North Dakota Senate Bill SB2113 Engrossed / Bill

                    25.8094.04000
Sixty-ninth
Legislative Assembly
of North Dakota
Introduced by
Human Services Committee
(At the request of the Department of Health and Human Services)
A BILL for an Act to create and enact two new sections to chapter 50-06 of the North Dakota 
Century Code, relating to certified community behavioral health clinics and the financing of 
health and human services; to amend and reenact section 12.1-04-06, subsection 4 of section 
20.1-03-04, sections 25-03.1-03.1 and 25-03.1-04, subsection 3 of section 25-03.1-08, section 
25-03.1-10, subdivision b of subsection 2 of section 26.1-36-08, subdivisions c and d of 
subsection 2 of section 26.1-36-09, subsection 9 of section 43-12.1-04, subsection 6 of section 
43-41-02, subdivision b of subsection 1 of section 44-04-18.30, sections 50-06-01, 50-06-01.4, 
50-06-01.7, 50-06-05.1, 50-06-05.2, 50-06-05.3, 50-06-05.4, 50-06-05.5, 50-06-06.2, 
50-06-06.5, and 50-06-06.13, subsections 1 and 3 of section 50-06-15, sections 50-06-33 and 
50-06-41.3, subsection 1 of section 50-06-42, subsection 1 of section 50-06-42.1, and sections 
50-06-46, 50-06.2-01, 50-06.2-02, 50-06.2-03, 50-06.3-02, and 50-06.3-04 of the North Dakota 
Century Code, relating to the powers and duties of the department of health and human 
services and membership of the cross disability advisory council; to provide an appropriation; 
and to provide an expiration date.
BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
SECTION 1. AMENDMENT. Section 12.1-04-06 of the North Dakota Century Code is 
amended and reenacted as follows:
12.1-04-06. Temporary detention for purposes of examination.
Whenever there is reason to doubt the defendant's fitness to proceed, the court may order 
temporary detention of the defendant for the purpose of an examination. The temporary 
detention must be in the least restrictive appropriate setting, including the state hospital, the life 
skills and transition center, or other suitable facility for a reasonable period, not to exceed thirty 
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REENGROSSED SENATE BILL NO. 2113
THIRD ENGROSSMENT
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days, for such examination. In lieu of detention, the court may allow the defendant to remain in 
the defendant's present residential setting or other suitable residential setting for the purpose of 
examination, subject to any reasonable limitation the court may impose. A human service 
centerstate-operated behavioral health clinic may be considered if the court is aware an inquiry 
was made before the court ordered the evaluation to ensure appropriate resources exist at the 
human service centerstate-operated behavioral health clinic being ordered to conduct the 
examination. While the defendant is detained, the defendant's legal counsel, family, and others 
necessary to assist in the defendant's case must have reasonable opportunity to examine and 
confer with the defendant.
SECTION 2. AMENDMENT. Subsection 4 of section 20.1-03-04 of the North Dakota 
Century Code is amended and reenacted as follows:
4.Life skills and transition center patients, North Dakota youth correctional center 
students, school for the deaf students, North Dakota vision services - school for the 
blind students, state hospital patients, clients of regional human service centersstate-
operated behavioral health clinics under direct therapeutic care, and residents of 
facilities licensed by the department of health and human services may fish without a 
resident fishing license. Patients of these institutions must be identified. The 
department shall issue authority to each institution.
SECTION 3. AMENDMENT. Section 25-03.1-03.1 of the North Dakota Century Code is 
amended and reenacted as follows:
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 centerstate-operated behavioral health clinic, 
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.
SECTION 4. AMENDMENT. Section 25-03.1-04 of the North Dakota Century Code is 
amended and reenacted as follows:
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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 centerstate-operated behavioral health clinic. 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 centerstate-
operated behavioral health clinic 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 centerstate-operated behavioral health clinic, 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 
centerstate-operated behavioral health clinic any relevant protected health information 
regarding that treatment. Upon receipt of the request, the regional human service centerstate-
operated behavioral health clinic 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.
SECTION 5. AMENDMENT. Subsection 3 of section 25-03.1-08 of the North Dakota 
Century Code is amended and reenacted as follows:
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 
centerstate-operated behavioral health clinic 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 
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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.
SECTION 6. AMENDMENT. Section 25-03.1-10 of the North Dakota Century Code is 
amended and reenacted as follows:
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 centerstate-operated behavioral health 
clinic. 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.
SECTION 7. AMENDMENT. Subdivision b of subsection 2 of section 26.1-36-08 of the 
North Dakota Century Code is amended and reenacted as follows:
b.In the case of benefits provided for partial hospitalization, the benefits must be 
provided for a minimum of one hundred twenty days of services covered under 
this section and section 26.1-36-09 in any calendar year. Services provided 
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under this subdivision must be provided by an addiction treatment program 
licensed under chapter 50-31. For services provided in regional human service 
centersstate-operated behavioral health clinics, charges must be reasonably 
similar to the charges for care provided by hospitals as defined in this subsection.
SECTION 8. AMENDMENT. Subdivisions c and d of subsection 2 of section 26.1-36-09 of 
the North Dakota Century Code are amended and reenacted as follows:
c.In the case of benefits provided for partial hospitalization, the benefits must be 
provided for a minimum of one hundred twenty days of services covered under 
this section and section 26.1-36-08 in any calendar year. Partial hospitalization 
must be provided by a hospital as defined under section 52-01-01 and rules of 
the department of health and human services pursuant thereto or by a regional 
human service centerstate-operated behavioral health clinic licensed under 
section 50-06-05.2, offering treatment for the prevention or cure of mental 
disorder or other related illness. For services provided in regional human service 
centersstate-operated behavioral health clinics, charges must be reasonably 
similar to the charges for care provided by hospitals as defined in this subsection.
d.In the case of benefits provided for residential treatment, the benefits must be 
provided for a minimum of one hundred twenty days of services covered under 
this section in any calendar year. Residential treatment services must be 
provided by a hospital as defined under section 52-01-01 and rules of the 
department of health and human services; by a regional human service 
centerstate-operated behavioral health clinic licensed under section 50-06-05.2 
offering treatment for the prevention or cure of mental disorder or other related 
illness; or by a residential treatment program. For services provided in a regional 
human service centerstate-operated behavioral health clinic, charges must be 
reasonably similar to the charges for care provided by a hospital as defined in 
this subsection.
SECTION 9. AMENDMENT. Subsection 9 of section 43-12.1-04 of the North Dakota 
Century Code is amended and reenacted as follows:
9.A person that provides medications, other than by the parenteral route:
a.Within a correctional facility, in compliance with section 12-44.1-29;
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b.Within a psychiatric residential treatment facility for children licensed under 
chapter 25-03.2 and North Dakota Administrative Code chapter 75-03-17;
c.Within a treatment or care center for individuals with developmental disabilities 
licensed under chapter 25-16;
d.Within a group home, a qualified residential treatment program, or an adult foster 
care facility licensed under section 50-11-01;
e.Within the life skills and transition center, to the extent the individual who 
provides medications is a direct training technician or a vocational training 
technician as approved by the department of health and human services;
f.Within a human service centerstate-operated behavioral health clinic licensed 
under chapter 50-06; or
g.Within a primary or secondary school under a program established under section 
15.1-19-23 if the individual has received education and training in medication 
administration and has received written consent of the student's parent or 
guardian; or
h.Who is an employee of a qualified service provider agency who meets the criteria 
set forth in subsection 2 of section 50-24.1-18.
