2012 North Dakota Century Code Title 23 Health and Safety Chapter 23-01 State Department of Health
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TITLE 23
HEALTH AND SAFETY
CHAPTER 23-01
STATE DEPARTMENT OF HEALTH
23-01-01. State department of health - Officers.
The state department of health consists of a health council, a state health officer, section
chiefs, directors of divisions, and other employees of the department.
23-01-01.1. State department of health to replace state department of health and
consolidated laboratories.
Wherever the terms "North Dakota state department of health", "department of health",
"health department", "state department of health and consolidated laboratories", "North Dakota
state laboratories department", "state laboratories department", "state laboratories department
director", or "state laboratories director" appear in this code, the term "state department of
health" must be substituted therefor.
Wherever the terms "state food commissioner and chemist" and "commissioner" when
referring to the state food commissioner and chemist appear in chapters 19-17 and 19-18, the
term "state department of health" must be substituted therefor.
23-01-01.2. State department of health designated primary state environmental
agency.
The state department of health is the primary state environmental agency.
23-01-02. Health council - Members, terms of office, vacancies, compensation,
officers, meetings.
The health council consists of eleven members appointed by the governor in the following
manner: four persons from the health care field, five persons representing consumer interests,
one person from the energy industry, and one from the manufacturing and processing industry.
The governor may select members to the council from recommendations submitted by trade,
professional, and consumer organizations. On the expiration of the term of any member, the
governor, in the manner provided by this section, shall appoint for a term of three years, persons
to take the place of members whose terms on the council are about to expire. The officers of the
council must be elected annually. Any state agency may serve in an advisory capacity to the
health council at the discretion of the council. The council shall meet at least twice each year
and at other times as the council or its chairman may direct. The health council shall have as
standing committees any committees the council may find necessary. The chairman of the
council shall select the members of these committees. The members of the council are entitled
to receive sixty-two dollars and fifty cents as compensation per day and their necessary mileage
and travel expenses as provided in sections 44-08-04 and 54-06-09 while attending council
meetings or in the performance of any special duties as the council may direct. The per diem
and expenses must be audited and paid in the manner in which the expenses of state officers
are audited and paid. The compensation provided for in this section may not be paid to any
member of the council who received salary or other compensation as a regular employee of the
state, or any of its political subdivisions, or any institution or industry operated by the state.
23-01-02.1. Hospital utilization committees - Internal quality assurance review
committees - Reports - Immunity.
Repealed by S.L. 1997, ch. 234, § 5.
23-01-03. Powers and duties of the health council.
The health council shall:
1. Fix, subject to the provisions of section 23-01-02, the time and place of the meetings
of the council.
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2.
Make rules and regulations for the government of the council and its officers and
meetings.
3. Establish standards, rules, and regulations which are found necessary for the
maintenance of public health, including sanitation and disease control.
4. Provide for the development, establishment, and enforcement of basic standards for
hospitals and related medical institutions which render medical and nursing care, and
for the construction and maintenance of such institutions, such standards to cover
matters pertaining to sanitation, building construction, fire protection measures,
nursing procedures, and preservation of medical records. No rule may be adopted with
respect to building construction of existing medical hospitals or related medical
institutions unless the rule relates to safety factors or the hospital or related medical
institution changes the scope of service in such a way that a different license is
required from the department pursuant to rules adopted under chapter 23-16.
5. Hold hearings on all matters brought before it by applicants and licensees of medical
hospitals with reference to the denial, suspension, or revocation of licenses and make
appropriate determination as specified herein.
The council may direct the state health officer to do or cause to be done any or all of the things
which may be required in the proper performance of the various duties placed upon the state
department of health.
23-01-03.1. Newborn metabolic and genetic disease screening tests.
The health council may authorize the use of newborn metabolic and genetic disease
screening tests, as provided for in chapter 25-17, for research purposes. The council shall adopt
rules to ensure that the results are used for legitimate research purposes and to ensure that the
confidentiality of the newborns and their families is protected.
23-01-03.2. Duties of the health council.
The health council shall:
1. Monitor overall health care costs and quality of health care in the state.
2. Recommend to the appropriate interim legislative committees changes to the health
care system in the state.
3. Publish an annual report on health care in the state.
23-01-03.3. Long-term care nursing scholarship and loan repayment grant program.
1. The state health council, in cooperation with the North Dakota long term care
association, shall administer the long-term care nursing scholarship and loan
repayment grant program. The purpose of the program is to provide matching funds to
nursing facilities for the facilities to use in recruiting and retaining nurses by providing
scholarships to nursing facility staff and other individuals to obtain a nursing education
and by assisting in the repayment of student loans for licensed nurses employed in a
nursing facility. The state health council shall adopt rules necessary to administer the
program, including rules establishing criteria regarding eligibility for and distribution of
program grants.
2. An applicant for a program grant shall establish that the applicant:
a. Is a licensed nursing facility;
b. Has available matching funds equal to the amount of the grant request; and
c. Meets the eligibility criteria established by rule.
3. An eligible applicant may receive a program grant not exceeding five thousand five
hundred dollars in the first year of the biennium. Any funds appropriated by the
legislative assembly for the grant program which are remaining after the first year of
the biennium may be distributed to eligible applicants in the second year of the
biennium in any amount determined by the state health council.
