# Title 75 — Department of Human Services

## Article 75-04 — Developmental Disabilities

## Chapter 75-04-01 — Licensing of Programs and Services for Individuals with Intellectual Disabilities - Developmental Disabilities

Developmental Disabilities
- Developmental Disabilities
Management Services
Developmental Disabilities [Repealed]

### § 75-04-01-01. Definitions.

In this chapter, unless the context or subject matter requires otherwise:
1. "Accreditation" means accredited by a department-approved national organization of a
licensee's compliance with a set of specified standards.
2. "Applicant" means an entity that has requested licensure from the North Dakota department of
health and human services pursuant to North Dakota Century Code chapter 25-16 and this
chapter.
3. "Application" means a request in the form and manner prescribed by the department signed
by the applicant or principal officer on behalf of the applicant.
4. "Authorized representative" means a person who has legal authority, either designated or
granted, to make decisions on behalf of the eligible individual.
5. "Day habilitation" means a day program of scheduled activities, formalized training, and staff
supports to promote skill development for the acquisition, retention, or improvement in
self-help, socialization, and adaptive skills. Activities should focus on improving a an eligible
individual's sensory, motor, cognitive, communication, and social interaction skills.
6. "Department" means the North Dakota department of health and human services.
7. "Developmental disability" means a severe, chronic disability of an individual which:
a. Is attributable to a mental or physical impairment or combination of mental and physical
impairments, including Down syndrome and fetal alcohol spectrum disorders, including
fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related
neurodevelopmental disorder;
b. Is manifested before the individual attains age twenty-two;
c. Is likely to continue indefinitely;
d. Results in substantial functional limitations in three or more of the following areas of
major life activity:
(1) Self-care;
(2) Receptive and expressive language;
(3) Learning;

(4) Mobility;
(5) Self-direction;
(6) Capacity for independent living; and
(7) Economic sufficiency; and
e. Reflects the individual's needs for a combination and sequence of special,
interdisciplinary, or generic care, treatment, or other services which are of lifelong or
extended duration and are individually planned and coordinated.
8. "Developmental disability services" means those services required to be provided by an entity
in order to obtain and maintain a license.
9. "Eligible individual" means an individual found eligible as determined through the application
of chapter 75-04-06 for services coordinated through intellectual disabilities - developmental
disabilities program management, on whose behalf services are provided or purchased.
10. "Employment support" means ongoing supports to assist eligible individuals in obtaining and
maintaining paid employment at or above minimum wage in an integrated setting. Services
are designed for eligible individuals who need intensive ongoing support to perform in a work
setting. Service includes on-the-job or off-the-job employment-related support for eligible
individuals needing intervention to assist them in maintaining employment, including job
development. Employment support includes individual employment support and small group
employment support.
11. "Family member" means relatives of a an eligible individual to the second degree of kinship.
12. "Family support services" means a family-centered support service contracted based on the
eligible individual's or primary caregiver's need for support in meeting the health,
developmental, and safety needs to remain in an appropriate home environment. Family
support services includes parenting support, respite, extended home health care, in-home
supports, and family care option.
13. "Governing body" means the individual or individuals designated in the articles of
incorporation of a corporation, bylaws, or constitution of a legal entity as being authorized to
act on behalf of the entity.
14. "Group home" means any community residential service facility, licensed by the department
pursuant to North Dakota Century Code chapter 25-16 and this chapter, housing more than
three individuals with developmental disabilities. "Group home" does not include a community
complex with self-contained rental units.
15. "Infant development" means a systematic application of an individualized family service plan
designed to alleviate or mediate developmental delay of the eligible individual from birth
through age two.
16. "Intellectual disability" means a diagnosis of the condition of intellectual disability, based on an
individually administered standardized intelligence test and standardized measure of adaptive
behavior as accepted by the American psychiatric association, and made by an appropriately
licensed professional.
17. "Intermediate care facility for individuals with intellectual disabilities" means a residential
health facility operated pursuant to title 42, Code of Federal Regulations, parts 442 and 483,
et seq.

18. "License" means authorization by the department to provide a service to eligible individuals,
pursuant to North Dakota Century Code chapter 25-16 and this chapter.
19. "Licensee" means that entity which has received authorization by the department, pursuant to
North Dakota Century Code chapter 25-16 and this chapter and who has executed a Medicaid
agreement with the department, to provide a service or services to eligible individuals.
20. "Prevocational services" means formalized training, experiences, and staff supports designed
to prepare eligible individuals for paid employment in integrated community settings. Services
are structured to develop general abilities and skills that support employability in a work
setting. Services are not directed at teaching job-specific skills, but at specific habilitative
goals outlined in the eligible individual's person-centered service plan.
21. "Primary caregiver" means a responsible person providing continuous care and supervision to
an eligible individual that prevents institutionalization in meeting the needs of the eligible
individual and who is not employed by or working under contract of a licensee pursuant to this
chapter.
22. "Principal officer" means the presiding member of a governing body, a chairperson, or
president of a board of directors.
23. "Program management" means a process of interconnected steps which will assist an eligible
individual in gaining access to needed services, including medical, social, educational, and
other services, regardless of the funding source for the services to which access is gained.
24. "Resident" means an individual receiving services provided through any licensed residential
facility or service.
25. "Residential services" means formalized training and supports provided to eligible individuals
to assist with and develop self-help, socialization, and adaptive skills that improve the eligible
individual's ability to independently reside and participate in an integrated community.
Residential services include residential rehabilitation and independent habilitation.
26. "Standards" means requirements which result in accreditation and, if applicable, certification
as an intermediate care facility for individuals with intellectual disabilities.
History: Effective April 1, 1982; amended effective June 1, 1986; December 1, 1995; April 1, 2000;
July 1, 2001; July 1, 2012; April 1, 2018; April 1, 2020; January 1, 2025.
General Authority: NDCC 25-01.2-18, 25-16-06, 50-06-16
Law Implemented: NDCC 25-01.2-18, 25-16-06
### § 75-04-01-02. License required and renewal.