SECTION 10. AMENDMENT. Subsection 6 of section 43-41-02 of the North Dakota 
Century Code is amended and reenacted as follows:
6.This chapter does not prevent individuals with master's or doctoral degrees in the field 
of counseling with specialization in mental health from serving as counselors or 
therapists in mental health in state institutions or regional human service centersstate-
operated behavioral health clinics, if they do not hold themselves out to the public as 
social workers.
SECTION 11. AMENDMENT. Subdivision b of subsection 1 of section 44-04-18.30 of the 
North Dakota Century Code is amended and reenacted as follows:
b."Public social services agency" means a state, county, or local public agency that 
provides human services, and includes regional human service centersstate-
operated behavioral health clinics, county social serviceshuman service zone 
boards, multicounty social services districtshuman service zones, and the 
department of health and human services.
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SECTION 12. AMENDMENT. Section 50-06-01 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06-01. Definitions.
As used in this chapter, unless the context otherwise requires:
1."Behavioral health" means the planning and implementation of preventive, 
consultative, diagnostic, treatment, crisis intervention, rehabilitative, and suicide 
prevention services for individuals with mental, emotional, or substance use disorders, 
and psychiatric conditions.
2."Behavioral health provider" means any licensed or accredited behavioral health 
provider in this state.
3."Certified community behavioral health clinic" means a private or public behavioral 
health clinic or a state-operated behavioral health clinic designated by the department 
to deliver a comprehensive range of mental health and substance use disorder 
services in accordance with the certification criteria set forth by the department.
4."Department" means the department of health and human services.
4.5."Human services" means:
a.A service or assistance provided to an individual or an individual's family in need 
of services or assistance, including child welfare services, economic assistance 
programs, medical services programs, and aging services programs, to assist the 
individual or the individual's family in achieving and maintaining basic 
self-sufficiency, including physical health, mental health, education, welfare, food 
and nutrition, and housing.
b.A service or assistance provided, administered, or supervised by the department 
in accordance with chapter 50-06.
c.Licensing duties as administered or supervised by the department or delegated 
by the department to a human service zone.
6."State-operated behavioral health clinic" means a department-operated behavioral 
health clinic established under section 50 	- 06 - 05.2. 
SECTION 13. AMENDMENT. Section 50-06-01.4 of the North Dakota Century Code is 
amended and reenacted as follows:
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50-06-01.4. Structure of the department.
1.The department includes the state hospital, the regional human service centersstate-
operated behavioral health clinics, a vocational rehabilitation unit, public health 
division, and other units or offices and administrative and fiscal support services as the 
commissioner of the department determines necessary. The department must be 
structured to promote efficient and effective operations and, consistent with fulfilling its 
prescribed statutory duties, shall act as the official agency of the state in the discharge 
of the following functions not otherwise by law made the responsibility of another state 
agency:
a.Administration of programs for children and families, including adoption services 
and the licensure of child-placing agencies, foster care services and the licensure 
of foster care arrangements, certification of shelter care services, child protection 
services, children's trust fund, licensure of early childhood programs, refugee 
services, in-home community-based services, quality control, and administration 
of the interstate compacts on the placement of children and juveniles.
b.Administration of programs for individuals with developmental disabilities, 
including licensure of facilities and services, the establishment funding for family 
members and corporate guardianships, and the design and implementation of a 
community-based service system for persons in need of habilitation.
c.Administration of aging service programs, including nutrition, transportation, 
advocacy, social, ombudsman, recreation, and related services funded under the 
Older Americans Act of 1965 [42 U.S.C. 3001 et seq.], home and 
community-based services, licensure of adult foster care homes, and the 
committee on aging.
d.Administration of behavioral health programs, including reviewing and identifying 
service needs and activities in the state's behavioral health system in an effort to 
ensure health and safety, access to services, and quality of services; establishing 
quality assurance standards for the licensure of substance use disorder program 
services and facilities; providing policy leadership in partnership with public and 
private entities; and providing chronic disease management, regional intervention 
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services, and twenty-four-hour crisis services for individuals with behavioral 
health disorders.
e.Administration of economic assistance programs, including temporary assistance 
for needy families, the supplemental nutrition assistance program, home energy 
assistance, child care assistance, refugee assistance, work experience, work 
incentive, and quality control.
f.Administration of medical service programs, including medical assistance for 
children's health insurance program, Medicaid waivers, early and periodic 
screening, diagnosis and treatment, utilization control, autism services, and 
claims processing.
g.Administration of general assistance.
h.Administration of child support.
i.Administration of program, services, and licensing outlined in title 23 and other 
previous duties of the state department of health and state health council.
2.The commissioner of the department or commissioner's designee shall consult with 
and maintain a close working relationship with the department of corrections and 
rehabilitation and the superintendents of the school for the deaf and the North Dakota 
vision services - school for the blind to develop programs for individuals with 
developmental disabilities; and with the superintendent of public instruction to 
maximize the use of resource persons in regional human service centersstate-
operated behavioral health clinics in the provision of special education services. The 
commissioner of the department or commissioner's designee shall also maintain a 
close liaison with human service zones.
3.By August 1, 2019, theThe department shall establish a template for the development 
of human service zone plans, including process and content requirements, access 
point expectations, client grievances procedures, human resources, and locally funded 
programs or services and how those services will be addressed.
4.The department shall develop, with assistance from the North Dakota association of 
counties, a process for consultation and technical assistance for human service zone 
working groups by August 1, 2019.
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SECTION 14. AMENDMENT. Section 50-06-01.7 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06-01.7. Behavioral health division - Administration - Fees.
1.The department shall administratively restructure the behavioral health division to 
require the division to develop and revise, when necessary, the state mental health 
plan and provide the behavioral health division the authority to implement and 
supervise a unified mental health delivery system and to assure the mental health 
services provided by the human service centersstate-operated behavioral health 
clinics, the state hospital, and contracted services are in accordance with the state 
plan.
2.The behavioral health division may establish nonrefundable application fees not to 
exceed three hundred dollars for administration and enforcement of licensing and 
certification activities. The department shall adopt rules as necessary to implement 
this section. All fees collected under this section must be paid to the behavioral health 
division and must be used to defray the cost of administering and enforcing licensing 
and certification activities.
SECTION 15. AMENDMENT. Section 50-06-05.1 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06-05.1. Powers and duties of the department. (Effective through June 30, 2027)
The department has the following powers and duties to be administered by the department 
through its state office or regional human service centersstate-operated behavioral health 
clinics, human service zones, or otherwise as directed by the department:
1.To act as the official agency of the state in any social welfare or human service activity 
initiated by the federal government not otherwise by law made the responsibility of 
another state agency.
2.To administer, allocate, and distribute any state and federal funds that may be made 
available for the purpose of providing financial assistance, care, and services to 
eligible persons and families who do not have sufficient income or other resources to 
provide a reasonable subsistence compatible with decency and health.
3.To provide preventive, rehabilitative, and other human services to help families and 
individuals to retain or attain capability for independence or self-care.
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4.To do needed research and study in the causes of social problems and to define 
appropriate and effective techniques in providing preventive and rehabilitative 
services.
5.To provide for the study, and to promote the well-being, of a child in need of protection, 
a child in need of services, and delinquent children.
6.To provide for the placing and supervision of children in need of substitute parental 
care, subject to the control of any court having jurisdiction and control of any such 
child.
7.To recommend appropriate human services related legislation to the legislative 
assembly.
8.To direct and supervise human service zone activities and administer a statewide 
program for state-funded human services, staffing, and administration costs related to 
the administration of human services.