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23-01-04. Effect of rules and regulations.
All rules and regulations promulgated by the health council under the powers granted by
any provisions of this title are binding upon all county and municipal health officers, and upon all
county, municipal, and private medical hospitals and upon related institutions, and have the
force and effect of law.
23-01-04.1. Rulemaking authority and procedure.
1. Except as provided in subsection 2, no rule which the state department of health,
hereinafter the department, adopts for the purpose of the state administering a
program under the federal Clean Air Act, federal Clean Water Act, federal Safe
Drinking Water Act, federal Resource Conservation and Recovery Act, federal
Comprehensive Environmental Response, Compensation and Liability Act, federal
Emergency Planning and Community Right to Know Act of 1986, federal Toxic
Substances Control Act, or federal Atomic Energy Act of 1954, may be more stringent
than corresponding federal regulations which address the same circumstances. In
adopting such rules, the department may incorporate by reference corresponding
federal regulations.
2. The department may adopt rules more stringent than corresponding federal
regulations or adopt rules where there are no corresponding federal regulations, for
the purposes described in subsection 1, only if it makes a written finding after public
comment and hearing and based upon evidence in the record, that corresponding
federal regulations are not adequate to protect public health and the environment of
the state. Those findings must be supported by an opinion of the department referring
to and evaluating the public health and environmental information and studies
contained in the record which form the basis for the department's conclusions.
3. If the department, upon petition by any person affected by a rule of the department,
identifies rules more stringent than federal regulations or rules where there are no
corresponding federal regulations, the department shall review and revise those rules
to comply with this section within nine months of the filing of the petition.
4. All existing rules of the department remain in full force and effect after July 10, 1989,
pending department review and revision under subsection 3.
5. Any person who is issued a notice of violation, or a denial of a permit or other
approval, based upon a rule of the department which is more stringent than a
corresponding federal regulation or where there is no corresponding federal regulation,
may assert a partial defense to that notice, or a partial challenge to that denial, on the
basis and to the extent that the department's rule violates this section by imposing
requirements more stringent than corresponding federal regulations, unless the more
stringent rule of the department has been adopted in compliance with this section.
6. The provisions of this section may not be construed so as to require the department to
review and propose revisions to any existing rule regarding the collection of fees by
the department in connection with the administration of any program identified in
subsection 1.
23-01-04.2. Legislative intent - Health vaccination charges.
It is the intent of the legislative assembly that the state department of health adopt rules
defining appropriate administration charges for vaccine provided by the department to
physicians, private clinics, and hospitals.
23-01-04.3. Alternative health care services pilot project - Application - Notice Hearing - Approval - Duration.
1. At any time that the health care needs of a city, township, or other geographic area are
not being adequately met, any person may apply to the state health council for
approval to conduct an alternative health care services pilot project. The application
must address the need for and benefits of the pilot project. It must also contain a
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detailed description of the nature and scope of the project, quality control,
organization, accountability, responsibility, and financial feasibility.
Upon receipt of an application under subsection 1, the state health council shall
schedule a public hearing, send notice to all interested parties, and give public notice
of the hearing by publication in the official newspaper of each county in the pilot project
area. At the hearing, the council shall accept written and oral testimony. The council
shall review the application and all testimony presented at the hearing and approve,
disapprove, or modify and approve the application based on criteria established by the
council. The criteria must address the availability and use of health personnel,
facilities, and services.
Notwithstanding any other provisions of law, upon approval of an application submitted
under subsection 1, the state health council, in consultation with the state health officer
and any other public or private entity consulted by the state health council, shall set
the standards for the delivery of health care services by the pilot project. The
standards may not adversely affect the state's participation in federal medicare and
medicaid programs. No more than three separate projects may be operational at any
time and no project may be operational for longer than five years.
23-01-05. Health officer - Qualifications, salary, term, duties - Advisory committee.
The governor shall appoint the state health officer who must have had substantive private or
public administrative experience and demonstrated experience in the management of people.
The state health officer is entitled to receive a salary commensurate with that person's training
and experience. The governor shall set the salary of the state health officer within the limits of
legislative appropriations to the department. The state health officer is entitled to receive all
necessary traveling expenses incurred in the performance of official business. The state health
officer may not engage in any other occupation or business that may conflict with the statutory
duties of the state health officer and holds office for a term of four years beginning January 1,
1993. The state health officer is the administrative officer of the state department of health. If the
governor does not appoint as state health officer a physician licensed in this state, the governor
shall appoint at least three licensed physicians recommended by the state medical association
to serve as an advisory committee to the state health officer. Each member of the advisory
committee is entitled to receive reimbursement of expenses in performing official duties in
amounts provided by law for other state officers. The term of the advisory committee coincides
with the term of the state health officer. A committee member serves at the pleasure of the
governor. The duties of the state health officer are as follows:
1. Enforce all rules and regulations as promulgated by the health council.
2. Hold public health unit boards of health responsible for enforcement of state rules,
serve in an advisory capacity to public health unit boards of health, and provide for
coordination of health activities.
3. Establish and enforce minimum standards of performance of the work of the local
department of health.
