# Title 50 — Public Welfare

## Chapter 50-25.2 — Vulnerable Adult Protection Services

### § 50-25.2-01. Definitions.

As used in this chapter, unless the context otherwise requires:
1. "Abuse" means any willful act or omission of a caregiver or any other person which
results in physical injury, mental anguish, unreasonable confinement, sexual abuse or
exploitation, or financial exploitation to or of a vulnerable adult.
2. "Adult" includes a minor emancipated by marriage.
3. "Adult protective services" means remedial, social, legal, health, mental health, and
referral services provided for the prevention, correction, or discontinuance of abuse or
neglect which are necessary and appropriate under the circumstances to protect an
abused or neglected vulnerable adult, ensure that the least restrictive alternative is
provided, prevent further abuse or neglect, and promote self-care and independent
living. The term includes the following services provided by the department or the
department's designee:
a. Receiving, evaluating, and assessing reports of alleged abuse or neglect;
b. Arranging for and coordinating the provision of essential services;
c. Providing case management and counseling for the purposes of planning and
providing social and other services needed by vulnerable adults;
d. Arranging for and coordinating the provision of other services, including financial
management or assistance, legal assistance, and the services of domestic
violence programs;
e. Monitoring the delivery of services to vulnerable adults and making progress
assessments; and
f. Arranging for or providing, and coordinating, other services consistent with this
chapter.
4. "Caregiver" means any person who has assumed the legal responsibility or a
contractual obligation for the care of a vulnerable adult or has voluntarily assumed
responsibility for the care of a vulnerable adult. The term includes a facility operated by
any public or private agency, organization, or institution which provides services to,
and has assumed responsibility for the care of, a vulnerable adult.
5. "Department" means the department of health and human services.
6. "Essential services" means those services necessary to maintain and safeguard the
physical and mental health of a vulnerable adult which include sufficient and
appropriate food and clothing, temperate and sanitary shelter, treatment for mental or
physical needs, appropriate treatment for medical needs as determined by a physician
or other health care provider, and proper supervision.
7. "Financial exploitation" means use or receipt of services provided by the vulnerable
adult without just compensation, the taking, acceptance, misappropriation, or misuse
of property or resources of a vulnerable adult by means of undue influence, breach of
a fiduciary relationship, deception, harassment, criminal coercion, theft, or other
unlawful or improper means.
8. "Least restrictive alternative" means adult protective services provided in a manner no
more restrictive of a vulnerable adult's liberty and no more intrusive than necessary to
achieve and ensure the provision of essential services.
9. "Living independently" includes using the telephone, shopping, preparing food,
housekeeping, and administering medications.
10. "Mental anguish" means psychological or emotional damage that requires medical
treatment or care or is characterized by behavioral change or physical symptoms.
11. "Neglect" means the failure of a caregiver to provide essential services necessary to
maintain the physical and mental health of a vulnerable adult, or the inability or lack of
desire of the vulnerable adult to provide essential services necessary to maintain and
safeguard the vulnerable adult's own physical and mental health.

12. "Physical injury" means damage to bodily tissue caused by nontherapeutic conduct,
which includes fractures, bruises, lacerations, internal injuries, dislocations, physical
pain, illness, or impairment of physical function.
13. "Self-care" includes maintaining personal hygiene, eating, and dressing.
14. "Sexual abuse or exploitation" includes those sex offenses defined in sections
12.1-20-02, 12.1-20-03, 12.1-20-04, 12.1-20-05, 12.1-20-06, 12.1-20-07, and
12.1-20-11.
15. "Substantial functional impairment" means a substantial incapability, because of
physical limitations, of living independently or providing self-care as determined
through observation, diagnosis, evaluation, or assessment.
16. "Substantial mental impairment" means a substantial disorder of thought, mood,
perception, orientation, or memory that grossly impairs judgment, behavior, or ability to
live independently or provide self-care as revealed by observation, diagnosis,
evaluation, or assessment.
17. "Vulnerable adult" means an adult who has a substantial mental or functional
impairment.
18. "Willfully" means willfully as defined in section 12.1-02-02.
### § 50-25.2-02. Adult protective services program - Rules.

The department shall develop, administer, and cause to be implemented a program of
protective services for vulnerable adults consistent with this chapter. In developing and
administering the program, the department, within the limits of legislative appropriation, shall
allocate and distribute funds for the purpose of providing adult protective services. All law
enforcement agencies, courts of competent jurisdiction, and appropriate state and local
agencies shall cooperate in the implementation and enforcement of this chapter. The
department may adopt rules in accordance with chapter 28-32 for the purpose of implementing
the provisions of this chapter.
### § 50-25.2-03. Reporting of abuse or neglect - Method of reporting.