9.To secure, hold, and administer for the purpose for which it is established any property 
and any funds donated to it either by will or deed, or otherwise, or through court order 
or otherwise available to the department, and to administer those funds or property in 
accordance with the instructions in the instrument creating them or in accordance with 
the instructions in the court order or otherwise.
10.To formulate standards and make appropriate inspections and investigations in 
accordance with such standards in connection with all licensing activities delegated by 
law to the department, including early childhood programs, nonmedical adult care 
facilities and maternity homes, and persons or organizations receiving and placing 
children, and to require those facilities, persons, and organizations to submit reports 
and information as the department may determine necessary.
11.To permit the making of any surveys of human service needs and activities if 
determined to be necessary.
12.To issue subpoenas, administer oaths, and compel attendance of witnesses and 
production of documents or papers whenever necessary in making the investigations 
provided for herein or in the discharge of its other duties. A subpoena may not be 
issued to compel the production of documents or papers relating to any private 
child-caring or child-placing agency or to compel the attendance as a witness of any 
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officer or employee of those facilities except upon the order of a judge of the district 
court of the judicial district in which the facilities are located.
13.To provide insofar as staff resources permit appropriate human services, including 
social histories, social or social-psychological evaluations, individual, group, family, 
and marital counseling, and related consultation, when referred by self, parent, 
guardian, human service zone, court, physician, or other individual or agency, and 
when application is made by self (if an adult or emancipated youth), parent, guardian, 
or agency having custody; also, on the same basis, to provide human services to 
children and adults in relation to their placement in or return from the life skills and 
transition center, state hospital, or North Dakota youth correctional center.
14.To provide insofar as staff resources permit social services, including 
social-psychological evaluations, predisposition reports, treatment, and aftercare 
services when requested by the judge of a juvenile court. A court order under section 
27 - 20.3 - 09, 27 - 20.4 - 08, or 27 - 20.4 - 17 or pursuant to rules adopted by the judicial  
branch regarding treatment, if available, at the state hospital or life skills and transition 
center shall comply with the requirements set forth in chapters 25 	- 03.1, 25 - 03.3, and 
25 - 04. 
15.To provide insofar as staff resources permit social services, including 
social-psychological evaluations, predisposition reports, and treatment, when 
requested by the judge in a criminal case. A court order under section 12.1 	- 32 - 02 or  
12.1 - 32 - 07 or pursuant to rules adopted by the judicial branch regarding treatment, if  
available, at the state hospital or life skills and transition center shall comply with 
requirements set forth in chapters 25 	- 03.1, 25 - 03.3, and 25 - 04. 
16.To act as the official agency of the state in the administration of the supplemental 
nutrition assistance program and to direct and supervise human service zone 
administration of that program. The department with the consent of the legislative 
assembly or the budget section if the legislative assembly is not in session may 
terminate the program if the rate of federal financial participation in administrative 
costs provided under Public Law 93-347 is decreased or limited, or if the state or 
counties become financially responsible for all or a portion of the coupon bonus 
payments under the Food Stamp Act. Any request considered by the budget section 
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must comply with section 54-35-02.9. The department may not deny assistance under 
the supplemental nutrition assistance program to any individual who has been 
convicted of a felony offense that has as an element the possession, use, or 
distribution of a controlled substance as defined in section 102(6) of the Controlled 
Substances Act [21 U.S.C. 802(6)].
17.To administer, allocate, and distribute any funds made available for the making of 
direct cash assistance payments, housing stabilization supports, and rental assistance 
and to promote cooperation and working agreements with public agencies and 
including the housing finance agency and department of commerce, and private 
human service agencies.
18.To act as the official agency of the state in the administration of the home energy 
assistance program; to direct and supervise human service zone administration of that 
program; and to take such actions, give such directions, and adopt such rules, subject 
to review in the courts of this state, as may be necessary or desirable to carry out this 
subsection. For purposes of the administration of the energy assistance program, 
funds are obligated at the earlier of the time a written commitment is made to pay a 
vendor or contractor for services or supplies delivered or to be delivered, or at the time 
payment is made to a vendor or contractor for services or supplies delivered or to be 
delivered. The provisions of this subsection concerning obligation of funds apply to 
payments and commitments made on or after July 1, 1991. The department with the 
consent of the legislative assembly or the budget section if the legislative assembly is 
not in session may terminate the program if the rate of federal financial participation in 
administrative costs is decreased or limited to less than fifty percent of total 
administrative costs, or if the state or counties become financially responsible for all or 
a portion of the cost of energy assistance program benefits. Any request considered 
by the budget section must comply with section 54-35-02.9
19.To administer, allocate, and distribute any funds made available for the payment of the 
cost of the special needs of any child under the age of twenty-one years, who is living 
in an adoptive home and would probably go without adoption except for acceptance by 
the adopted family, and whose adopted family does not have the economic ability and 
resources, as established by the department, to take care of the special needs of the 
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child, including legal fees, maintenance costs, medical and dental expenses, travel 
costs, and other costs incidental to the care of the child.
20.To exercise and carry out any other powers and duties granted the department under 
state law.
21.To administer, allocate, and distribute any funds made available for the payment of 
supervised independent living services, to develop standards regarding a supervised 
independent living program, to approve supervised independent living services for the 
purpose of providing foster care placement, and to apply for and administer federal 
and other funds that may be made available to undertake any of the activities 
described in this subsection.
22.With the approval of the governor, to lease or transfer use of any part of the life skills 
and transition center facilities or properties, located in section thirteen, township one 
hundred fifty-seven north, range fifty-three west, located in Walsh County, North 
Dakota, to the federal government, or any public or private agency, organization, or 
business enterprise, or any worthy undertaking, under the following provisions:
a.The department determines that the facility or property is not needed to serve 
any present or reasonably foreseeable need of the life skills and transition center.
b.The transaction is exempt from the provisions of section 50-06-06.6.
c.The term of any lease may not exceed ninety-nine years.
d.All required legal documents, papers, and instruments in any transaction must be 
reviewed and approved as to form and legality by the attorney general.
e.Any funds realized by any transaction must be deposited in the state's general 
fund.
23.To act as a decedent's successor for purposes of collecting amounts due to the 
department or human service zone, unless otherwise directed or determined by the 
department. Any affidavit submitted by the department under section 30.1-23-01 must 
conform to the requirements of that section except that the affidavit may state that 
twenty days have elapsed since the death of the decedent.
24.To provide those services necessary for the department and for human service zones 
to comply with the provisions of any law, rule, order, or regulation of the United States 
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or any federal agency or authority requiring civil service or merit standards or 
classifications as a condition for providing funds administered by the department.
25.For purposes of administration of programs, and subject to legislative appropriation, 
funds are obligated at the time a written commitment is made to pay a vendor or 
contractor for services or supplies either delivered or to be delivered. This subsection 
applies to payments and commitments made on or after January 1, 1997.
26.To determine eligibility for medical assistance and children's health insurance program 
benefits when the department receives a joint application for these benefits.
27.To develop a system of services and supports to provide behavioral health services 
and supports in the community for children at risk of or identified as having a 
behavioral health condition and for the families of these children. This system must 
include early intervention, treatment, and recovery services and supports and must 
interface with, but not include, child protective services or juvenile court.
28.To provide resources on mental health awareness and suicide prevention to the 
behavioral health resource coordinator at each public school and to the designated 
individual at a nonpublic school. The resources must include information on identifying 
warning signs, risk factors, and the availability of resources in the community, and also 
must include an evidence-based, online virtual mental health and suicide prevention 
simulation-based training program that incorporates hands-on practice, contextual 
learning, and personalized feedback through interactive role-playing. The provisions of 
chapter 54-44.4 do not apply to the online virtual mental health and suicide prevention 
simulation-based training program under this subsection.
