# Title 33 — State Department of Health

## Article 33-03 — Public Health Division

## Chapter 33-03-25 — Alternative Health Care Services Projects

### § 33-03-25-01. Definitions.

1. "Alternative health care services pilot project" means any health care service subject to
licensure or certification by the department in which the state health council must waive any
existing North Dakota law or rule in order for the project to be developed or operated. This
may include, but not be limited to, state laws or rules governing the standards of practice
regulating health professionals such as physicians, nurses, pharmacists, or other health
professionals; changes in state tax laws, health care reimbursement through state programs,
health facility and health program standards, and other changes judged appropriate by the
council. The intent of the alternative health care services pilot project is to provide a means for
testing new and experimental ways of providing health care services.
2. "Council" means the state health council.
3. "Department" means the state department of health.
4. "Waiver" means that applicable state laws or rules relative to the creation or operation of a
pilot project providing alternative health care services do not need to be met for a period of
time as specified by the council, but not exceeding the duration of the approved pilot project.
History: Effective December 1, 1991.
General Authority: NDCC 23-01-04.3
Law Implemented: NDCC 23-01-04.3
### § 33-03-25-02. Term of pilot project.

The term of the project must begin on the date of the council's initial approval. Any project
approved by the council must be for a term of up to one year with renewals for a maximum term of five
years.
History: Effective December 1, 1991.
General Authority: NDCC 23-01-04.3
Law Implemented: NDCC 23-01-04.3
### § 33-03-25-03. Process.

1. Forms for applying as a pilot project must be available from the department. Completed
applications must be submitted to the department.
2. The department shall review the application within sixty days of its receipt. The review must
evaluate the project for compliance with section 33-03-25-05 and with federal and state laws
and rules. Following its review, the department shall send the application and review to the

council. Upon submission of the application to the council, the department shall issue notices
of a public hearing on the application.
a. The notice must be at least thirty days prior to the public hearing and must appear in the
official newspaper of each county served by the pilot project.
b. At the same time the department issues the notice of a public hearing, the notice and a
copy of the application must be sent to public or private agencies or boards that have
been identified by the department as having a responsibility for licensure, certification, or
regulation of people or programs directly affected by the proposed project and to any
other person requesting a copy of the application or notice.
c. The public hearing must occur at the next regularly scheduled council meeting.
3. The council shall make a decision on the application within one hundred eighty days after the
public hearing.
History: Effective December 1, 1991.
General Authority: NDCC 23-01-04.3
Law Implemented: NDCC 23-01-04.3
### § 33-03-25-04. Criteria.

Criteria to be considered must include:
1. The number of people who will be served.
2. The size of the geographical area, its location, and its designation as a health professional
shortage area.
3. Evidence that the project will contain the cost of health care and provide a high quality of care.
4. Evidence that the project provides financial and geographical access to needed health care
services.
5. Evidence that the project is primary care focused with referral and emergency provisions.
6. Evidence of unmet health care needs which require the waivers requested.
History: Effective December 1, 1991.
General Authority: NDCC 23-01-04.3
Law Implemented: NDCC 23-01-04.3
### § 33-03-25-05. Standards.

1. Unless waived by the council, a pilot project must be in compliance with all state laws and
rules.
2. Each pilot project must maintain safety and quality associated with the provision of health care
services.
3. Personnel operating or providing health services must be competent and knowledgeable in
terms of the services provided.
4. Backup personnel must be available to provide emergency medical assistance.
5. The physical plant must be appropriate for the services provided.
History: Effective December 1, 1991.

General Authority: NDCC 23-01-04.3
Law Implemented: NDCC 23-01-04.3
### § 33-03-25-06. Report from pilot project.

As a condition of approval, the applicant must agree to report at least quarterly to the department
and provide information specified by the council and department.
History: Effective December 1, 1991.
General Authority: NDCC 23-01-04.3
Law Implemented: NDCC 23-01-04.3
### § 33-03-25-07. Onsite review and continued approval.

The department shall conduct an onsite review following initiation of the pilot project and at least
one annual unannounced onsite review to evaluate the pilot project. Based on the onsite reviews and
other information, the department shall provide an annual report to the council on each pilot project.
Based on its review and other information, the council shall renew its approval of the pilot project,
require modification of the pilot project, or deny continued operation of the pilot project.
History: Effective December 1, 1991.
General Authority: NDCC 23-01-04.3
Law Implemented: NDCC 23-01-04.3
### § 33-03-25-08. Council report.

The council shall provide a written report of its findings concerning each pilot project and will make
recommendations to the next legislative assembly concerning any necessary changes in North Dakota
statutes.
History: Effective December 1, 1991.
General Authority: NDCC 23-01-04.3
Law Implemented: NDCC 23-01-04.3
### § 33-03-25-09. Termination.

Any project may be terminated at any time by the council or at the request of the legal agent of the
project. The council may base its decision upon evidence that people have been or will be harmed by
further operation or use of the pilot project, upon evidence that the project is excessively costly to
operate or use, upon evidence that the project is not meeting its expressed purpose or meeting the
needs of the people served, or upon other evidence considered by the council sufficient to justify
termination. Discontinuance of a pilot project must be accomplished in an orderly fashion in a time
frame and manner approved by the department.
History: Effective December 1, 1991.
General Authority: NDCC 23-01-04.3
Law Implemented: NDCC 23-01-04.3