4. Study health problems and plan for their solution as may be necessary.
5. Collect, tabulate, and publish vital statistics for each important political or health
administrative unit of the state and for the state as a whole.
6. Promote the development of local health services and recommend the allocation of
health funds to local jurisdictions subject to the approval of the health council.
7. Collect and distribute health education material.
8. Maintain a central public health laboratory and where necessary, branch laboratories
for the standard function of diagnostic, sanitary and chemical examinations, and
production and procurement of therapeutic and biological preparations for the
prevention of disease and their distribution for public health purposes.
9. Establish a service for medical hospitals and related institutions to include licensing of
such institutions according to the standards promulgated by the health council and
consultation service to communities planning the construction of new hospitals and
related institutions.
10. Comply with the state merit system policies of personnel administration.
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Establish a program to provide information to the surviving family of a child whose
cause of death is suspected to have been the sudden infant death syndrome.
Issue any orders relating to disease control measures deemed necessary to prevent
the spread of communicable disease. Disease control measures may include special
immunization activities and decontamination measures. The state health officer may
apply to the district court in a judicial district where a communicable disease is present
for an injunction canceling public events or closing places of business. On application
of the state health officer showing the necessity of such cancellation, the court may
issue an ex parte preliminary injunction, pending a full hearing.
Make bacteriological examination of bodily secretions and excretions and of waters
and foods.
Make preparations and examinations of pathological tissues submitted by the state
health officer, by any county superintendent of public health, or by any physician who
has been regularly licensed to practice in this state.
Make all required analyses and preparations, and furnish the results thereof, as
expeditiously and promptly as possible.
Cause sanitary statistics to be collected and tabulated, and cause to be ascertained by
research work such methods as will lead to the improvement of the sanitation of the
various parts of the state.
From time to time, cause to be issued bulletins and reports setting forth the results of
the sanitary and pathological work done in the laboratories embodying all useful and
important information resulting from the work carried on in the laboratories during the
year, the substance of such bulletins and reports to be incorporated in the annual
report of the state health officer.
Establish by rule a schedule of reasonable fees that may be charged for laboratory
analysis. No charge may be made for any analysis conducted in connection with any
public health incident affecting an entire region, community, or neighborhood.
a. Establish a review process for instances in which the department is requested to
conduct an epidemiological assessment of a commercial building. The
epidemiological assessment must include:
(1) A statement of whether there are known environmental causes;
(2) If there are known environmental causes identified, a recommendation of
how they can be remediated or mitigated; and
(3) If there are no known environmental causes identified, a statement that no
known causes exist.
b. Costs for remediation, mitigation, and consultant services are the responsibility of
the building owner. Proof of remediation of any identified environmental concern
related to the epidemiological assessment is the burden of the building owner.
23-01-05.1. Organ or tissue transplant assistance administration - Standing
appropriation.
The state health officer shall select a private nonprofit patient-oriented organization
incorporated in this state for the purpose of administering financial assistance to organ or tissue
transplant patients who are residents of this state. The state health officer shall adopt rules
governing administration of this section. The organization selected shall administer and provide
grants from available funds to alleviate demonstrated financial needs of transplant patients for
any costs associated with transplant operations, under guidelines based on current social
service eligibility requirements. There is hereby created as a special fund in the state treasury
an organ transplant support fund, the principal and income of which is hereby appropriated to
the organization selected under this section. The organization administering the fund may solicit
contributions from private or governmental sources and such contributions may be deposited in
the fund.
23-01-05.2. Administration of epinephrine - Liability.
1. The state health officer shall adopt rules to authorize a layperson to administer
epinephrine to an individual who has a severe allergic reaction.
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3.
An individual authorized to administer epinephrine by the state health officer may
obtain premeasured doses of epinephrine and the necessary paraphernalia for
epinephrine administration from any licensed physician or pharmacist.
An individual authorized to administer epinephrine by the state health officer, and the
employer of such an individual, is not civilly or criminally liable for any act or omission
of that individual when acting in good faith while rendering emergency treatment to an
individual who has a severe adverse reaction, except when the conduct amounts to
gross negligence.
23-01-05.3. Immunization data.
1. The state department of health may establish an immunization information system and
may require the childhood immunizations specified in subsection 1 of section
23-07-17.1 and other information be reported to the department. The state department
of health may only require the reporting of childhood immunizations and other data
upon completion of the immunization information reporting system. A health care
provider who administers a childhood immunization shall report the patient's identifying
information, the immunization that is administered, and other required information to
the department. The report must be submitted using electronic media, and must
contain the data content and use the format and codes specified by the department.
2. If a health care provider fails to submit an immunization report required under this
section within four weeks of vaccination:
a. That health care provider may not order or receive any vaccine from the North
Dakota immunization program until that provider submits all reports required
under this section.
b. The state department of health shall make a report to that health care provider's
occupational licensing entity outlining that provider's failure to comply with the
reporting requirements under this section.
3. Notwithstanding any other provision of law, a health care provider, elementary or
secondary school, early childhood facility, public or private postsecondary educational
institution, city or county board of health, district health unit, and the state health officer
may exchange immunization data in any manner with one another. Immunization data
that may be exchanged under this section is limited to the date and type of
immunization administered to a patient and may be exchanged regardless of the date
of the immunization.