29.To administer, allocate, and distribute any funds made available for kinship care 
services and payments and services in response to the federal Family First Prevention 
Services Act as part of the Bipartisan Budget Act of 2018 [Pub. L. 115-123].
30.To contract with another human service zone or any other public or private person to 
discharge any of the department's duties or exercise any of the department's powers 
to administer human services.
31.To act on behalf of the department of public instruction to administer part B, 
section 619 of the Individuals with Disabilities Education Act [Pub. L. 108-446; 229 
Stat. 2647; 20 U.S.C. 1411 et seq.].
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32.In the event of a disruption of operations, to provide meals at a fair value or without a 
charge to employees of the department at the North Dakota state hospital, life skills 
and transition center, and regional human service centersstate-operated behavioral 
health clinics twenty-four hour staffed residential units as required by the job 
assignments of the employees.
33.May pay a stipend, within the limit of legislative appropriation, to a recipient or a 
provider of a recipient receiving assistance or services under any program 
administered by or under the supervision and direction of the department to allow the 
recipient or provider to serve on a council or board.
34.Notwithstanding any other requirements, to appeal an order of a judge of the district 
court or juvenile court that orders the department to perform or provide a function, 
service, or duty.
35.To require providers that receive funding from the department to submit process and 
outcome measures to the department for programs and services supported by state 
funding for the department to evaluate the administration of the programs and services 
using the appropriation.
Powers and duties of the department. (Effective after June 30, 2027) The department 
has the following powers and duties to be administered by the department through its state 
office or regional human service centersstate-operated behavioral health clinics, human service 
zones, or otherwise as directed by the department:
1.To act as the official agency of the state in any social welfare or human service activity 
initiated by the federal government not otherwise by law made the responsibility of 
another state agency.
2.To administer, allocate, and distribute any state and federal funds that may be made 
available for the purpose of providing financial assistance, care, and services to 
eligible persons and families who do not have sufficient income or other resources to 
provide a reasonable subsistence compatible with decency and health.
3.To provide preventive, rehabilitative, and other human services to help families and 
individuals to retain or attain capability for independence or self-care.
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4.To do needed research and study in the causes of social problems and to define 
appropriate and effective techniques in providing preventive and rehabilitative 
services.
5.To provide for the study, and to promote the well-being, of a child in need of protection, 
a child in need of services, and delinquent children.
6.To provide for the placing and supervision of children in need of substitute parental 
care, subject to the control of any court having jurisdiction and control of any such 
child.
7.To recommend appropriate human services related legislation to the legislative 
assembly.
8.To direct and supervise human service zone activities and administer a statewide 
program for state-funded human services, staffing, and administration costs related to 
the administration of human services.
9.To secure, hold, and administer for the purpose for which it is established any property 
and any funds donated to it either by will or deed, or otherwise, or through court order 
or otherwise available to the department, and to administer those funds or property in 
accordance with the instructions in the instrument creating them or in accordance with 
the instructions in the court order or otherwise.
10.To formulate standards and make appropriate inspections and investigations in 
accordance with such standards in connection with all licensing activities delegated by 
law to the department, including early childhood programs, nonmedical adult care 
facilities and maternity homes, and persons or organizations receiving and placing 
children, and to require those facilities, persons, and organizations to submit reports 
and information as the department may determine necessary.
11.To permit the making of any surveys of human service needs and activities if 
determined to be necessary.
12.To issue subpoenas, administer oaths, and compel attendance of witnesses and 
production of documents or papers whenever necessary in making the investigations 
provided for herein or in the discharge of its other duties. A subpoena may not be 
issued to compel the production of documents or papers relating to any private 
child-caring or child-placing agency or to compel the attendance as a witness of any 
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officer or employee of those facilities except upon the order of a judge of the district 
court of the judicial district in which the facilities are located.
13.To provide insofar as staff resources permit appropriate human services, including 
social histories, social or social-psychological evaluations, individual, group, family, 
and marital counseling, and related consultation, when referred by self, parent, 
guardian, human service zone, court, physician, or other individual or agency, and 
when application is made by self (if an adult or emancipated youth), parent, guardian, 
or agency having custody; also, on the same basis, to provide human services to 
children and adults in relation to their placement in or return from the life skills and 
transition center, state hospital, or North Dakota youth correctional center.
14.To provide insofar as staff resources permit social services, including 
social-psychological evaluations, predisposition reports, treatment, and aftercare 
services when requested by the judge of a juvenile court. A court order under section 
12.1 - 32 - 02 or 12.1 - 32 - 07 or pursuant to rules adopted by the judicial branch regarding  
treatment, if available, at the state hospital or life skills and transition center shall 
comply with requirements set forth in chapters 25 	- 03.1, 25 - 03.3, and 25 - 04. 
15.To provide insofar as staff resources permit social services, including 
social-psychological evaluations, predisposition reports, and treatment, when 
requested by the judge in a criminal case. A court order under section 12.1 	- 32 - 02 or  
12.1 - 32 - 07 or pursuant to rules adopted by the judicial branch regarding treatment, if  
available, at the state hospital or life skills and transition center shall comply with 
requirements set forth in chapters 25 	- 03.1, 25 - 03.3, and 25 - 04. 
16.To act as the official agency of the state in the administration of the supplemental 
nutrition assistance program and to direct and supervise human service zone 
administration of that program. The department with the consent of the legislative 
assembly or the budget section if the legislative assembly is not in session may 
terminate the program if the rate of federal financial participation in administrative 
costs provided under Public Law 93-347 is decreased or limited, or if the state or 
counties become financially responsible for all or a portion of the coupon bonus 
payments under the Food Stamp Act. Any request considered by the budget section 
must comply with section 54-35-02.9. The department may not deny assistance under 
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the supplemental nutrition assistance program to any individual who has been 
convicted of a felony offense that has as an element the possession, use, or 
distribution of a controlled substance as defined in section 102(6) of the Controlled 
Substances Act [21 U.S.C. 802(6)].
17.To administer, allocate, and distribute any funds made available for the making of 
direct cash assistance payments, housing stabilization supports, and rental assistance 
and to promote cooperation and working agreements with public agencies and 
including the housing finance agency and department of commerce, and private 
human services agencies.
18.To act as the official agency of the state in the administration of the home energy 
assistance program; to direct and supervise human service zone administration of that 
program; and to take such actions, give such directions, and adopt such rules, subject 
to review in the courts of this state, as may be necessary or desirable to carry out this 
subsection. For purposes of the administration of the energy assistance program, 
funds are obligated at the earlier of the time a written commitment is made to pay a 
vendor or contractor for services or supplies delivered or to be delivered, or at the time 
payment is made to a vendor or contractor for services or supplies delivered or to be 
delivered. The provisions of this subsection concerning obligation of funds apply to 
payments and commitments made on or after July 1, 1991. The department with the 
consent of the legislative assembly or the budget section if the legislative assembly is 
not in session may terminate the program if the rate of federal financial participation in 
administrative costs is decreased or limited to less than fifty percent of total 
administrative costs, or if the state or counties become financially responsible for all or 
a portion of the cost of energy assistance program benefits. Any request considered 
by the budget section must comply with section 54-35-02.9
19.To administer, allocate, and distribute any funds made available for the payment of the 
cost of the special needs of any child under the age of twenty-one years, who is living 
in an adoptive home and would probably go without adoption except for acceptance by 
the adopted family, and whose adopted family does not have the economic ability and 
resources, as established by the department, to take care of the special needs of the 
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child, including legal fees, maintenance costs, medical and dental expenses, travel 
costs, and other costs incidental to the care of the child.