1. No individual, association of individuals, partnership, limited liability company, or corporation
shall offer or provide a service or own, manage, or operate a facility offering or providing a
service to more than two individuals with developmental disabilities without first having
obtained a license from the department unless the facility is:
a. Exempted by North Dakota Century Code section 15.1-34-02; or
b. Operated by a nonprofit corporation that receives no payments from the state or any
political subdivision and provides only day supports for six or fewer individuals with
developmental disabilities. "Payment" does not include donations of goods and services
or discounts on goods and services.
2. Licensure does not create an obligation for the state to purchase services from the licensee.

3. At the discretion of the department, the department may issue a single license for a discrete
service or issue multiple licenses by service location.
4. A license is nontransferable, expires not more than one year from the effective date of the
license, and is valid for the services or locations identified therein.
5. A license issued by the department must include the legal name of the licensee, the address
or location where services are provided, the occupancy or service limitations, the unique
services authorized, the region and counties where services are provided, and the expiration
date of the license.
6. A licensee shall submit to the department an application for a license no later than sixty days
prior to the expiration date of a valid license. If the licensee is not able to provide the
application within this time frame, a request to waive the sixty days submission timeline must
be submitted to the department prior to the license expiration date. If the licensee continues to
meet all standards established by North Dakota Century Code chapters 25-01.2 and 25-16
and the rules of the department, the department shall issue a license renewal.
7. The licensee shall place the license in an area accessible to the public where it may be readily
seen, except in residences or residential areas of a facility where a license must be available
to the public or the department upon request.
8. Licensees shall sign a Medicaid provider agreement and required addendums with the
department to provide services to eligible individuals.
9. A licensee who voluntarily terminates a license shall submit a new application to reapply for
licensure.
History: Effective April 1, 1982; amended effective June 1, 1986; December 1, 1995; July 1, 2001;
July 1, 2012; April 1, 2018; January 1, 2025.
General Authority: NDCC 25-01.2-18, 25-16-06, 50-06-16
Law Implemented: NDCC 25-01.2-18, 25-16-02, 25-16-03
### § 75-04-01-03. Application.

1. An applicant shall submit an application for a license to provide services or operate a facility to
the department in the form and manner prescribed by the department.
2. An application is not complete until all required information and verifications are submitted to
the department. The department may declare an application withdrawn if an applicant fails to
submit all required information and verifications within thirty days of the department's
notification to the applicant the application is incomplete.
3. Within sixty days from the date of the receipt of the completed application, the department
shall notify the applicant of the department's intent to grant or deny a license.
History: Effective April 1, 1982; amended effective January 1, 2025.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03
### § 75-04-01-03.1. Types of licenses.

A license issued pursuant to North Dakota Century Code chapter 25-16 and this chapter must be
identified as a provisional, unrestricted, or restricted license.
1. A "provisional license" may be issued to an applicant who complies with the rules of the
department, North Dakota Century Code chapters 25-01.2 and 25-16, and who has engaged

in obtaining accreditation. The licensee shall obtain accreditation by the expiration of the
provisional license. A provisional license may be extended for an additional six months only
upon the department's determination the licensee has made significant progress toward
obtaining accreditation.
2. An "unrestricted license" may be issued to an applicant who complies with the rules of the
department and North Dakota Century Code chapters 25-01.2 and 25-16, and who is
accredited.
3. A "restricted license" may be issued to a licensee upon a finding of noncompliance with the
rules of the department and North Dakota Century Code chapters 25-01.2 and 25-16.
a. The department may not issue a restricted license to a licensee whose practices or
facilities pose a clear and present danger to the health and safety of eligible individuals.
b. The department may issue a restricted license for any or all services provided, or
facilities operated by the licensee.
c. Upon a finding that the licensee is not in compliance, the department shall notify the
licensee, in writing, of its intent to issue a restricted license. The notice must provide the
reasons for the action, the specific services that are affected by the restricted license,
and describe the corrective actions required of the licensee.
d. The licensee shall, within ten days of the receipt of notice under subdivision c, submit to
the department, on a form provided, a plan of correction. The plan of correction must
include the elements of noncompliance, a description of the corrective action to be
undertaken, and a date certain of compliance. The department may accept, modify, or
reject the licensee's plan of correction and shall notify the licensees of its decision within
thirty days. If the plan of correction is not submitted or it is rejected, the department shall
notify the licensee the license has been revoked. The department may conduct periodic
inspection of the facilities and operations of the licensee to evaluate the implementation
of the plan of correction.
e. The department shall terminate a restricted license and issue an unrestricted license to
the licensee upon successful completion of an accepted plan of correction.
f. A restricted license may be extended for an additional six months only upon the
department's determination the licensee has made significant progress toward meeting
the standards identified in the plan of correction or the licensee has shown good cause
for failure to implement the plan of correction.
History: Effective January 1, 2025.
General Authority: NDCC 25-01.2-18, 25-16-06, 50-06-16
Law Implemented: NDCC 25-01.2-18, 25-16-02, 25-16-03
### § 75-04-01-04. License denial or revocation.

The department may deny a license to an applicant or licensee or revoke an existing license upon
a finding of noncompliance with North Dakota Century Code chapter 25-01.2 or 25-16 or the rules of
the department.
1. If the department denies a license, the applicant or licensee may not reapply for a license for a
period of six months from the date of denial. After the six-month period has elapsed, the
applicant or licensee may submit a new application to the department.