23-01-05.4. Department to employ state forensic examiner - Qualifications - Duties.
The state department of health may employ and establish the qualifications and
compensation of the state forensic examiner. The state forensic examiner must be a physician
who is board-certified or board-eligible in forensic pathology, who is licensed to practice in this
state, and who is in good standing in the profession. The state forensic examiner shall:
1. Exercise all authority conferred upon the coroner under chapter 11-19.1 and any other
law;
2. Consult with local coroners on the performance of their duties as coroners;
3. Conduct investigations into the cause of death of and perform autopsies on any
deceased human body whenever requested to do so by the acting local county
coroner or the local state's attorney;
4. Provide training and educational materials to local county coroners, law enforcement,
and any other person the state forensic examiner deems necessary;
5. Maintain complete records of the cause, manner, and mode of death necessary for
accurate health statistics and for public health purposes; and
6. Perform other duties assigned by the state health officer.
23-01-05.5. Autopsy reports - Confidential - Exceptions.
1. As used in this section:
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"Autopsy report" means the report of the forensic examiner or the examiner's
designee on the post-mortem examination of a deceased individual to determine
the cause and manner of death, including any written analysis, diagram,
photograph, or toxicological test results.
b. "Report of death" means the official findings on the cause of death and manner of
death issued by the state forensic examiner, the examiner's designee, county
coroner, or pathologist performing an autopsy ordered by a county coroner or by
the state forensic examiner and which is the face page of the autopsy report
identifying the decedent and stating the cause of death and manner of death.
An autopsy report and any working papers and notes relating to an autopsy report are
confidential and may be disclosed only as permitted by this section. The report of
death is a public record subject to disclosure under section 44-04-18.
Subject to the limitations on the disclosure of an autopsy photograph or other visual
image or video or audio recording of an autopsy required under section 44-04-18.18,
any working papers and notes relating to a final autopsy report may be disclosed
pursuant to a court order and as otherwise expressly provided by law.
The state forensic examiner or the examiner's designee shall disclose a copy of the
autopsy report:
a. To any county coroner, including a coroner in any state or Canadian province,
with jurisdiction over the death, and the coroner may use or disclose these
records for purposes of an investigation, inquest, or prosecution.
b. To any state's attorney or criminal justice agency, including a prosecutor or
criminal justice agency of the United States, any state, or any Canadian province,
with jurisdiction over an investigation of the death and the state's attorney or
criminal justice agency may use or disclose these records for the purposes of an
investigation or prosecution.
c. To workforce safety and insurance if the death is related to the decedent's work,
and to any other workers' compensation or other similar program, established by
law, that provides benefits for work-related injuries or illness without regard to
fault if there is no criminal investigation.
d. To the child fatality review panel if there is no active criminal investigation.
e. In accordance with a court order.
The state forensic examiner or the examiner's designee upon request shall disclose a
copy of the autopsy report to:
a. The decedent's personal representative and to the decedent's spouse, child, or
parent, upon proof of the relationship, if there is no active criminal investigation.
b. A physician or hospital who treated the deceased immediately prior to death if
there is no active criminal investigation.
c. An insurance company upon proof that the decedent's life was covered by a
policy issued by the company if there is no active criminal investigation.
d. The food and drug administration, the national transportation safety board, the
occupational health and safety administration, and any other federal or state
agency with authority to obtain an autopsy report to investigate a death resulting
from the decedent's type of injury or illness.
e. A professional or research organization collecting data to initiate or advance
death investigation standards, after the identifiers necessary to create a limited
data set under title 45, Code of Federal Regulations, part 164, section 514,
subsection e have been removed from the report.
The forensic examiner, the examiner's designee, any county coroner or county medical
coroner, and any public employee who, in good faith, discloses autopsy findings, an
autopsy report, or other information relating to an autopsy report or cause of death to a
person who the public official or employee reasonably believes is entitled to that
information under this section is immune from any liability, civil or criminal, for making
that disclosure. For the purposes of any proceeding, the good faith of any public
employee who makes a disclosure under this section is presumed.
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23-01-06. Biennial report - Contents.
The state health officer shall submit a biennial report to the governor and the secretary of
state in accordance with section 54-06-04. In addition to any requirements established pursuant
to section 54-06-04, the report must cover the following subjects:
1. The activities of the various divisions, the work accomplished during the two years
covered by the report, and an analysis of the program of each of the divisions.
2. The expenditures of the state department of health.
3. The expenditures in each county board of health or the district board of health.
4. Any reports relating to the hospital program as required by the health council.
23-01-07. Structure of department.
Repealed by S.L. 1993, ch. 218, § 10.
23-01-08. Directors of divisions - Deputy - Appointment, salary, duties.
The state health officer shall appoint directors of the various divisions of the department and
shall determine the salary, within the limits of legislative appropriations to the department and in
conformity with the state merit system, to be received by such persons. The duties of such
director must be those prescribed by the state health officer. The state health officer may
appoint a deputy state health officer. A deputy state health officer who does not hold a
health-related degree may not individually issue an order regarding public health unless the
order is cosigned by a physician who is employed by the department or cosigned by the state
epidemiologist. The deputy state health officer serves at the pleasure of the state health officer.