20.To exercise and carry out any other powers and duties granted the department under 
state law.
21.To administer, allocate, and distribute any funds made available for the payment of 
supervised independent living services, to develop standards regarding a supervised 
independent living program, to approve supervised independent living services for the 
purpose of providing foster care placement, and to apply for and administer federal 
and other funds that may be made available to undertake any of the activities 
described in this subsection.
22.With the approval of the governor, to lease or transfer use of any part of the life skills 
and transition center facilities or properties, located in section thirteen, township one 
hundred fifty-seven north, range fifty-three west, located in Walsh County, North 
Dakota, to the federal government, or any public or private agency, organization, or 
business enterprise, or any worthy undertaking, under the following provisions:
a.The department determines that the facility or property is not needed to serve 
any present or reasonably foreseeable need of the life skills and transition center.
b.The transaction is exempt from the provisions of section 50-06-06.6.
c.The term of any lease may not exceed ninety-nine years.
d.All required legal documents, papers, and instruments in any transaction must be 
reviewed and approved as to form and legality by the attorney general.
e.Any funds realized by any transaction must be deposited in the state's general 
fund.
23.To act as a decedent's successor for purposes of collecting amounts due to the 
department or human service zone, unless otherwise directed or determined by the 
department. Any affidavit submitted by the department under section 30.1-23-01 must 
conform to the requirements of that section except that the affidavit may state that 
twenty days have elapsed since the death of the decedent.
24.To provide those services necessary for the department and for human service zones 
to comply with the provisions of any law, rule, order, or regulation of the United States 
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or any federal agency or authority requiring civil service or merit standards or 
classifications as a condition for providing funds administered by the department.
25.For purposes of administration of programs, and subject to legislative appropriation, 
funds are obligated at the time a written commitment is made to pay a vendor or 
contractor for services or supplies either delivered or to be delivered. This subsection 
applies to payments and commitments made on or after January 1, 1997.
26.To determine eligibility for medical assistance and children's health insurance program 
benefits when the department receives a joint application for these benefits.
27.To develop a system of services and supports to provide behavioral health services 
and supports in the community for children at risk of or identified as having a 
behavioral health condition and for the families of these children. This system must 
include early intervention, treatment, and recovery services and supports and must 
interface with, but not include, child protective services or juvenile court.
28.To provide resources on mental health awareness and suicide prevention to the 
behavioral health resource coordinator at each school. The resources must include 
information on identifying warning signs, risk factors, and the availability of resources 
in the community.
29.To administer, allocate, and distribute any funds made available for kinship care 
services and payments and services in response to the federal Family First Prevention 
Services Act as part of the Bipartisan Budget Act of 2018 [Pub. L. 115-123].
30.To contract with another human service zone or any other public or private person to 
discharge any of the department's duties or exercise any of the department's powers 
to administer human services.
31.To act on behalf of the department of public instruction to administer part B, 
section 619 of the Individuals with Disabilities Education Act [Pub. L. 108-446; 229 
Stat. 2647; 20 U.S.C. 1411 et seq.].
32.In the event of a disruption of operations, to provide meals at a fair value or without a 
charge to employees of the department at the North Dakota state hospital, life skills 
and transition center, and regional human service centersstate-operated behavioral 
health clinics twenty-four hour staffed residential units as required by the job 
assignments of the employees.
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33.May pay a stipend, within the limit of legislative appropriation, to a recipient or a 
provider of a recipient receiving assistance or services under any program 
administered by or under the supervision and direction of the department to allow the 
recipient or provider to serve on a council or board.
34.Notwithstanding any other requirements, to appeal an order of a judge of the district 
court or juvenile court that orders the department to perform or provide a function, 
service, or duty.
35.To require providers that receive funding from the department to submit process and 
outcome measures to the department for programs and services supported by state 
funding for the department to evaluate the administration of the programs and services 
using the appropriation for the program or service.
SECTION 16. AMENDMENT. Section 50-06-05.2 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06-05.2. Regional human service centersState-operated behavioral health clinics - 
Licensure.
Human
1.Community-based behavioral health services must be delivered through regional 
human service centersstate-operated behavioral health clinics in the areas designated 
by the governor's executive order 1978-12 dated October 5, 1978. The department 
shall request appropriations and resources sufficient for accreditation:
a.Accreditation and to ensure maintenance of the accreditation for the regional 
human service centersstate-operated behavioral health clinics, including 
associated facilities, by the council on accreditationthe social current or by a 
similar national accrediting body accepted by the department; and
b.Certification as a certified community behavioral health clinic.
2.The regional human service centersstate-operated behavioral health clinics are 
subject to licensing or certification by the department. The department may use the 
accreditation as a basis for licensing in lieu of adopted rules for the operation of the 
regional human service centersstate - operated behavioral health clinics 	. The 
department shallmay adopt rules for the operation of the regional human service 
centersstate-operated behavioral health clinics. A regional human service centerstate-
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operated behavioral health clinic may not operate without a license or certification 
issued in accordance with this section or section  30 of this Act . Regional human 
service centersState-operated behavioral health clinics are authorized to receive 
federal and other funds available to finance, in whole or in part, the services and 
operations of the centersstate-operated behavioral health clinics.
SECTION 17. AMENDMENT. Section 50-06-05.3 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06-05.3. Regional human service centersState-operated behavioral health clinics - 
Powers - Duties - Human service advisoryAdvisory groups.
1.Regional human service centersState-operated behavioral health clinics shall provide 
human services and assistance to all eligible individuals and families to help 
individuals and families achieve or maintainsupport individuals in achieving social, 
emotional, and economic self-sufficiency by providing human services and assistance 
to:
a.Prevent, reduce, or eliminate dependencyBuild resilience, self-sufficiency, and 
independence;
b.Prevent or reduce inappropriateSupport individuals to succeed in the least 
restrictive environments, reduce the need for institutional care by providing for 
care while institutionalized or providing foraccess to community-based orand 
other forms of less restrictivesupportive services that span the continuum of care;
c.Secure referral or admission for institutional careFacilitate access to specialized 
care when needed and coordinate timely referrals and transitions to appropriate 
levels of care;
d.Provide outpatient diagnostic and treatment services; and
e.Provide rehabilitationrehabilitative and crisis services for patients withsupport for 
individuals with mental health, emotional, or substance use disorders, an 
intellectual disability, and other psychiatric conditions, particularly for those 
patients who have received prior treatment in anchallenges, including those with 
complex needs, to promote continuity of care and successful reentry from 
inpatient facilitysettings.
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2.Regional human service centersState-operated behavioral health clinics shall deliver 
services in the manner prescribed by the department.
3.Regional human service centersState-operated behavioral health clinics may provide 
behavioral health collaborative care and consultation services, including psychiatric 
consultation, with private providers and correctional facility providers.