2. If the department revokes a license, the licensee may not reapply for a license for a period of
one year from the date of the revocation. After the one-year period has elapsed, the licensee
may submit a new application to the department.
3. A license denial or revocation may affect all or some of the services and facilities operated by
a licensee.
4. Notification is made upon mailing or upon electronic transmission. The notice must identify
any law, rule, or standard alleged to have been violated, the factual basis for the allegation,
the specific service or facility responsible for the violation, the date after which the denial or
revocation is final, and the procedure for appealing the action.
5. If an action to revoke a license is appealed, the licensee may continue to provide services
until the final appeal decision is rendered unless continued operations would jeopardize the
health and safety of eligible individuals.
6. The licensee, upon final revocation notification, shall destroy the license.
History: Effective April 1, 1982; amended effective June 1, 1986; April 1, 2018; January 1, 2025.
General Authority: NDCC 25-01.2-18, 25-16-06, 50-06-16
Law Implemented: NDCC 25-01.2-18, 25-16-03, 25-16-08
### § 75-04-01-05. Notification of license.

Repealed effective January 1, 2025.
### § 75-04-01-06. Disclosure of criminal record.

1. Each member of the governing body of the applicant, the chief executive officer, and any
employees, volunteers, or agents who receive and disburse funds on behalf of the governing
body, or who provide any direct service to eligible individuals, shall disclose to the department
if they have been found guilty of, pled guilty to, or pled no contest to a criminal offense or been
placed on the Medicaid exclusion list.
2. The applicant or licensee shall conduct federal and state criminal background checks on all
individuals employed who work with eligible individuals, including volunteers. If the applicant
or licensee is contracting or subcontracting with other entities, there must be an agreement
ensuring federal and state criminal background checks have been completed on all individuals
employed who work with eligible individuals, including volunteers.
3. The applicant or licensee shall disclose to the department the names, type of offenses, dates
of having been found guilty of, pled guilty to, or pled no contest to a criminal offense, and
position and duties within the applicant's organization of employees and volunteers with a
criminal record.
4. Disclosure may not disqualify the applicant from licensure or an individual from employment or
volunteering, unless the applicant or individual has been found guilty of, pled guilty to, or pled
no contest to, a crime having direct bearing on the capacity of the applicant, employee, or
volunteer to provide a service under the provision of this chapter or the convicted applicant,
employee, or volunteer is not sufficiently rehabilitated.
5. The department shall determine the effect of an applicant, employee, or volunteer having been
found guilty of, pled guilty to, or pled no contest to, a criminal offense.
History: Effective April 1, 1982; amended effective June 1, 1986; December 1, 1995; April 1, 2000;
April 1, 2018; January 1, 2025.

General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03.1
### § 75-04-01-06.1. Criminal conviction - Effect on operation of licensee or employment by

licensee.
1. A licensee may not employ in any capacity that involves or permits contact between the
employee or volunteer and any individual cared for by the licensee, an individual who is
known to have been found guilty of, pled guilty to, or pled no contest to:
a. An offense described in North Dakota Century Code chapters 12.1-16, homicide;
12.1-18, kidnapping; 12.1-27.2, sexual performances by children; or 12.1-41, Uniform Act
on Prevention of and Remedies for Human Trafficking; or in North Dakota Century Code
sections 12.1-17-01, simple assault, if a class C felony under subdivision a of
subsection 2 of that section; 12.1-17-01.1, assault; 12.1-17-01.2, domestic violence;
12.1-17-02, aggravated assault; 12.1-17-03, reckless endangerment; 12.1-17-04,
terrorizing; 12.1-17-06, criminal coercion; 12.1-17-07.1, stalking; 12.1-17-12, assault or
homicide while fleeing a police officer; 12.1-20-03, gross sexual imposition;
12.1-20-03.1, continuous sexual abuse of a child; 12.1-20-04, sexual imposition;
12.1-20-05, corruption or solicitation of minors; 12.1-20-05.1, luring minors by computer
or other electronic means; 12.1-20-06, sexual abuse of wards; 12.1-20-06.1, sexual
exploitation by therapist; 12.1-20-07, sexual assault; 12.1-20-12.3, sexual extortion;
12.1-21-01, arson; 12.1-22-01, robbery; or 12.1-22-02, burglary, if a class B felony under
subdivision b of subsection 2 of that section; 12.1-29-01, promoting prostitution;
12.1-29-02, facilitating prostitution; 12.1-31-05, child procurement; 12.1-31-07,
endangering a vulnerable adult; 12.1-31-07.1, exploitation of a vulnerable adult;
14-09-22, abuse of child; 14-09-22.1, neglect of child; subsection 1 of section
26.1-02.1-02.1, fraudulent insurance acts; or an offense under the laws of another
jurisdiction which requires proof of substantially similar elements as required for
conviction under any of the enumerated North Dakota statutes; or
b. An offense, other than an offense identified in subdivision a, if the department determines
that the individual has not been sufficiently rehabilitated.
2. For purposes of subdivision b of subsection 1, an offender's completion of a period of three
years after final discharge or release from any term of probation, parole, or other form of
community correction, or imprisonment, without subsequent charge or conviction, is prima
facie evidence of sufficient rehabilitation.
3. The department has determined that the offenses enumerated in subdivision a of subsection 1
have a direct bearing on the individual's ability to serve the public in a capacity involving the
provision of services to eligible individuals.
4. In the case of an offense described in North Dakota Century Code sections 12.1-17-01, simple
assault, if a felony; 12.1-17-01.1, assault; 12.1-17-01.2, domestic violence, if a misdemeanor;
12.1-17-03, reckless endangerment; 12.1-17-04, terrorizing; 12.1-17-06, criminal coercion;
12.1-17-07.1, stalking; 12.1-18-03, unlawful imprisonment; 12.1-20-05, correction or
solicitation of minors, if a misdemeanor; 12.1-20-07, sexual assault, if a misdemeanor; or
equivalent conduct in another jurisdiction which requires proof of substantially similar elements
as required for conviction, the department may determine the individual has been sufficiently
rehabilitated if five years have elapsed after final discharge or release from any term of
probation, parole, or other form of community corrections or imprisonment.
5. An individual is known to have been found guilty of, pled guilty to, or pled no contest to an
offense when it is:

a. Common knowledge in the community;
b. Acknowledged by the individual;
c. Reported to the licensee as the result of an employee background check; or
d. Discovered by the department or licensee.
History: Effective July 1, 2001; amended effective April 1, 2018; January 1, 2025.
General Authority: NDCC 25-01.2-18, 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03, 25-16-03.1
### § 75-04-01-07. Content of license.