1. Any medical or mental health professional or personnel, law enforcement officer,
firefighter, member of the clergy, or caregiver having knowledge a vulnerable adult has
been subjected to abuse or neglect, or who observes a vulnerable adult being
subjected to conditions or circumstances that reasonably would result in abuse or
neglect, shall report the information to the department, or the department's designee,
or to an appropriate law enforcement agency if the knowledge is derived from
information received by that individual in that individual's official or professional
capacity. A member of the clergy, however, is not required to report the information if
the knowledge is derived from information received in the capacity of spiritual adviser.
An individual in the position of a long-term care ombudsman is not a mandated
reporter of suspected abuse or neglect. For purposes of this subsection, "medical or
mental health professional or personnel" means a professional or personnel providing
health care or services to a vulnerable adult, on a full-time or part-time basis, on an
individual basis or at the request of a caregiver, and includes a medical examiner,
coroner, dentist, dental hygienist, optometrist, pharmacist, chiropractor, podiatrist,
physical therapist, occupational therapist, tier 1 through tier 4 mental health
professional as defined under section 25-01-01, emergency medical services
personnel, hospital personnel, nursing home personnel, congregate care personnel, or
any other person providing medical and mental health services to a vulnerable adult.
2. A report, if required by section 25-01.3-04, satisfies all reporting requirements of this
chapter.
3. Any person not required to report under subsection 1 who has reasonable cause to
believe that a vulnerable adult has been subjected to abuse or neglect, or who
observes a vulnerable adult being subjected to conditions or circumstances that
reasonably would result in abuse or neglect, may report the information to the
department or the department's designee or to an appropriate law enforcement

agency. A law enforcement agency receiving a report under this section shall
immediately notify the department or the department's designee of the report.
4. An individual required to report under subsection 1 shall make an oral or written report
and a person voluntarily reporting under subsection 2 may make an oral or written
report, as soon as possible. To the extent reasonably possible, a person who makes a
report under this section shall include in the report:
a. The name, age, and residence address of the alleged vulnerable adult;
b. The name and residence address of the caregiver, if any;
c. The nature and extent of the alleged abuse or neglect or the conditions and
circumstances that would reasonably be expected to result in abuse or neglect;
d. Any evidence of previous abuse or neglect, including the nature and extent of the
abuse or neglect; and
e. Any other information in the opinion of the person making the report may be
helpful in establishing the cause of the alleged abuse or neglect and the identity
of the individual responsible for the alleged abuse or neglect.
### § 50-25.2-04. Referral of complaints concerning long-term care facilities.

Any report received by the department or the department's designee under section
adversely affect or may have adversely affected the health, safety, welfare, or personal or civil
rights of a resident in a long-term care facility, as defined in section 50-10.1-01, or an individual
who was discharged from a long-term care facility within one month of the complaint, must be
referred to the state long-term care ombudsman.
### § 50-25.2-05. Evaluation and assessment - Participation by law enforcement agencies -

Entry.
1. The department or the department's designee shall immediately evaluate and assess
any report received by the department or the department's designee under section
50-25.2-03, including the residence of the alleged vulnerable adult and the
circumstances surrounding the report. For the purpose of evaluating a report or
providing other adult protective services, the department or the department's designee
may:
a. Interview the alleged vulnerable adult, with or without notice to the caregiver or
any other person, and interview the caregiver and any other individual who may
have knowledge of the circumstances surrounding the report;
b. Enter any premises in which the alleged vulnerable adult is an occupant, with the
consent of the alleged vulnerable adult or the caregiver;
c. Have access to all records of the vulnerable adult:
(1) If the vulnerable adult, or the caregiver or legal representative of the
vulnerable adult, has authorized the department or the department's
designee to have access;
(2) If the vulnerable adult, because of a substantial functional or mental
impairment, is unable to authorize the department or the department's
designee to have such access, does not have a legal guardian or other legal
representative, and is an individual with respect to whom a report was
received by the department or the department's designee; or
(3) If the vulnerable adult, because of a substantial functional or mental
impairment, is unable to authorize the department or the department's
designee to have such access, the legal guardian or other legal
representative is alleged to cause the circumstances surrounding the report,
and is an individual with respect to whom a report was received by the
department or the department's designee;
d. Coordinate the assessment and the provision of other adult protective services
with other state or local agencies, departments, or institutions, including the
agency of the protection and advocacy project, or private agencies,