4.Each regional human service centerstate-operated behavioral health clinic must have 
a human servicesbehavioral health clinic advisory group consisting of the human 
service zone directors of the region served, the public health directors of the region 
served, two current county commissioners appointed by the commissioner of the 
department or the commissioner's designee, and five additional members appointed 
by the commissioner of the department or the commissioner's designee. Each 
behavioral health clinic advisory group member must be a resident of the region the 
member is appointed to serve. The term of office for each appointed member is two 
years and arranged so that the term of three of the appointed members expires at the 
end of the first year and the term of the remaining four appointed members expires at 
the end of the second year, except for those first members appointed, three members 
shall serve a one-year term and four members shall serve a two-year term. The 
commissioner of the department or the commissioner's designee shall select the 
appointed members of each human servicebehavioral health clinic advisory group on 
the basis of population of the counties in the region served by the regional human 
service centerstate-operated behavioral health clinic. Each county in the region must 
be represented by at least one member on the human servicebehavioral health clinic 
advisory group. To the extent possible, appointed membership of the behavioral health 
clinic advisory group must reflect regional interests in the fields of developmental 
disabilities, social services, mental health, and substance use disorders. The 
commissioner of the department or the commissioner's designee shall appoint a 
chairman for each behavioral health clinic advisory group from the membership of the 
behavioral health clinic advisory group. The commissioner of the department or the 
commissioner's designee shall fill a vacancy occurring within ana behavioral health 
clinic advisory group for other than the expiration of a term in the same manner as 
original appointments, except that appointments must be made only for the unexpired 
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term. The department shall compensate appointed members of a human 
servicebehavioral health clinic advisory group at the rate of forty-five dollars per day, 
not to exceed twenty-five days in any one year. The department also shall pay 
members for mileage and actual expenses incurred in attending meetings and in the 
performance of their official duties in the amounts provided by law for other state 
officers.
SECTION 18. AMENDMENT. Section 50-06-05.4 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06-05.4. Duties of human servicebehavioral health clinic advisory groups.
Each human servicebehavioral health clinic advisory group of the regional human service 
centersstate-operated behavioral health clinics shall perform the following duties:
1.Provide information to the department relative to needs assessment and the planning 
and development of health and social resources for the effective and efficient delivery 
of high-quality humanbehavioral health services fully accessible to all citizens.
2.Review services and programs provided by the regional human service centersstate-
operated behavioral health clinics and make periodic recommendations for 
improvement in services, programs, or facilities.
3.Promote cooperation and working agreements with public agencies, including public 
health and corrections and private human servicebehavioral health agencies.
4.Promote local and regional financing from public and private sources.
SECTION 19. AMENDMENT. Section 50-06-05.5 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06-05.5. Director of regional centerstate-operated behavioral health clinic - 
Medical director.
Each regional human service centerstate-operated behavioral health clinic must be headed 
by a regional director appointed by the commissioner of the department. The regionalstate-
operated behavioral health clinic director must be accountable to the commissioner of the 
department or the commissioner's designee. Each regionalstate-operated behavioral health 
clinic director may employ the staff necessary to discharge the center'sstate-operated 
behavioral health clinic's responsibilities. A regionalstate-operated behavioral health clinic 
director, subject to the approval of the commissioner of the department or the commissioner's 
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designee, and within the limit of legislative appropriations, may make contractual arrangements 
with public or private agencies or with individuals and organizations to discharge the regional 
human service center'sstate-operated behavioral health clinic's service delivery responsibilities. 
Each regional director shall hire a qualified medical professional who must be designated as the 
medical director of the centerstate-operated behavioral health clinic. The medical director is 
responsible for coordinating mental health and medically related services. The medical 
director's position may be part time or full time as determined appropriate by the regionalstate-
operated behavioral health clinic director, with the concurrence of the commissioner of the 
department or the commissioner's designee. As used in this section, "qualified medical 
professional" means a board-eligible or board-certified psychiatrist, when such an individual can 
be employed, and when this is not possible, an individual possessing at least a medical degree.
SECTION 20. AMENDMENT. Section 50-06-06.2 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06-06.2. Clinic services - Provider qualification - Utilization of federal funds.
Within the limits of legislative appropriation therefor and in accordance with rules 
established by the department, the department may defray the costs of preventive diagnostic, 
therapeutic, rehabilitative, or palliative items or services furnished medical assistance eligible 
individuals by regional human service centersstate-operated behavioral health clinics or 
designated behavioral health providers. Within the limits of legislative appropriations and to the 
extent permitted by state and federal law and regulations established thereunder, it is the intent 
of the legislative assembly that federal funds available under title XIX of the Social Security Act 
[42 U.S.C. 1396 et seq.] be utilized to defray the costs of identifiable mental health clinic 
services furnished eligible individuals in regional human service centersstate-operated 
behavioral health clinics and that federal funds available under title XX of the Social Security Act 
[42 U.S.C. 1397 et seq.] be utilized to defray the costs of identifiable human services furnished 
to eligible individuals by human service zones and regional human service centersstate-
operated behavioral health clinics.
SECTION 21. AMENDMENT. Section 50-06-06.5 of the North Dakota Century Code is 
amended and reenacted as follows:
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50-06-06.5. Continuum of services for individuals with serious and persistent mental 
illness.
1.The department shall develop a plan for an integrated, multidisciplinary continuum of 
services for individuals with serious and persistent mental illness. The continuum may 
consist of an array of services provided by private mental health professionals, private 
agencies, human service zones, regional human service centersstate-operated 
behavioral health clinics, community-based residential care and treatment facilities, 
and private and public inpatient psychiatric hospitals. When appropriate, access to the 
continuum must be through regional human service centers. Within the limits of 
legislative appropriations, the plan for a continuum may include:
a.Programs, and appropriate related facilities, to provide socialization skills.
b.Programs, and appropriate related facilities, to provide basic living skills.
c.Appropriate residential facilities and other housing options.
d.Appropriate training, placement, and support to enhance potential for 
employment.
e.Appropriate delivery and control of necessary medication.
f.Appropriate economic assistance.
g.An inpatient facility with appropriate programs to respond to persons who require 
hospitalization.
h.Peer and recovery support.
i.Crisis service that is available twenty-four hours a day seven days a week.
2.The continuum of care must provide that a person requiring treatment be submitted to 
the least restrictive available conditions necessary to achieve the purposes of 
treatment. The department shall ensure appropriate cooperation with human service 
zones and private providers in achieving the continuum of care.
SECTION 22. AMENDMENT. Section 50-06-06.13 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06-06.13. Treatment services for children with serious emotional disorders.
1.The department shall establish a program to provide out-of-home treatment services 
for a Medicaid-eligible child with a serious emotional disorder. The department may 
not require a parent or legal guardian to transfer legal custody of the child in order to 
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have the child placed in an out-of-home treatment program if the sole reason for the 
placement is the need to obtain services for the child's emotional or behavioral 
problems. With departmental approval, a parent with legal and physical custody or a 
legal guardian of the child may obtain treatment services for the child through the 
program. A parent without physical custody of a child, who disagrees with a child's 
treatment under this section, may request a judicial determination regarding the child's 
treatment.
2.The department may establish a program to prevent out-of-home placement for a 
Medicaid-eligible child with a behavior health condition as defined in the "Diagnostic 
and Statistical Manual of Mental Disorders", American psychiatric association, fifth 
edition, text revision (2013).
SECTION 23. AMENDMENT. Subsections 1 and 3 of section 50-06-15 of the North Dakota 
Century Code are amended and reenacted as follows:
1.Individually identifiable information concerning an individual applying for or receiving 
assistance or services under any program administered by or under the supervision 
and direction of the department is confidential, except that any such information, 
including an individual's social security number, may be used and disclosed:
a.In the administration of any such program;
b.In accordance with a program's participation in the department's master client 
index data matching system, unless prohibited by federal law;
c.As specifically authorized by the rules of the department; or
d.As permitted or required by other law; or
e.Notwithstanding confidentiality laws set forth in titles   14, 23, 25, 43, and   50 and 
the department's rules, within and between the department's divisions to assist 
with or to provide assistance or services under any program administered by or 
under the supervision and direction of the department. The disclosure of 
information under this subdivision must comply with applicable federal laws and 
regulations.