Repealed effective January 1, 2025.
### § 75-04-01-08. Types of licenses.

Repealed effective January 1, 2025.
### § 75-04-01-09. Restricted license.

Repealed effective January 1, 2025.
### § 75-04-01-10. Provisional license.

Repealed effective January 1, 2025.
### § 75-04-01-11. License renewal.

Repealed effective January 1, 2025.
### § 75-04-01-12. Display of license.

Repealed effective January 1, 2025.
### § 75-04-01-12.1. Provider agreement.

Repealed effective January 1, 2025.
### § 75-04-01-13. Purchase of service or recognition of unlicensed entities.

The department may not recognize or approve the activities of unlicensed entities in securing public
funds from the United States, North Dakota, or any of its political subdivisions. The department may not
purchase any service from such entities.
History: Effective April 1, 1982; amended effective June 1, 1986; April 1, 2018.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-18-03
### § 75-04-01-14. Unlicensed entities - Notification.

Upon a determination that activities subject to licensure are occurring or have occurred, the
department shall notify the parties that the activities are subject to licensure. The notice must include a

citation of the applicable provisions of these rules, an application for a license, a date by which the
application must be submitted, and, if applicable, a request for the parties to explain that the activities
identified in the notification are not subject to licensure. The parties must receive notification within
seven days and the entity is required to submit a complete application to the department within thirty
days of notice.
History: Effective April 1, 1982; amended effective December 1, 1995; April 1, 2018.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-02
### § 75-04-01-15. Standards of the department.

The department herein adopts and makes a part of this chapter for all licensees the current
standards used for accreditation, additionally, for intermediate care facilities for individuals with
intellectual disabilities, standards for certification under title 42, Code of Federal Regulations, parts 442
and 483 et seq. If a licensee fails to meet an accreditation standard, the department may analyze the
licensee's failure using the appropriate current standards. Infant development licensees who have
attained accreditation status are not required to maintain accreditation status.
History: Effective April 1, 1982; amended effective June 1, 1986; December 1, 1995; April 1, 2000;
May 1, 2006; July 1, 2012; April 1, 2018; January 1, 2025.
General Authority: NDCC 25-01.2-18, 25-16-06, 50-06-16
Law Implemented: NDCC 25-01.2-02, 25-01.2-18, 25-16-06
### § 75-04-01-16. Imposition of the standards.

The licensee, at the request of the department, shall submit copies of reports generated by the
accreditation process.
History: Effective April 1, 1982; amended effective June 1, 1986; January 1, 2025.
General Authority: NDCC 25-01.2-18, 25-16-06, 50-06-16
Law Implemented: NDCC 25-01.2-02, 25-01.2-18, 25-16-06
### § 75-04-01-17. Identification of developmental disability services subject to licensure.

1. Developmental disability services provided to eligible individuals must be identified and
licensed by the following titles:
a. Residential services:
(1) Residential habilitation; or
(2) Independent habilitation;
b. Day habilitation;
c. Intermediate care facility for individuals with intellectual disabilities;
d. Employment supports:
(1) Individual employment supports; or
(2) Small group employment supports;
e. Prevocational services;
f. Family support services:
(1) Parenting supports;

(2) In-home supports;
(3) Respite;
(4) Extended home health care; or
(5) Family care option; or
g. Infant development services.
2. For services that allow a virtual service delivery option, the licensee shall identify that option
on the license application.
History: Effective April 1, 1982; amended effective June 1, 1986; December 1, 1995; July 1, 1996;
July 1, 2001; July 1, 2012; April 1, 2018; April 1, 2020; January 1, 2025.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-06
### § 75-04-01-18. Identification of ancillary services subject to registration.

Repealed effective June 1, 1986.
### § 75-04-01-19. Licensure of intermediate care facilities for the developmentally disabled.

Repealed effective June 1, 1986.
### § 75-04-01-20. Applicant guarantees and assurances.

1. Applicants shall submit, in a manner prescribed by the department, evidence that policies and
procedures approved by the governing body are written and implemented in a manner which:
a. Guarantees each eligible individual a person-centered service plan pursuant to the
provisions of North Dakota Century Code section 25-01.2-14;
b. Guarantees each eligible individual, authorized representative, or advocate receives
written notice of the eligible individual's rights in the manner provided by North Dakota
Century Code section 25-01.2-16;
c. Guarantees each eligible individual has a right to appropriate treatment, services, and
habilitation and these are provided in the least restrictive appropriate setting pursuant to
North Dakota Century Code section 25-01.2-02;
d. Guarantees the eligible individual the right to receive authorized services and supports
included in his or her person-centered service plan in a timely manner and the
opportunity to fully participate in the benefits of community living, vote, worship, socialize,
freely communicate, have visitors, own and use personal property, and unrestricted
access to legal counsel, and guarantees that all rules regarding such conduct are posted
or made available pursuant to North Dakota Century Code sections 25-01.2-03,
25-01.2-04, and 25-01.2-05;
e. Guarantees any restrictions implemented are based upon an eligible individual's
assessed need and are imposed pursuant to the provisions of due process and a person-
centered service plan;
f. Guarantees the confidentiality of all eligible individual records;

