# Title 23 — Health and Safety

## Chapter 23-12 — Public Health, Miscellaneous Provisions

### § 23-12-01. Disinfection of secondhand goods.

Repealed by S.L. 1975, ch. 225, § 1.
### § 23-12-02. Penalty for not disinfecting secondhand goods.

Repealed by S.L. 1975, ch. 106, § 673; S.L. 1975, ch. 225, § 1.
### § 23-12-03. Use of public drinking cup prohibited - Penalty.

Any person in charge of any:
1. Public conveyance;
2. Passenger terminal building;
3. Public, parochial, or private school, or other educational institution; or
4. Public building
who furnishes or permits the common use of public drinking cups in such place is guilty of an
infraction.
### § 23-12-04. Permission to establish hospital in residence block of city required.

No hospital which treats patients for pay may be established in any residence block of any
city in this state unless the person, firm, corporation, or limited liability company proposing to
establish the same files with the city auditor the written consent of the resident freeholders of
such block.
### § 23-12-05. Advertising certain cures and drugs and specialization prohibited - Penalty.

Repealed by S.L. 1975, ch. 106, § 673.
### § 23-12-06. Injury to public health - Penalty.

Repealed by S.L. 1975, ch. 106, § 673.
### § 23-12-07. Violation of health laws - General penalty.

Any person who willfully violates any provision of this title, if another penalty is not
specifically provided for such violation, is guilty of an infraction.
### § 23-12-08. Emergency medical service authorized.

If emergency medical services are not provided by a licensed ambulance service under
chapter 23-27, any county or municipality of the state of North Dakota, by itself, or in
combination with any other county or municipality of the state of North Dakota, may, acting
through its governing body, establish, maintain, contract for, or otherwise provide emergency
medical service for such county or municipality; and for this purpose, out of any funds of such
county or municipality not otherwise committed, may buy, rent, lease, or otherwise contract for
all such vehicles, equipment, or other facilities or services which may be necessary to effectuate
such purpose.
### § 23-12-09. Smoking in public places and places of employment - Definitions.

In sections 23-12-09 through 23-12-11, unless the context or subject matter otherwise
requires:
1. "Bar" means a retail alcoholic beverage establishment licensed under chapter 5-02
that is devoted to the serving of alcoholic beverages for consumption by guests on the
premises and in which the serving of food is only incidental to the consumption of
those beverages. The term includes a bar located within a hotel, bowling center,
restaurant, or other establishment that is not licensed primarily or exclusively to sell
alcoholic beverages.
2. "Business" means a sole proprietorship, partnership, association, joint venture,
corporation, or other business entity, either for profit or not for profit, including retail

establishments where goods or services are sold and professional corporations and
other entities where professional services are delivered.
3. "E-cigarette" means any electronic oral device, such as one composed of a heating
element and battery or electronic circuit, or both, which provides a vapor of nicotine or
any other substances, and the use or inhalation of which simulates smoking. The term
shall include any such device, whether manufactured, distributed, marketed, or sold as
an e-cigarette, e-cigar, and e-pipe or under any other product, name, or descriptor.
4. "Employee" means an individual who is employed by an employer in consideration for
direct or indirect monetary wages or profit, or an individual who volunteers services for
an employer.
5. "Employer" means an individual, business, or private club, including a municipal
corporation or trust, or the state and its agencies and political subdivisions that
employs the services of one or more individuals.
6. "Enclosed area" means all space between a floor and ceiling that has thirty-three
percent or more of the surface area of its perimeter bounded by opened or closed
walls, windows, or doorways. A wall includes any physical barrier regardless of
whether it is opened or closed, temporary or permanent, or contains openings of any
kind, and includes retractable dividers and garage doors.
7. "Entrance" means an exterior door that actuates to the left or right which allows access
to a public place.
8. "Health care facility" means any office or institution providing health care services or
treatment of diseases, whether physical, mental or emotional, or other medical,
physiological or psychological conditions. Some examples of health care facilities
include hospitals; clinics; ambulatory surgery centers; outpatient care facilities; weight
control clinics; nursing homes; homes for the aging or chronically ill; nursing, basic,
long-term, or assisted living facilities; laboratories; and offices of any medical
professional licensed under title 43, including all specialties and subspecialties in
those fields. This definition shall include all waiting rooms, hallways, private rooms,
semiprivate rooms, wards within health care facilities, and any mobile or temporary
health care facilities.
9. "Health care services" means services provided by any health care facility. Some
examples of health care services are medical, surgical, dental, vision, chiropractic,
psychological, and pharmaceutical services.
10. "Place of employment" means an area under the control of a public or private
employer, including work areas, auditoriums, classrooms, conference rooms,
elevators, employee cafeterias, employee lounges, hallways, meeting rooms, private
offices, restrooms, temporary offices, vehicles, and stairs. A private residence is not a
place of employment unless it is used as a licensed child care, adult day care, or
health care facility.
11. "Public place" means an area which the public enters. Some examples of public
places are publicly owned buildings, vehicles, or offices; bars; bingo facilities; gambling
and gaming facilities as defined in section 12.1-28-01; child care and adult day care
facilities subject to licensure by the department of health and human services,
including those operated in private homes; convention facilities; educational facilities,
both public and private; facilities primarily used for exhibiting a motion picture, stage,
drama, lecture, musical recital, or other similar performance; financial institutions;
health care facilities; hotels and motels, including all rooms that are rented to guests;
laundromats; any common areas in apartment buildings, condominiums, mobile home
parks, retirement facilities, nursing homes, and other multiple-unit residential facilities;
private and semi-private nursing home rooms; museums, libraries, galleries, and
aquariums; polling places; professional offices; public transportation facilities, including
buses, trains, airplanes and similar aircraft, taxicabs and similar vehicles such as
towncars and limousines when used for public transportation, and ticket, boarding, and
waiting areas of public transit facilities, including bus and train stations and airports;
reception areas; restaurants; retail food production and marketing establishments;
retail service establishments; retail stores, including tobacco and hookah