3.As used in this section, "individually identifiable information" means information, 
including an individual's name, address, telephone number, facsimile number, social 
security number, electronic mail address, program identification number, protected 
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health information, personally identifiable information, or any other unique identifying 
number, characteristic, or code, as well as demographic information collected from an 
individual, that:
a.Is created or received by the department; and
b.Relates to:
(1)The past, present, or future assistance or services applied for or received by 
an individual under any program administered by or under the supervision 
and direction of the department that identifies the individual or with respect 
to which there is a reasonable basis to believe the information can be used 
to identify the individual; or
(2)A report, or any other information obtained, concerning an applicant or a 
provider of or an individual applying for or receiving assistance or services 
under any program administered by or under the supervision and direction 
of the department.
SECTION 24. AMENDMENT. Section 50-06-33 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06-33. Dementia care services.
As used in this section, "dementia" means the condition of an individual involving loss of 
memory and impairment of cognitive functions severe enough to interfere with the individual's 
daily life. The department shall contract with a private provider for a dementia care services 
program in each area of the state served by a regional human service centerstate-operated 
behavioral health clinic. The dementia care services must include:
1.Identifying available services within the region;
2.Providing information to medical professionals, law enforcement, and the public 
regarding the symptoms of dementia, the benefits of early detection and treatment, 
and the services available to individuals with dementia and their caregivers;
3.Assessing the needs of individuals with dementia and their caregivers;
4.Training care providers to manage and provide for the care of individuals with 
dementia;
5.Providing consultation services to individuals with dementia and their caregivers; and
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6.Facilitating the referral of individuals with dementia and their caregivers to appropriate 
care and support services.
SECTION 25. AMENDMENT. Section 50-06-41.3 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06-41.3. Behavioral health bed management system.
1.The department shall establish and maintain a behavioral health bed management 
system to improve utilization of behavioral health bed capacity. 
2.Public and private providers of residential or inpatient behavioral health services, 
except the department of corrections and rehabilitation and geropsychiatric facilities, 
shall participate in and report daily.
3.Geropsychiatric facilities shall participate in and report  	weekly and within forty 	- eight  
hours of a bed becoming available.
4.Public and private providers of residential or inpatient behavioral health services 
required to participate in and report to the department shall provide the information 
and documentation necessary to maintain the behavioral health bed management 
system in the form and manner prescribed by the department, unless otherwise 
specified.
SECTION 26. AMENDMENT. Subsection 1 of section 50-06-42 of the North Dakota 
Century Code is amended and reenacted as follows:
1.The department shall establish and administer, within the limits of legislative 
appropriations, a voucher system to address underserved areas and gaps in the 
state's substance abuse treatment system and to assist in the payment of addiction 
treatment services provided by licensed substance abuse treatment programs, 
excluding regional human service centersstate-operated behavioral health clinics and 
hospital- or medical clinic-based programs for medical management of withdrawal. An 
out-of-state licensed substance abuse treatment program located within a bordering 
state may participate in the voucher program to serve an underserved area of this 
state pursuant to the rules adopted by the department. The department shall develop 
rules to include processes and requirements for an out-of-state provider to receive 
reimbursement only for outpatient and community-based services upon a provider 
completing an assessment of need and receiving approval from the department.
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SECTION 27. AMENDMENT. Subsection 1 of section 50-06-42.1 of the North Dakota 
Century Code is amended and reenacted as follows:
1.A licensed substance abuse treatment program, excluding regional human service 
centersstate-operated behavioral health clinics and hospital or medical clinic-based 
programs for medical management of withdrawal, may apply for a competitive 
substance use disorder treatment voucher system grant. A licensed substance abuse 
treatment program is eligible for a one-time grant award. To receive a grant, a licensed 
substance abuse treatment program shall:
a.Submit an application in the form and manner prescribed by the department;
b.Enter a grant agreement with the department;
c.Use grant funds for a licensed substance abuse treatment program with fewer 
than seventeen beds in an underserved area, as determined by the department, 
in the state's substance abuse treatment system;
d.Use the grant funds to support the provision of substance use disorder treatment 
in underserved areas of the state's substance abuse treatment system;
e.Provide and disclose information needed to comply with the department's data 
collection requirements; and
f.Operate in compliance with grant requirements.
SECTION 28. AMENDMENT. Section 50-06-46 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06-46. Cross-disability advisory council - Appointment - Duties. (Expired effective 
August 1, 20252027)
1.The cross-disability advisory council shall participate with and provide feedback to the 
department regarding the implementation, planning, and design of the cross-disability 
children's waiver, level of care reform for the comprehensive developmental disabilities 
Medicaid home and community-based waiver, and a service option that will allow 
payment to a legally responsible individual who provides extraordinary care to an 
eligible individual through the Medicaid 1915(c) waivers. This subsection does not 
apply to the Medicaid 1915(c) home and community-based services aged and 
disabled waivers.
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2.The department shall contract with a qualified, independent third party to facilitate and 
provide support services to the council. The contracted facilitator and the department 
shall appoint the cross-disability advisory council members in accordance with 
subsection 3 and establish the length of member terms and the structure of the 
cross-disability advisory council. A representative from the contracted facilitator shall 
serve as the presiding officer of the advisory council.
3.The cross-disability advisory council consists of up to fifteen voting members. A 
majority of the members of the council must be family members of individuals with a 
disability, or must be who represent a broad range of disabilities and regions of the 
state. The members are:
a.Two individuals with a disability, who receive Medicaid home and 
community-based services. The remaining members of the council must be 
appointed based on their professional subject matter expertise in or knowledge of 
the needs and interests of individuals with disabilities. The council's membership 
must represent different regions of the state and a broad range of disabilities that 
pertain to the Medicaid home and community-based services.;
b.One individual with a developmental disability or who is Medicaid qualified, who 
does not receive Medicaid home or community 	- based services; 
c.Four individuals representing diverse organizations advocating for individuals 
with disabilities;
d.One individual who is a provider or representative of developmental disability 
services;
e.One individual representing an organization and advocating for individuals with 
behavioral health needs;
f.One individual representing an organization advocating for individuals with fetal 
alcohol spectrum disorder;
g.One individual representing tribal communities, with a focus on disability 
services;
h.Two individuals who are parents or guardians of children under the age of 
eighteen with disabilities; and
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i.Two individuals who are parents or guardians of individuals age eighteen or over 
with disabilities.
4.Upon request of the department, state agency representatives shall participate with 
the cross-disability advisory council in a nonvoting role.
4.5.The cross-disability advisory council shall meet at least quarterly and may appoint 
subcommittees to address specific topics or disabilities, which may include autism 
spectrum disorder, traumatic brain injury, and fetal alcohol spectrum disorder. A 
majority of the voting members of the council constitutes a quorum.
5.6.The cross-disability advisory council shall:
a.Discuss strategies to address gaps or needs regarding individuals with 
disabilities and Medicaid home and community-based services, including 
eligibility of legally responsible individuals;
b.Provide for the active participation of stakeholders, including consumers and 
providers; and
c.Receive information from the department and its consultants.
6.7.The cross-disability advisory council members, excluding the contracted facilitator, are 
entitled to reimbursement from the department for travel and lodging at the same rate 
as provided for state officers and employees.
SECTION 29. A new section to chapter 50-06 of the North Dakota Century Code is created 
and enacted as follows:
Certified community behavioral health clinics - Rules.
1.To operate in this state, a certified community behavioral health clinic must be certified 
by the department.
2.The department shall adopt rules for the certification of community behavioral health 
clinics, including assessment of need in the proposed location.