23-01-09. Duties of director of consolidated laboratories branch.
Repealed by S.L. 1993, ch. 218, § 10.
23-01-09.1. Duties of state toxicologist.
Repealed by S.L. 2003, ch. 469, § 13.
23-01-10. Office space.
The state shall provide suitable office space in Bismarck for housing and maintaining the
state department of health. Special fireproof vaults must be provided for the storage of birth and
death certificates.
23-01-11. Acceptance of funds and right to qualify for benefits under federal laws
authorized.
The state department of health may:
1. Accept funds from cities, counties, the federal government, private organizations, and
individuals for infancy and maternal hygiene, for other public health work and for the
purpose of conducting a survey of existing medical hospitals and related institutions,
planning of needed hospital construction and for construction and maintenance of
such medical hospitals and related institutions. When approved by the governor of this
state, the state department of health may match the same from any unexpended
portion of its appropriation in accordance with specifications agreed to or required by
congressional act. All infancy and maternal hygiene and public health work must be
done under the supervision of the state department of health.
2. Adopt rules necessary to enable the state to be in compliance with any federal laws in
order to qualify for any federal funds related to medical facilities or agencies licensed
by the state department of health.
23-01-12. Hospital records to be kept at direction of state health officer.
When any person is admitted into a lying-in hospital or other institution, public or private, to
which persons resort for the treatment of disease or for confinement, or to which persons are
committed by process of law, the superintendent, manager, or other person in charge of such
institution shall make a record of all the personal and statistical particulars relative to such
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person. The record must be in such form as is directed by the state health officer. In the case of
any person admitted or committed for medical treatment of disease, the physician in charge
shall specify for entry in the records the nature of the disease and where, in the physician's
opinion, it was contracted. The personal particulars and information required for compliance with
the provisions of this section must be obtained from the individual personally if practicable, and
when the information cannot be obtained from the individual, from the individual's relatives or
friends or from any other person acquainted with the facts.
23-01-13. Blood plasma - Obtaining, storing, and distributing.
Repealed by S.L. 1991, ch. 263, § 1.
23-01-14. State department of health authorized to transfer future accumulated fees.
As a continuing policy, the state department of health may automatically from time to time
transfer unclaimed fees on deposit with the Bank of North Dakota or other authorized depository
to the state general fund when the unclaimed status has existed for a period of at least three
years.
23-01-15. Research studies confidential - Penalty.
1. All information, records of interviews, written reports, statements, notes, memoranda,
or other data procured by the state department of health, in connection with studies
conducted by the state department of health, or carried on by the department jointly
with other persons, agencies, or organizations, or procured by such other persons,
agencies, or organizations, for the purpose of reducing the morbidity or mortality from
any cause or condition of health is confidential and must be used solely for the
purposes of medical or scientific research.
2. Such information, records, reports, statements, notes, memoranda, or other data is not
admissible as evidence in any action of any kind in any court or before any other
tribunal, board, agency, or person. Such information, records, reports, statements,
notes, memoranda, or other data may not be exhibited nor their contents disclosed in
any way, in whole or in part, by any officer or representative of the state department of
health, nor by any other person, except as may be necessary for the purpose of
furthering the research project to which they relate. No person participating in such
research project may disclose, in any manner, the information so obtained except in
strict conformity with such research project. No officer or employee of said department
may interview any patient named in any such report, nor a relative of any such patient,
unless the consent of the attending physician and surgeon is first obtained.
3. The furnishing of such information to the state department of health or its authorized
representative, or to any other cooperating agency in such research project, does not
subject any person, hospital, sanitarium, rest home, nursing home, or other person or
agency furnishing such information, to any action for damages or other relief.
23-01-16. Dairy products - Joint standards.
The state department of health and the dairy department of the department of agriculture
shall jointly adopt a set of uniform standards in relation to all matters falling within their joint
jurisdiction regarding dairy products. The state department of health, district health units,
municipal health departments or units, and the dairy department shall each be permitted to
accept any inspection report of the other department or unit regarding the inspection of dairy
products and the producers and processors of such products, when such report is based
substantially upon standards conforming with the milk ordinance and code recommended by the
United States public health service.
23-01-17. Noise harmful to health and safety - Power to regulate - Hearings - Appeal Penalty - Injunction.
Repealed by S.L. 1991, ch. 264, § 1.
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23-01-18. State department of health responsible for control of rabies.
Repealed by S.L. 1999, ch. 243, § 2.
23-01-19. Extermination of rabies.
Repealed by S.L. 1999, ch. 243, § 2.
23-01-20. Traumatic head injury defined.
Repealed by S.L. 1999, ch. 231, § 1.
23-01-21. Central registry of traumatic head injury - Establishment - Reports.
Repealed by S.L. 1999, ch. 231, § 1.
23-01-22. Department to employ waste management facility inspectors.