g. Guarantees the eligible individual receives adequate remuneration for compensable
labor, that subminimum wages are paid only pursuant to title 29, Code of Federal
Regulations, part 525, et seq., that the eligible individual has the right to seek meaningful
employment in integrated settings, that restrictions upon eligible individual access to
money are subject to the provisions of a person-centered service plan, that assets
managed by the applicant on behalf of the eligible individual inure solely to the benefit of
that eligible individual, that each eligible individual is assessed on the individual's ability
to manage the individual's finances, and that, in the event the applicant or licensee is a
representative payee of an eligible individual, the informed consent of the eligible
individual is obtained and documented;
h. Guarantees the eligible individual timely access to preferred and qualified medical and
dental services, adequate protection from infectious and communicable diseases, and
receives safe and effective administration of medications, as well as prevention of drug
use as a substitute for programming;
i. Guarantees the eligible individual freedom from corporal punishment, imposition of
isolation, seclusion, chemical, physical, or mechanical restraint, except as prescribed by
North Dakota Century Code section 25-01.2-10 or this chapter, and guarantees the
eligible individual freedom from psychosurgery, sterilization, medical behavioral research,
pharmacological research, and electroconvulsive therapy, except as prescribed by North
Dakota Century Code sections 25-01.2-09 and 25-01.2-11;
j. Guarantees, where applicable, a nutritious diet, approved by a qualified dietitian, will be
provided in sufficient quantities to meet the eligible individual's dietary needs and
preferences;
k. Guarantees the eligible individual the right to choose and refuse services, who provides
the services, the right of the eligible individual and the eligible individual's representatives
to be informed of the possible consequences of the refusal, alternative services
available, and specifically, the extent to which such refusal may impact the eligible
individual or others;
l. Assures the eligible individual safe and sanitary living and working arrangements and
provides for emergencies or disasters and first-aid training for staff;
m. Assures the existence and operation of both behavior management and human rights
committees;
n. Assures the residential provider agency will coordinate with services outside the
residential setting in which an eligible individual lives;
o. Assures adaptive equipment, where appropriate for mobility, activities of daily living, or
communication is provided consistent with the person-centered service plan;
p. Assures all staff demonstrate basic professional competencies as required by their job
descriptions and complies with all required trainings, credentialing, and professional
development activities;
q. Assures at least annually, outcomes are evaluated to determine whether an eligible
individual is achieving the individual's goals and objectives;
r. Assures all vehicles providing transportation to eligible individuals are routinely inspected
and maintained, licensed by the department of transportation, transport no more
individuals than the manufacturer's recommended maximum capacity, handicapped
accessible, where appropriate, and are driven by individuals who hold a valid state

driver's license. Additionally, all vehicles owned by the licensee must be equipped with a
first-aid kit and a fire extinguisher;
s. Assures an annual inspection is conducted to ensure environments are sanitary and
hazard free;
t. Guarantees incidents of alleged abuse, neglect, and exploitation are thoroughly
investigated and reported to the governing body, chief executive officer, authorized
representative, or advocate, the protection and advocacy project, and the department
with written records of these proceedings being retained for three years; guarantees that
all incidents of restraint utilized to control or modify an eligible individual's behavior are
recorded and reported to the governing body; guarantees any incident resulting in injury
to the eligible individual or staff that requires medical attention or hospitalization must be
recorded and reported to the governing body immediately, and as soon thereafter as
possible to the authorized representative or advocate; and guarantees incidents resulting
in injury to the eligible individual or staff that requires extended hospitalization,
endangers life, or results in permanent disability must also be reported to the department
immediately; and guarantees corrective action plans are implemented;
u. Guarantees a grievance procedure, reviewed and approved by the department, affords
the eligible individual or the authorized representative or advocate the right to have any
grievance addressed; and guarantees that grievance records are maintained and must
note the nature of the grievance, individuals submitting the grievance, and the resolution
of the grievance;
v. Assures policies and procedures are established and maintained for the management
and maintenance of property and equipment purchased or depreciated with state funds.
The applicant shall make the records, and items identified in them, available for
inspection by the department, or designee, upon request to facilitate a determination of
the adequacy with which the applicant is managing property and equipment;
w. Assures policies and procedures regarding admission to their services and termination of
services are in conformance with the rules of the department;
x. Assures all documentation, data reporting requirements, rules, regulations, and policies
are conducted as required by the department; and
y. Assures all applicable federal and state laws and regulations are being abided by.
2. Licensees shall submit evidence, satisfactory to the department, of accreditation.
3. The department shall determine the degree to which the unaccredited applicant's policies and
procedures are in compliance with the standards.
History: Effective April 1, 1982; amended effective June 1, 1986; December 1, 1995; April 1, 2018;
January 1, 2025.
General Authority: NDCC 25-01.2-18, 25-16-06, 50-06-16
Law Implemented: NDCC 25-01.2-02, 25-01.2-03, 25-01.2-04, 25-01.2-05, 25-01.2-06, 25-01.2-07,
25-01.2-09, 25-01.2-10, 25-01.2-11, 25-01.2-14, 25-01.2-16, 25-01.2-18, 25-16-06
### § 75-04-01-20.1. Wages of eligible individuals.

Licensees paying subminimum wages for work performed shall submit to the department a true,
correct, and current copy of a certificate from the United States department of labor authorizing the
payment of subminimum wages.
History: Effective December 1, 1995; amended effective January 1, 2025.

General Authority: NDCC 25-01.2-18, 25-16-06, 50-06-16
Law Implemented: NDCC 25-01.2-06, 25-01.2-18, 25-16-06
### § 75-04-01-20.2. Recording and reporting abuse, neglect, exploitation, and use of restraint.