3.The department may deny a request to become or revoke a certified community 
behavioral health clinic's certification based on failure to comply with the rules adopted 
by the department or deny a request to become a certified community behavioral 
health clinic based on the assessment of need determination.
SECTION 30. A new section to chapter 50-06 of the North Dakota Century Code is created 
and enacted as follows:
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Financing of health and human services.
1.The powers and duties carried out by the department under this title may be financed 
out of a special fund within the state treasury to be known as the health and human 
services operating special fund;
2.The commissioner of the department or the commissioner's designee and the state 
treasurer shall deposit in the health and human services operating special fund, at 
such times as they may become available;
a.All moneys received from any of the counties within the state;
b.All moneys received from the United States under the provisions of the Social 
Security Act;
c.Such moneys as may be periodically required from legislative appropriations for 
department purposes; and
d.All public moneys received from any other source.
3.Expenditures made under this title must be paid upon vouchers prepared by the office 
of management and budget drawn on the state treasurer against the health and 
human services operating special fund and signed by the state auditor and state 
treasurer after approval by the office of management and budget. Expenditures to be 
supported by itemized vouchers must be signed by the commissioner of the 
department or by the commissioner's designee and certified to the office of 
management and budget.
4.Any funds received from federal agencies must be deposited and disbursed as 
provided and in accordance with Acts of Congress or the regulations of the federal 
agencies from which the funds were received.
SECTION 31. AMENDMENT. Section 50-06.2-01 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06.2-01. Purpose - Interpretation.
It is the purpose of this chapter to establish a system for planning, coordinating, and 
providing comprehensive human services administered by human service zones and human 
service centersstate-operated behavioral health clinics. This chapter must be construed to 
effectuate the following public purposes:
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1.To help individuals or their families to achieve, maintain, or support the highest 
attainable level of personal independence and economic self-sufficiency.
2.To prevent, remedy, or alleviate neglect, abuse, or exploitation of children and adults 
unable to protect their own interests.
3.To provide a continuum of community-based services adequate to appropriately 
sustain individuals in their homes and in their communities and to delay or prevent 
institutional care.
4.To preserve, rehabilitate, and reunite families.
5.To assist in securing referral or admission of individuals to institutional care when other 
forms of care are not appropriate.
SECTION 32. AMENDMENT. Section 50-06.2-02 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06.2-02. Definitions.
As used in this chapter:
1."Comprehensive human services" means services included in the comprehensive 
human services plan published by the state agency and human services required by 
state law or state agency regulation or federal law or regulation as a condition for the 
receipt of federal financial participation in programs administered under the provisions 
of this title.
2."Family home care" means the provision of room, board, supervisory care, and 
personal services to an eligible elderly or disabled person by the spouse or by one of 
the following relatives, or the current or former spouse of one of the following relatives, 
of the elderly or disabled person: parent, grandparent, adult child, adult sibling, adult 
grandchild, adult niece, or adult nephew. The family home care provider need not be 
present in the home on a twenty-four-hour basis if the welfare and safety of the client 
is maintained.
3."Human service center" means a regional center established under section 
50-06-05.3.
4."Human service zone" means a county or consolidated group of counties 
administering human services within a designated area in accordance with an 
agreement or plan approved by the state agency.
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5.4."Human service zone plan" means the human service zone plan required by section 
50-06.2-04.
6.5."Human services" means:
a.A service or assistance provided to an individual or an individual's family in need 
of services or assistance, including child welfare services, economic assistance 
programs, medical service programs, and aging service programs, to assist the 
individual or the individual's family in achieving and maintaining basic 
self-sufficiency, including physical health, mental health, education, welfare, food 
and nutrition, and housing.
b.A service or assistance provided, administered, or supervised by the department 
in accordance with chapter 50-06.
c.Licensing duties as administered or supervised by the department or delegated 
by the department to a human service zone.
7.6."Qualified service provider" means a human service zone or independent contractor 
which agrees to meet standards for service and operations established by the state 
agency.
8.7."State agency" means the department of health and human services.
8."State-operated behavioral health clinic" means a department-operated behavioral 
health clinic established under section 50 	- 06 - 05.2. 
SECTION 33. AMENDMENT. Section 50-06.2-03 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06.2-03. Powers and duties of the state agency.
1.The state agency has the following powers or duties under this chapter:
1.a.To act as the official agency of the state in the administration of the human 
services for individuals and families in conformity with state and federal 
requirements.
2.b.To prepare, at least biennially, a comprehensive human services plan which 
must:
a.(1)Include human services determined essential in effectuating the purposes of 
this chapter.
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b.(2)Detail the human services identified by the state agency for provision by 
human service centers and the services which the human service zones 
make available in approved human service zone plans as a condition for the 
receipt of any funds allocated or distributed by the state agency.
3.c.To make available, through human service zone or human service centersstate-
operated behavioral health clinics, any or all of the services set out in the 
comprehensive human services plan on behalf of those individuals and families 
determined to be eligible for those services under criteria established by the state 
agency.
4.d.To supervise and direct the comprehensive human services administered by 
human service zone and human service centersstate-operated behavioral health 
clinics through standard-setting, technical assistance, approval of human service 
zone and regional plans, preparation of the comprehensive human services plan, 
evaluation of comprehensive human services, and distribution of public money 
for services.
5.e.Within the limits of legislative appropriations and at rates determined payable by 
the state agency, to pay qualified service providers, which meet standards for 
services and operations, for the provision of the following services as defined in 
the comprehensive human services plan which are provided to individuals who, 
on the basis of functional assessments, income, and resources, are determined 
eligible for the services in accordance with rules adopted by the state agency:
a.(1)Homemaker services;
b.(2)Chore services;
c.(3)Respite care;
d.(4)Home health aide services;
e.(5)Case management;
f.(6)Family home care;
g.(7)Personal attendant care;
h.(8)Adult family foster care; and
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i.(9)Such other services as the state agency determines to be essential and 
appropriate to sustain individuals in their homes and in their communities 
and to delay or prevent institutional care.
6.f.To take actions, give directions, and adopt rules as necessary to carry out the 
provisions of this chapter.
2.For purposes of this chapter, resources do not include the individual's primary home 
and the first fifty thousand dollars of liquid assets.
SECTION 34. AMENDMENT. Section 50-06.3-02 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06.3-02. Fees for services at regional centers.
The department may charge and collect fees and expenses for services provided through 
its regional human service centersstate-operated behavioral health clinics, and may authorize 
charging of fees for child support services. The department may establish fee scales which 
recognize the service recipient's or responsible relative's ability to pay. The department shall 
adopt such rules as are necessary to implement this chapter and to define terms used in this 
chapter.
SECTION 35. AMENDMENT. Section 50-06.3-04 of the North Dakota Century Code is 
amended and reenacted as follows:
50-06.3-04. Liability for payment.
The recipient, patient, recipient's or patient's estate, and recipient's or patient's spouse are 
liable for fees and expenses for services rendered by the department, through its regional 
human service centersstate-operated behavioral health clinics, and for care and treatment 
expenses charged at the state hospital. The parents of a recipient or patient are responsible for 
services, care, and treatment provided prior to the eighteenth birthday of the recipient or patient.
SECTION 36. APPROPRIATION - DEPARTMENT OF HEALTH AND HUMAN SERVICES - 
ONE-TIME FUNDING. There is appropriated out of any moneys in the general fund in the state 
treasury, not otherwise appropriated, the sum of $150,000, or so much of the sum as may be 
necessary, to the department of health and human services for the purpose of constructing 
behavioral health clinic signage, for the biennium beginning July 1, 2025, and ending June 30, 
2027. This funding is considered a one-time funding item.
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