number of clients served: Compensation limit: 1 - 15 $25,000 16 - 30 $35,000 31 - 45 $45,000 46 + $50,000

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The limits in this section are intended to be the total compensation allowed by this state in any one year regardless of the number of owners performing work for the treatment or care center. A proration of the total compensation for owners who perform services in this state and who perform services in other states must be made on the basis of individual time distribution records. For family members working in direct care, housekeeping, maintenance, dietary, or clerical positions, wages are limited to the wage paid to any nonrelated employee, with the same qualifications and experience, working in a similar job function for that treatment or care center. The allowable compensation limit is inclusive of all salaries and related fringe benefits and may not be construed to be an addition or enhancement to the rate payable to a treatment or care center.

25-18-06. Extraordinary client needs — Effect on fee. [Repealed]

Repealed by S.L. 2005, ch. 252, § 4.

25-18-07. Trust fund. [Repealed]

Repealed by S.L. 2005, ch. 252, § 4.

25-18-08. Transition to establishment of fees. [Repealed]

Repealed by S.L. 2005, ch. 252, § 4.

25-18-09. Federal requirements — Supremacy.

If any provision of this chapter is determined by the United States government to be in conflict with existing or future requirements of the United States government so as to limit or preclude federal financial participation in medical assistance, the department shall comply with the federal requirements to the extent necessary to obtain federal financial participation and shall not comply with the provisions of this chapter if necessary to avoid a loss of federal financial participation.

25-18-10. Exclusion of state-owned or state-operated treatment or care centers.

This chapter does not apply to state-owned or state-operated treatment or care centers.

25-18-11. Rulemaking authority of the department. [Repealed]

Repealed by S.L. 2005, ch. 252, § 4.

25-18-12. Reporting to legislative council. [Repealed]

Repealed by S.L. 2005, ch. 252, § 4.

25-18-13. Treatment or care center budget flexibility.

The department shall allow treatment or care centers to transfer funds received from the department between budget categories and line items.

25-18-14. Maximum annual return on investment.

Profit-motivated institutions or facilities must be allowed an annual return on investment in fixed assets related to client care. The maximum return on investment must be established based upon the existing debt divided by original asset cost and must be determined as follows:

Annual average percentage debt to annual average assets Return 51 to 80 percent - 2 percent return on original cost of fixed assets 0 to 50 percent - 3 percent return on original cost of fixed assets

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25-18-15. Payment for services to medically fragile children.

The department may consider the unique level of care, the additional cost required to provide services to medically fragile clients under twenty-one years of age, and the actual and reasonable cost of providing services to individuals with developmental disabilities when reimbursing an intermediate care facility for individuals with intellectual disabilities.