1. Licensees shall implement policies and procedures to assure incidents of alleged abuse,
neglect, exploitation, and restraints:
a. Are reported to the governing body, chief executive officer or designee of the licensee,
authorized representative, advocate, and the protection and advocacy project;
b. Are thoroughly investigated, the findings reported to the governing body, chief executive
officer or designee of the licensee, authorized representative, advocate, and the
protection and advocacy project and that the report and the action taken are recorded in
writing and retained for three years; and
c. Are immediately reported to the department.
2. Incidents resulting in injury to the staff or an eligible individual, requiring medical attention,
hospitalization, endangering life, or result in a permanent disability must be recorded and
reported to the governing body, chief executive officer or designee of the licensee, and to the
department immediately, and as soon thereafter as possible to the authorized representative
or advocate.
History: Effective December 1, 1995; amended effective April 1, 2018; January 1, 2025.
General Authority: NDCC 25-01.2-18, 25-16-06, 50-06-16
Law Implemented: NDCC 25-01.2-18, 25-16-06, 50-25.1-02
### § 75-04-01-21. Legal status of applicant.

The applicant shall submit, in a form or manner prescribed by the department, the following items:
1. A correct and current statement of their articles of incorporation, bylaws, license issued by a
local unit of government, partnership agreement, or any other evidence of legal registration of
the entity;
2. A correct and current statement of tax exempt or taxable status under the laws of North
Dakota or the United States;
3. A current list of partners or members of the governing body and any advisory board with their
contact information, principal occupation, term of office, and status as an eligible individual or
authorized representative and any changes in this list since last submission for all nonprofit
applicants and licensees;
4. A statement disclosing the owner of record of any buildings, facilities, or equipment used by
the applicant, the relationship of the owner to the applicant, and the cost, if any, of such use to
the applicant and the identity of the entity responsible for the maintenance and upkeep of the
property;
5. A statement disclosing any financial benefit which may accrue to the applicant or to be
diverted to personal use, including director's fees or expenses, dividends, return on
investment, rent or lease proceeds, salaries, pensions or annuities, or any other payments or
gratuities; and
6. The amount of any payments made to any member or members of the governing body of the
applicant, or board or body of a related organization, exclusive of reimbursement for actual
and reasonable personal expenses.

History: Effective April 1, 1982; amended effective June 1, 1986; December 1, 1995; April 1, 2018;
January 1, 2025.
General Authority: NDCC 25-01.2-08, 25-16-06, 50-06-16
Law Implemented: NDCC 25-01.2-08, 25-16-06
### § 75-04-01-22. Applicant's buildings.

Applicants or licensees occupying buildings, whether owned or leased, shall provide the
department with a license or registration certificate properly issued pursuant to North Dakota Century
Code chapter 15.1-34 or 50-11 or with:
1. The written report of an authorized fire inspector, following an initial or subsequent annual
inspection of a building pursuant to section 75-04-01-23, which states:
a. Rated occupancy and approval of the building for occupancy; or
b. Existing hazards and recommendations for correction which, if followed, would result in
approval of the building for occupancy;
2. A written statement prepared by the appropriate county or municipal official having jurisdiction
that the premises are in compliance with local zoning laws and ordinances; and
3. For existing buildings, floor plans drawn to scale showing the use of each room or area and a
site plan showing the source of utilities and waste disposal; or
4. Plans and specifications of buildings and site plans for facilities, proposed for use, but not yet
constructed, showing the proposed use of each room or area and the source of utilities and
waste disposal.
History: Effective April 1, 1982; amended effective June 1, 1986; December 1, 1995; April 1, 2018;
January 1, 2022; January 1, 2025.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-06
### § 75-04-01-23. Safety codes.

1. Applicant's or licensee's intermediate care facilities for individuals with intellectual disabilities
shall meet the provisions of either the health care occupancies chapters or the residential
board and care occupancies chapter of the Life Safety Code of the national fire protection
association, 2012 edition.
2. Applicant's or licensee's group home facilities which are not intermediate care facilities for
individuals with intellectual disabilities shall meet the applicable life safety standards
established by the local governing municipality's ordinances. If the local governing municipality
has no ordinances establishing life safety standards, the group home facilities shall meet the
one-family and two-family dwellings chapter of the Life Safety Code of the national fire
protection association, 2012 edition.
3. Upon written application, and good cause shown to the satisfaction of the department, the
department may grant a variance from any specific requirement of the Life Safety Code, upon
terms the department may prescribe, except no variance may permit or authorize a danger to
the health or safety of the residents of the facility.
4. Applicant's or licensee's facilities housing individuals with multiple physical disabilities or
impairments of mobility shall conform to American National Standards Institute Standard
No. A117.1 (1980), or, if remodeled or newly constructed after July 1, 1995, with appropriate
standards as required by the Americans with Disabilities Act of 1990, Public Law 101-336.

5. Applicant's or licensee's buildings used to provide day services must conform to the
appropriate occupancy chapters of the Life Safety Code of the national fire protection
association, 2012 edition, and must meet applicable accessibility standards as required by the
Americans with Disabilities Act of 1990, Public Law 101-336. The selection of an appropriate
Life Safety Code chapter shall be determined considering:
a. Primary activities in the facility;
b. The ability of eligible individuals occupying the facility to take action for self-preservation
in an emergency; and
c. Assistance available to eligible individuals occupying the facility for evacuation in an
emergency.
6. All licensed day service facilities must be surveyed for Life Safety Code compliance at least
annually. The department must be notified and a resurvey may be required if any of the
following conditions are present between annual inspections:
a. Occupancy increases of ten percent or more;
b. Primary usage of the facility changes;
c. Hazardous materials or processes are introduced into the facility;
d. Building alterations or modifications take place;
e. Eligible individuals requiring substantial assistance to evacuate in an emergency are
enrolled;
f. There are public or eligible individual concerns about safety conditions; or
g. Other changes occur in physical facilities, activities, materials and contents, or numbers
and capabilities of eligible individuals enrolled which may affect safety in an emergency.
History: Effective April 1, 1982; amended effective June 1, 1986; August 1, 1987; December 1, 1995;
April 1, 2000; May 1, 2004; July 1, 2012; April 1, 2020; January 1, 2025.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-06
### § 75-04-01-24. Entry, access to records, and inspection.