The state department of health shall employ and establish the qualifications, duties, and
compensation of at least one full-time inspector for each commercial, nonpublicly owned waste
management disposal or incineration facility that accepts more than twenty-five thousand tons
[22679.5 kilograms] per year of hazardous waste, industrial waste, nuclear waste, or ash
resulting from the incineration of municipal solid waste. This section does not apply to any
energy conversion facility or coal mining operation that disposes of its solid waste onsite. The
department may require inspectors for those facilities that accept less than twenty-five thousand
tons [22679.5 kilograms] per year. The facility inspector shall conduct regular inspections of the
operating procedure and conditions of the facility and report the findings to the department on a
regular basis. If an inspector discovers a condition at a facility that is likely to cause imminent
harm to the health and safety of the public or environment, the inspector shall notify the
department. The department shall proceed as provided by sections 23-29-10 and 23-29-11.
The department shall assess the owner or operator of a waste management facility that
accepts hazardous waste, industrial waste, nuclear waste, or ash resulting from the incineration
of municipal solid waste an annual fee to pay the salaries, wages, and operating expenses
associated with employing an inspector for the facility. The owner or operator of the facility shall
submit the fee to the department by July first of each year. Any fees collected must be deposited
in the department's operating fund in the state treasury and any expenditures from the fund are
subject to appropriation by the legislative assembly. If a facility begins operation after July first of
any year, the owner or operator of the facility shall pay to the department a prorated fee for the
fiscal year before the facility may begin accepting waste. Moneys in the waste management
facility account may be spent by the department within the limits of legislative appropriation.
23-01-23. Permit or investigatory hearings - Exemption from chapters 28-32 and
54-57.
A permit hearing conducted for purposes of receiving public comment or an investigatory
hearing conducted under chapters 23-20.1, 23-20.3, 23-25, 23-29, 61-28, and 61-28.1 is not an
adjudicative proceeding under chapter 28-32 and is not subject to the requirements of chapter
54-57.
23-01-24. Health care cost and quality review program - Penalty.
The department of health shall conduct a continuous program to review and improve the
quality of health care in the state. The department may contract with a qualified person or
organization to develop and implement the program. The department shall use the program to
compile relevant information about the quality of health care in this state which will allow the
department to evaluate the cost, quality, and outcomes of health care. The department shall
establish and consult a provider advisory committee composed of health care providers
regarding the data that is a cost-effective process for collecting and evaluating the information.
The state health officer may assess against a provider a penalty of one hundred dollars per day
for each day the provider willfully refuses to provide the department with information requested
for use with the program, but the penalty may not exceed one thousand dollars for each
request. A provider against whom a fee is assessed may appeal that assessment to the state
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health council. If the provider fails to pay the penalty, the health council may, in the county
where the provider's principal place of business is located, initiate a civil action against the
provider to collect the penalty. As used in this section, "provider" means a person who is
licensed, certified, or otherwise authorized by the law of this state to administer health care in
the ordinary course of business or professional practice. The department shall ensure that
patient privacy is protected throughout the compilation and use of the information. The
department shall evaluate data management capabilities in the state and shall organize its
capabilities to provide information about the cost of care on an individual provider basis as well
as a collective basis.
23-01-25. Commercial feed, insecticide, fungicide, rodenticide, fertilizer, and soil
conditioner laws - Laboratory function.
Notwithstanding any other provision of law, any laboratory test or analysis required under
chapter 19-13.1, 19-18, or 19-20.1 must be performed by the state department of health for the
agriculture commissioner at no charge.
23-01-26. State department of health - Indirect cost recoveries.
Notwithstanding section 54-44.1-15, the state department of health may deposit indirect
cost recoveries in its operating account.
23-01-27. Donated dental services program.
The state department of health shall contract with the North Dakota dental association, or
other appropriate and qualified organizations, to develop and administer a donated dental
services program through which volunteer dentists provide comprehensive dental care for
needy, disabled, aged, or medically compromised individuals. The volunteers will treat
individuals through the program and, with the exception of certain dental laboratory costs, will
fully donate their services and supplies. The contract must specify the responsibilities of the
administering organization and include:
1. Establishment of a network of volunteer dentists, including dental specialists, volunteer
dental laboratories, and other appropriate volunteer professionals to donate dental
services to eligible individuals;
2. Establishment of a system to refer eligible individuals to appropriate volunteers;
3. Development and implementation of a public awareness campaign to educate eligible
individuals about the availability of the program;
4. Provision of appropriate administrative and technical support to the program; and
5. Submission of an annual report to the state department of health that:
a. Accounts for all program funds;
b. Reports the number of individuals served by the program and the number of
dentists and dental laboratories participating as providers in the program;
c. Includes any other information required by the state department of health; and
d. Performs, as required by the state department of health, any other duty relating to
the program.
23-01-28. Combined purchasing with local public health units - Continuing
appropriation.
The state department of health may make combined or joint purchases with or on behalf of
local public health units for items or services. Payments received by the state department of
health from local public health units pursuant to a combined or joint purchase must be deposited
in the operating fund and are appropriated as a standing and continuing appropriation to the
state department of health for the purpose of this section.
23-01-29. Bone marrow donor education.
The state department of health shall provide information and educational materials to the
public regarding bone marrow donation through the national marrow donor program. The
department shall seek assistance from the national marrow donor program to establish a
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system to distribute materials, ensure that the materials are updated periodically, and address
the education and recruitment of minority populations.