organizations, and professionals providing services necessary or advisable for
the vulnerable adult; and
e. Request records, except as prohibited under title 42, Code of Federal
Regulations, part 2, from a medical, dental, or mental health professional,
hospital, medical or mental health facility, or health care clinic regarding a
vulnerable adult with respect to whom a report was received by the department or
the department's designee. A medical, dental, or mental health professional,
hospital, medical or mental health facility, or health care clinic shall disclose to the
department or the department's designee, upon request, the records of a patient
or client which are relevant to a vulnerable adult evaluation, assessment or other
adult protective services. The department, or the department's designee, shall
limit the request for records to the minimum amount of records necessary to
enable a determination to be made or to support other adult protective services.
2. If a report alleges, or circumstances surrounding the report indicate, a violation of a
criminal statute or an imminent danger of serious physical injury or death of the
vulnerable adult, the department or the department's designee shall notify the
appropriate law enforcement agency. In such a case, the law enforcement agency may
investigate the allegations in the report, take immediate steps if necessary to protect
the vulnerable adult, and institute legal proceedings if appropriate. The law
enforcement agency shall notify the department or the department's designee if such
action is taken. This section does not limit the responsibilities of law enforcement
agencies to enforce the laws of this state or preclude law enforcement agencies from
investigating, as appropriate, any alleged criminal conduct. In all other cases of
alleged abuse or neglect, the department or the department's designee may request
assistance in an evaluation or the provision of other adult protective services from an
appropriate law enforcement agency if necessary under the circumstances.
3. If the alleged vulnerable adult, or the caregiver, does not consent to an evaluation or
investigation, a search warrant may be issued by a magistrate pursuant to law upon a
showing of probable cause to believe that abuse or neglect has occurred. A law
enforcement officer may make a reasonable entry of the premises without a search
warrant or consent of the alleged vulnerable adult or caregiver for the purpose of
rendering assistance if the officer has probable cause to believe that the delay of entry
would cause the alleged vulnerable adult to be in imminent danger of serious physical
injury or death.
### § 50-25.2-06. Provision of adult protective services.

If the department or the department's designee determines that a vulnerable adult
demonstrates a need for adult protective services, the department or the department's designee
shall provide, or arrange for the provision of, adult protective services, provided the vulnerable
adult consents to and accepts the services.
### § 50-25.2-07. Refusal or inability to accept adult protective services - Department

alternatives.
If a vulnerable adult who is subject to abuse or neglect is unable to consent and accept, or
the caregiver refuses, adult protective services determined by the department or the
department's designee to be necessary under this chapter, the department or the department's
designee may pursue any administrative, legal, and other remedies authorized by law which are
necessary and appropriate under the circumstances to protect the vulnerable adult and prevent
further abuse or neglect. The state's attorney of the county in which the vulnerable adult resides
or is located shall assist the department or the department's designee, upon request, in
pursuing an appropriate remedy. Available remedies include seeking:
1. The appointment of a guardian under chapter 30.1-28 or a conservator under chapter
30.1-29;
2. A restraining order or other court order necessary under the circumstances;

3. The removal of an abusive or neglectful guardian or conservator and appointment of a
suitable person as guardian or conservator, pursuant to sections 30.1-28-07 and
30.1-29-15;
4. The provision of appropriate treatment under chapter 25-03.1;
5. The criminal prosecution of the individual responsible for the abuse or neglect; and
6. Any other available administrative, legal, or other remedies on behalf of the vulnerable
adult.
### § 50-25.2-08. Cost of adult protective services.

The vulnerable adult is responsible for the costs of providing adult protective services,
except the receipt, evaluation, and assessment of reports of suspected abuse or neglect
pursuant to subdivision a of subsection 3 of section 50-25.2-01, if the department or the
department's designee determines, based on standards set by the department, that the
vulnerable adult is financially capable of paying for the protective services received either
through the vulnerable adult's own income or resources or other programs for which the
vulnerable adult may be eligible. The department or the department's designee is not
responsible for the cost of providing adult protective services unless the provision of the
services is specifically provided by law and funding exists to provide the services.
### § 50-25.2-09. Immunity from liability.

The following persons are immune from any civil or criminal liability that otherwise might
result from the person's actions taken pursuant to this chapter:
1. Any person, other than an alleged perpetrator, making a report or participating in an
investigation, evaluation, or assessment under this chapter if the person is acting in
good faith.
2. Any person, employed by the department or the department's designee or a law
enforcement agency, conducting or supervising an investigation, evaluation, or
assessment or implementing or enforcing the provisions of this chapter if the person is
acting in good faith and exercising due care.
### § 50-25.2-10. Penalty for failure to report - Penalty and civil liability for false reports.