1. The applicant or licensee shall affirm the right of the department, or designee, to enter any of
the buildings or facilities and access to its records to determine compliance with the rules of
the department, to facilitate verification of the information submitted with an application for
licensure, and to investigate complaints.
2. The licensee shall authorize the department, or designee, entry to its facilities and access to
its records in the event the licensee declares bankruptcy, transfers ownership, ceases
operations, evicts residents of its facilities, or the contract with the department is terminated by
either of the parties. The department's entry is for the purpose of facilitating the orderly
transfer of eligible individuals to an alternative service or the maintenance of appropriate
service until an orderly transfer can be made.
History: Effective April 1, 1982; amended effective December 1, 1995; April 1, 2018; January 1, 2025.
General Authority: NDCC 25-01.2-08, 25-16-06, 50-06-16
Law Implemented: NDCC 25-01.2-08, 25-16-06

### § 75-04-01-25. Access to records.

Repealed effective January 1, 2025.
### § 75-04-01-26. Denial of access to facilities and records.

Any applicant or licensee which denies the department, or designee, access to a facility or its
records, may have its license revoked or its application denied.
History: Effective April 1, 1982; amended effective December 1, 1995; April 1, 2018; January 1, 2025.
General Authority: NDCC 25-01.2-08, 25-16-06, 50-06-16
Law Implemented: NDCC 25-01.2-08, 25-16-06
### § 75-04-01-27. Group home design.

1. Group home facilities shall be small enough and of a modest design, minimizing the length of
hallways, the number of exterior corners, and the complexity of construction, to ensure the
development of meaningful interpersonal relationships and the provision of proper
programming, services, and direct care. New or remodeled homes completed after July 1,
1985, are limited to occupancy by no more than eight individuals with developmental
disabilities.
2. Group home facilities shall simulate the most homelike atmosphere possible in order to
encourage a personalized environment.
3. Group home facilities shall provide, at a minimum, enough living space, based on the needs of
both males and females, with provisions for privacy and appropriate access to quiet areas
where an individual can be alone.
4. Group home facilities shall provide arrangement of space for all eligible individuals to
participate in various activities, both in groups and singly. Space must be arranged to minimize
noise for communication at normal conversational levels.
5. Group home facilities shall be accessible to nonambulatory eligible individuals, visitors, and
employees.
History: Effective June 1, 1986; amended effective December 1, 1995; January 1, 2025.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03
### § 75-04-01-28. Group home location.

1. Group home facilities must be located at least three hundred feet [91.44 meters] from
hazardous areas, including bulk fuel or chemical storage, anhydrous ammonia facilities, or
other fire hazards or sources of noxious or odoriferous emissions.
2. Group home facilities may not be located in areas subject to adverse environmental
conditions, including mud slides, harmful air pollution, smoke or dust, sewage hazards, rodent
or vermin infestations, excessive noise, vibrations, or vehicular traffic.
3. Group home facilities may not be located in an area within the one-hundred-year base flood
elevations unless:
a. The facility is covered by flood insurance as required by 42 U.S.C. 4101; or

b. The finished lowest floor elevation is above the one-hundred-year base flood elevation
and the facility is free from significant adverse effects of the velocity of moving water or
by wave impact during the one-hundred-year flood.
4. Group home facilities must be located in residential neighborhoods reasonably accessible to
shops, commercial facilities, and other community facilities; and shall be located not less than
six hundred feet [182.88 meters] from existing group homes or day service facilities licensed
by the department, schools for individuals with disabilities, long-term care facilities, or other
institutional facilities. Upon written application, and good cause shown, the department may
grant a variance from the provisions of this subsection upon terms the department may
prescribe.
History: Effective June 1, 1986; amended effective December 1, 1995; January 1, 2025.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03
### § 75-04-01-29. Group home bedrooms.

1. Bedrooms in group home facilities must accommodate no more than two individuals.
2. Bedrooms in group home facilities must provide at least eighty square feet [7.43 square
meters] per individual in a single occupancy bedroom, and at least sixty square feet
[5.57 square meters] per individual in a double occupancy bedroom, both exclusive of closet
and bathroom space. Bedrooms in newly constructed homes or existing homes converted to
group home facilities completed after July 1, 1985, must provide at least one hundred square
feet [9.29 square meters] per individual in a single occupancy bedroom, and at least eighty
square feet [7.43 square meters] per individual in a double occupancy bedroom, both
exclusive of closet and bathroom space.
3. Bedrooms in group home facilities must be located on outside walls and separated from other
rooms and spaces by walls extending from floor to ceiling and be at or above grade level.
4. Bedrooms in group home facilities must not have doors with vision panels and must be
capable of being locked from the inside of the bedroom, except when justified by a specific
assessed need and documented in the person-centered service plan.
5. Each eligible individual must have the opportunity to furnish and decorate their bedrooms as
they choose, including a chest of drawers, table, or desk.
6. Bedrooms in group home facilities must provide storage space for clothing in the bedroom
which is accessible to all, including nonambulatory individuals.
History: Effective June 1, 1986; amended effective December 1, 1995; April 1, 2018; January 1, 2025.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03
### § 75-04-01-30. Group home kitchens.

A kitchen in a group home facility must:
1. Provide sufficient space for participation by both staff and eligible individuals in the preparation
of food.
2. Provide appropriate space and equipment, including a two-compartment sink, to adequately
serve the food preparation and storage requirements of the facility.

3. Have hot water supplied to sinks in the range of one hundred ten to one hundred forty
degrees Fahrenheit [47.22 to 60 degrees Celsius], as controlled by a tempering valve, located
to preclude eligible individual access.
History: Effective June 1, 1986; amended effective December 1, 1995; January 1, 2025.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03
### § 75-04-01-31. Group home bathrooms.