23-01-30. Zoning regulation of concentrated animal feeding operations - Central
repository.
The state department of health shall establish, operate, and maintain an electronically
accessible central repository for all county and township zoning regulations that pertain to
concentrated animal feeding operations. The county auditor of a county and the township clerk
of a township having a zoning regulation that pertains to concentrated animal feeding operations
shall file the regulation with the state department of health for inclusion in the central repository.
23-01-31. North Dakota health information technology steering committee.
Repealed by S.L. 2009, ch. 519, § 6.
23-01-32. Viral hepatitis program - Vaccination - Study.
1. The state department of health shall establish and administer a viral hepatitis program
with the goal of distributing to residents of the state who are at an increased risk for
exposure to viral hepatitis information that addresses the higher incidence of
hepatitis C exposure and infection among these populations, addresses the dangers
presented by the disease, and provides contacts for additional information and
referrals.
2. The department shall establish a list of classes of individuals by category that are at
increased risk for viral hepatitis exposure. The list must be consistent with
recommendations developed by the federal centers for disease control and prevention.
The department shall determine the type of information the department will distribute
under the program and the form and manner of distribution.
3. The department shall establish a vaccination and testing program, to be coordinated
by the department through local public health units.
23-01-33. Human papilloma virus - Information.
The state department of health shall educate the public about the human papilloma virus
and the availability of a human papilloma virus vaccine; promote immunization against the
human papilloma virus; and distribute informational material regarding the human papilloma
virus and the human papilloma virus vaccine. The department shall distribute the informational
material through relevant department programs and divisions, including breast and cervical
cancer control programs; immunization programs; family planning programs; and human
immunodeficiency virus and sexually transmitted disease programs. Informational materials
distributed must include the recommendations of the advisory committee on immunization
practices of the federal centers for disease control and prevention; contain information relevant
to the target populations of each of the participating programs and divisions distributing the
informational material; and contain information regarding the availability of the vaccine through
the vaccines for children program operated by the department under 42 U.S.C. 1396s, and the
medical assistance program.
23-01-34. Children with special health care needs - Program administration.
The state department of health shall administer programs for children with special health
care needs as may be necessary to conform to title 5, part 2, of the federal Social Security Act,
as amended through July 1, 2007 [Pub. L. 74-271; 49 Stat. 620; 42 U.S.C. 701 et seq.],
including providing services and assistance to children with special health care needs and their
families and developing and operating clinics for the identification, screening, referral, and
treatment of children with special health care needs.
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23-01-35. Tattooing, body piercing, branding, subdermal implants, or scarification Permit - Fee - Adoption of rules - Exemptions - Injury reports.
1. A person may not operate a facility providing tattooing, body piercing, branding,
subdermal implant, or scarification services without a permit issued by the department
under this section. The holder of a permit shall display the permit in a conspicuous
place at the facility for which the permit is issued. A permit issued under this section
expires annually. An applicant for a permit shall submit an application for a permit to
the department, on a form provided by the department, with a permit fee established
by the department. The application must include the name and complete mailing
address and street address of the facility and any other information reasonably
required by the department for the administration of this section.
2. The health council shall adopt rules to regulate any person that receives compensation
for engaging in the practice of tattooing, body piercing, branding, subdermal implants,
or scarification. The rules must establish health and safety requirements and
limitations with respect to the age of an individual who may receive a tattoo, body
piercing, or scarification and may prohibit any practice that the health council deems
unsafe or a threat to public health.
3. A facility is exempt from subsection 1 if the facility provides body piercing that is limited
to the piercing of the noncartilaginous perimeter or lobe of the ear and the facility does
not provide tattooing, branding, scarification, or subdermal implants. A person is
exempt from regulation under subsection 2 if the person's practice under this section is
limited to piercing of the noncartilaginous perimeter or lobe of the ear. A licensed
health care professional acting within that professional's scope of practice and the
associated medical facility are exempt from this section.
4. If a customer of a facility regulated under this section reports to the facility an injury the
customer or operator of the facility believes to have resulted from the tattooing, body
piercing, branding, subdermal implanting, or scarification provided at the facility, the
operator of the facility shall provide the customer with written information on how to
report the alleged injury to the state department of health. If a licensed health care
professional treats a patient for an injury the professional determines, in the exercise
of professional judgment, occurred as a result of a service regulated under this
section, the professional shall report the circumstances to the state department of
health. A licensed health care professional is immune from liability for making or not
making a report under this subsection.
5. The fees established by the department must be based on the cost of conducting
routine and complaint inspections and enforcement actions and preparing and sending
license renewals. Fees collected under this section must be deposited in the
department's operating fund in the state treasury and any expenditure from the fund is
subject to appropriation by the legislative assembly. The department shall waive all or
a portion of the fee for any facility that is subject to local jurisdiction.
23-01-36. Appeal from permit proceedings.