1. Any person required to report under subsection 1 of section 50-25.2-03 who willfully
fails to do so is guilty of an infraction.
2. Any person who willfully makes a false report, or provides false information which
causes the report to be made, is guilty of a class B misdemeanor unless the false
report is made to a law enforcement official, in which case the person who causes the
false report to be made is guilty of a class A misdemeanor.
3. A person who willfully makes a false report, or provides false information that causes a
report to be made, is liable in a civil action for all damages suffered by the person
reported.
### § 50-25.2-11. Retaliation prohibited - Presumption - Penalty.

1. An employer who imposes any form of discipline or retaliation against an employee
solely because the employee reported in good faith having knowledge of or
reasonable cause to suspect that a vulnerable adult is or has been abused or
neglected, or because the employee is a vulnerable adult with respect to whom a
report was made, is guilty of a class B misdemeanor.
2. The employer of a person permitted to report pursuant to section 50-25.2-12 who
retaliates against the person because of a report is liable to that person in a civil action
for all damages.
3. A rebuttable presumption that retaliation has occurred arises when an adverse action
is taken within ninety days of the report. An adverse action includes:
a. The discharge from or termination of employment;

b. The demotion, negative work performance evaluation, reduction of hours worked,
reduction of benefits or work privileges, or reduction in remuneration for services
of the employee; or
c. The restriction or prohibition of access by the employee to any place of
employment or persons affiliated with the place of employment.
### § 50-25.2-11.1. Civil remedy for financial exploitation - Damages - Commencement of

action.
1. A vulnerable adult who has been financially exploited has a cause of action against
any perpetrator and may recover damages for that exploitation. The action may be
brought in a court of competent jurisdiction by:
a. The vulnerable adult;
b. The vulnerable adult's guardian or conservator;
c. Any person acting on behalf of the vulnerable adult with the consent of the
vulnerable adult; or
d. The personal representative of the estate of a deceased victim.
2. An action for financial exploitation of a vulnerable adult must be proven by clear and
convincing evidence. If financial exploitation is proven, the court shall award to the
plaintiff actual damages, reasonable attorney's fees and costs, and reasonable fees for
the services of a guardian ad litem if appointed by the court.
3. If the financial exploitation of the vulnerable adult by the perpetrator involved
oppression, fraud, deception, or actual malice, the court may award exemplary
damages in accordance with section 32-03.2-11.
4. An action for damages for financial exploitation of a vulnerable adult must be
commenced within six years after the plaintiff discovers or, through exercise of
reasonable diligence, should have discovered the facts constituting the financial
exploitation.
### § 50-25.2-12. Confidentiality of records - Authorized disclosures.

All reports made under this chapter and all records and information obtained or generated
as a result of the reports are confidential, but must be made available to:
1. A physician who examines a vulnerable adult whom the physician reasonably suspects
may have been subject to abuse or neglect if the identity of individuals reporting under
section 50-25.2-03 is protected.
2. Authorized staff of the department or the department's designee, law enforcement
agencies, and other agencies investigating, evaluating, or assessing the report or
providing adult protective services.
3. A vulnerable adult who is the subject of a report if the identity of individuals reporting
under section 50-25.2-03 is protected.
4. Public officials, and their authorized agents, who require the information in connection
with the discharge of their official duties.
5. A court when it determines that the information is necessary for determination of an
issue before the court.
6. A person engaged in a bona fide research or auditing purpose if no information
identifying the subjects of a report is made available to the researcher or auditor.
7. A guardian or legal representative of the vulnerable adult who is the subject of a report
if the identity of individuals reporting under section 50-25.2-03 is protected and the
guardian or legal representative is not suspected of abusing or neglecting the
vulnerable adult.
### § 50-25.2-13. Information, education, and training programs.

1. The department shall conduct a public information and education program. The
elements and goals of the program must include:

a. Informing the public regarding the laws governing the abuse or neglect of
vulnerable adults, the voluntary and mandatory reporting authorized by this
chapter, and the need for and availability of adult protective services.
b. Providing caregivers with information regarding services to alleviate the
emotional, psychological, physical, or financial stress associated with the
caregiver and vulnerable adult relationship.
2. The department shall institute a program of education and training for the department,
the department's designee, and law enforcement agency staff and other individuals
who provide adult protective services.
### § 50-25.2-14. Implementation contingent upon appropriation.

The department and human service zones are not required to implement or enforce this
chapter with respect to any zone, region, area, or county of this state if the legislative assembly
does not provide an appropriation to support the implementation and enforcement of this
chapter within that zone, region, area, or county.