1. A bathroom in a group home facility must:
a. Be located in places that facilitate maximum self-care by eligible individuals.
b. Provide showers, bathtubs, toilets, and lavatories approximating normal patterns found in
homes, unless specifically contraindicated by program needs.
c. Support only up to four individuals each.
d. Have hot water supplied to lavatories and bathing facilities in the range of one hundred
ten to one hundred forty degrees Fahrenheit [47.22 to 60 degrees Celsius], as controlled
by a tempering valve, located to preclude eligible individual access.
2. At least one bathroom per group home facility must be accessible and usable by
nonambulatory eligible individuals, visitors, and employees.
History: Effective June 1, 1986; amended effective December 1, 1995; January 1, 2025.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03
### § 75-04-01-32. Group home laundry.

1. Laundry space within group home facilities must provide a washer and dryer, storage for
laundry supplies, accommodations for ironing, and counterspace for folding clothing and linen.
2. Hot water supplied to clothes washers must be in the range of one hundred thirty-five to one
hundred forty degrees Fahrenheit [57.22 to 60 degrees Celsius].
History: Effective June 1, 1986; amended effective December 1, 1995.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03
### § 75-04-01-33. Group home use of space.

1. Group home facilities shall provide free use of space within the living unit, with due regard for
privacy, personal possessions, and programs; with limitations of personal areas of supervisory
staff.
2. Group home facilities shall provide for an individual to personalize the individual's portion of
the living unit and mount pictures on the walls.
History: Effective June 1, 1986; amended effective December 1, 1995.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03
### § 75-04-01-34. Group home staff accommodations.

Repealed effective December 1, 1995.

### § 75-04-01-35. Water supply.

1. Group home facilities for individuals with developmental disabilities shall be located in areas
where public or private water supplies approved by the department of environmental quality
are available. Approved public water supplies must be used where available.
2. When a private water supply is used, water samples must be submitted at the earliest possible
date prior to occupancy and every six months thereafter to determine chemical and
bacteriological acceptability.
History: Effective June 1, 1986; amended effective December 1, 1995.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03
### § 75-04-01-36. Sewage disposal.

1. Group home facilities for individuals with developmental disabilities shall be located in areas
where public or private sewage disposal systems approved by the department of
environmental quality are available. Approved public sewage disposal systems must be used,
where available.
2. Plans and specifications for proposed private sewage disposal system or alteration to such
systems must be approved by the department of environmental quality prior to the
construction, maintenance, and operation of such systems.
History: Effective June 1, 1986; amended effective December 1, 1995.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03
### § 75-04-01-37. Emergency plans.

There must be written plans and procedures, that are clearly communicated to and periodically
reviewed with staff and eligible individuals for meeting emergencies, including fire, serious illness,
severe weather, and missing individuals. Applicable requirements of state law and regulations by the
state fire marshal and applicable licensing authorities must be met.
History: Effective June 1, 1986; amended effective December 1, 1995; January 1, 2025.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03
### § 75-04-01-38. Insurance and bond requirements.

1. Licensees shall secure and maintain insurance and bonds appropriate for the size of the
programs, including:
a. A blanket fidelity bond equal to not less than ten percent of the total operating costs of
the program;
b. Property insurance covering all risks at replacement costs and costs of extra expense for
loss of use;
c. Liability insurance covering bodily injury, property damage, personal injury, teacher
liability, professional liability, and umbrella liability as applicable; and
d. Automobile or vehicle insurance covering property damage, comprehensive, collision,
uninsured motorist, bodily injury, and no fault.

2. The department shall determine the adequacy of the insurance coverages maintained by the
applicant.
History: Effective June 1, 1986; amended effective December 1, 1995.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03
### § 75-04-01-39. Variance.

Upon written application and good cause shown to the satisfaction of the department, the
department may grant a variance, to an institutional intermediate care facility for individuals with
intellectual disabilities, or group homes, from subsection 1 of section 75-04-01-27, subsections 1, 2,
and 3 of section 75-04-01-29, and subsection 3 of section 75-04-01-31, except no variance may permit
or authorize a danger to the health or safety of an individual served by the facility.
History: Effective July 1, 1996; amended effective July 1, 2012; April 1, 2018.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-06
### § 75-04-01-40. Documentation and data reporting requirements.

1. A licensee shall submit and retain all requisite documentation to demonstrate the right to
receive payment for all services and supports and comply with all federal and state laws,
regulations, and policies necessary to disclose the nature and extent of services provided and
all information to support claims submitted by, or on behalf of, the licensee.
2. The department may require a licensee to submit a statement of policies and procedures, and
evidence of the implementation of the statement, in order to facilitate a determination the
licensee is in compliance with the rules of the department and with North Dakota Century
Code chapters 25-01.2 and 25-16.
3. A licensee shall maintain program records, fiscal records, and supporting documentation,
including:
a. Authorization from the department for each eligible individual for whom service is billed;
b. Attendance sheets and other records documenting the days and times the eligible
individuals received the billed services from the licensee; and
c. Records of all bills submitted to the department for payment.
4. A licensee shall report the results of designated quality and performance indicators, as
requested by the department.
5. A licensee shall retain a copy of the records required for six years from the date of the bill
unless an audit in process requires a longer retention.
6. The department maintains the right to withhold a payment for services or suspend or
terminate Medicaid enrollment if the licensee has failed to abide by terms of the Medicaid
contract, federal and state laws, regulations, and policies regarding documentation or data
reporting.
History: Effective April 1, 2018; amended effective January 1, 2025.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03

### § 75-04-01-41. Appeals.

An applicant or licensee principal officer may appeal a decision to deny or revoke a license by filing
a written appeal with the department. The appeal must be postmarked or received by the department
within ten calendar days of the applicant's or licensee's receipt of written notice of the decision to deny
or revoke the license. Upon receipt of a timely appeal, an administrative hearing may be conducted in
the manner prescribed by chapter 75-01-03.
History: Effective January 1, 2025.
General Authority: NDCC 25-16-06, 50-06-16
Law Implemented: NDCC 25-16-03