An appeal from the issuance, denial, modification, or revocation of a permit issued under
chapter 23-20.3, 23-25, 23-29, or 61-28 may be made by the person who filed the permit
application, or by any person who is aggrieved by the permit application decision, provided that
person participated in or provided comments during the hearing process for the permit
application, modification, or revocation. An appeal must be taken within thirty days after the final
permit application determination is mailed by first-class mail to the permit applicant and to any
interested person who has requested a copy of the final permit determination during the permit
hearing process. Except as provided in this section, an appeal of the final permit determination
is governed by sections 28-32-40, 28-32-42, 28-32-43, 28-32-44, 28-32-46, and 28-32-49. The
department may substitute final permit conditions and written responses to public comments for
findings of fact and conclusions of law. Except for a violation of chapter 23-20.3, 23-25, 23-29,
or 61-28 which occurs after the permit is issued, or any permit condition, rule, order, limitation,
or other applicable requirement implementing those chapters which occurs after the permit is
issued, any challenge to the department's issuance, modification, or revocation of the permit or
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permit conditions must be made in the permit hearing process and may not be raised in any
collateral or subsequent legal proceeding, and the applicant and any aggrieved person may
raise on appeal only issues that were raised to the department in the permit hearing process.
23-01-37. Survey program - Health facilities construction or renovation projects.
1. The state department of health shall conduct a life safety survey process for all health
facilities licensed by the division of health facilities of the state department of health
during and at the conclusion of a construction, renovation, or construction and
renovation project.
2. The department may charge a reasonable fee for the review of plans for construction,
renovation, or construction and renovation projects performed under this section
based on the size of the project. Revenues derived from the fees collected under this
subsection must be deposited in the department's operating fund in the state treasury.
3. The department shall design and operate the program in a manner that will provide
that the surveyor that performs a life safety survey under this section does not violate
the federal requirements associated with medicare-certified life safety surveys.
23-01-38. Electronic drug prior authorization and transmission - Limitations.
1. Effective August 1, 2013, a drug prior authorization request must be accessible to a
health care provider with the provider's electronic prescribing software system and
must be accepted electronically, through a secure electronic transmission, by the
payer, by the insurance company, or by the pharmacy benefit manager responsible for
implementing or adjudicating or for implementing and adjudicating the authorization or
denial of the prior authorization request. For purposes of this section, a facsimile is not
an electronic transmission.
2. Effective August 1, 2013, electronic transmission devices used to communicate a
prescription to a pharmacist may not use any means or permit any other person to use
any means, including advertising, commercial messaging, and popup advertisements,
to influence or attempt to influence through economic incentives the prescribing
decision of a prescribing practitioner at the point of care. Such means may not be
triggered by or be in specific response to the input, selection, or act of a prescribing
practitioner or the prescribing practitioner's staff in prescribing a certain
pharmaceutical or directing a patient to a certain pharmacy. Any electronic
communication sent to the prescriber, including advertising, commercial messaging, or
popup advertisements must be consistent with the product label, supported by
scientific evidence, and meet the federal food and drug administration requirements for
advertising pharmaceutical products.
3. Electronic prescribing software may show information regarding a payer's formulary if
the software is not designed to preclude or make more difficult the act of a prescribing
practitioner or patient selecting any particular pharmacy or pharmaceutical.
23-01-39. Immunization program - Provider choice - Purchasing.
1. As used in this section:
a. "Department" means the state department of health.
b. "North Dakota immunization advisory committee" means the group of private
health care providers, local public health units, department staff, and other
applicable individuals which makes immunization and vaccine selection
recommendations to the North Dakota immunization program.
c. "North Dakota immunization program" means the program administered by the
department to provide vaccinations to North Dakota children consistent with state
and federal law.
d. "Program-eligible child" means any child, who is under nineteen years of age,
whose custodial parent or legal guardian resides in this state.
e. "Vaccine" means any vaccine recommended by the federal advisory committee
on immunization practices of the centers for disease control and prevention.
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f.
2.
"Vaccines for children program" is a federally funded program that provides
vaccines at no cost to eligible children pursuant to section 1928 of the Social
Security Act [42 U.S.C. 1396s].
As part of the North Dakota immunization program:
a. The department shall implement a provider choice system as part of the state's
implementation of the vaccines for children program. This provider choice system
must provide a health care provider participating in the state's vaccines for
children program or in any other immunization program for children, adolescents,
or adults which is administered through the state using federal or state funds,
may select any licensed vaccine, including combination vaccines, and any
dosage forms that have in effect a recommendation from the federal advisory
committee on immunization practices. This subsection does not apply in the
event of a disaster, public health emergency, terrorist attack, hostile military or
paramilitary action, or extraordinary law enforcement emergency.
b. The department shall establish a program through which the department
purchases vaccines through the federal vaccine purchasing contract.
(1) The department shall supply public health units with the purchased
vaccines. A public health unit that receives vaccines under this subdivision
shall administer the vaccines to program-eligible children.
(2) A public health unit that receives vaccines under this purchasing program
may not bill an insurer for the cost of the vaccine but may charge an
administration fee.
(3) The department shall fund this purchasing program through participation in
the vaccines for children program, the federal section 317 vaccine program,
and state funds appropriated for this purpose. If it appears there will be
inadequate funds to fund this purchasing program, the department shall
petition the emergency commission for a transfer from the state contingency
fund. The emergency commission may grant the transfer request, or so
much thereof as may be necessary, to fund this purchasing program.
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