establishments; rooms, chambers, places of meeting or public assembly, including
school buildings; shopping malls; sports arenas; theaters; and waiting rooms.
12. "Publicly owned building, vehicle, or office" means a place or vehicle owned, leased, or
rented by any state or political subdivision, or by any agency supported by
appropriation of, or by contracts or grants from, funds derived from the collection of
taxes.
13. "Restaurant" includes every building or other structure, or any part thereof, and all
buildings in connection therewith that are kept, used, maintained, advertised, or held
out to the public as a place where food is served. Some examples of restaurants
include coffee shops, cafeterias, sandwich stands, private and public school cafeterias,
kitchens, and catering facilities in which food is prepared on the premises for serving
elsewhere, and a bar area within a restaurant.
14. "Shopping mall" means an enclosed public walkway or hall area that serves to connect
retail or professional businesses.
15. "Smoking" means inhaling, exhaling, burning, or carrying any lighted or heated cigar,
cigarette, or pipe, or any other lighted or heated tobacco or plant product intended for
inhalation, in any manner or in any form. Smoking also includes the use of an
e-cigarette which creates a vapor, in any manner or any form, or the use of any oral
smoking device for the purpose of circumventing the prohibition of smoking in this Act.
16. "Sports arena" means an indoor or outdoor place where members of the public
assemble to engage in physical exercise, participate in athletic competition, or witness
sports or other events. Some examples of sports arenas include sports pavilions,
stadiums, gymnasiums, health spas, boxing arenas, swimming pools, roller and ice
rinks, and bowling centers.
### § 23-12-10. Smoking restrictions - Exceptions - Retaliation - Application.

1. In order to protect the public health and welfare and to recognize the need for
individuals to breathe smoke-free air, smoking is prohibited in all enclosed areas of:
a. Public places; and
b. Places of employment.
2. Smoking is prohibited within twenty feet [6.10 meters] of entrances, exits, operable
windows, air intakes, and ventilation systems of enclosed areas in which smoking is
prohibited. Owners, operators, managers, employers, or other persons who own or
control a public place or place of employment may seek to rebut the presumption that
twenty feet [6.10 meters] is a reasonable minimum distance by making application to
the director of the local health department or district in which the public place or place
of employment is located. The presumption will be rebutted if the applicant can show
by clear and convincing evidence that, given the unique circumstances presented by
the location of entrances, exits, windows that open, ventilation intakes, or other
factors, smoke will not infiltrate or reach the entrances, exits, open windows, or
ventilation intakes or enter into such public place or place of employment and,
therefore, the public health and safety will be adequately protected by a lesser
distance.
3. The following areas are exempt from subsections 1 and 2:
a. Private residences, except those residences used as a child care, adult day care,
or health care facility subject to licensure by the department of health and human
services.
b. Outdoor areas of places of employment, except those listed in subsection 2.
c. Any area that is not commonly accessible to the public and which is part of an
owner-operated business having no employee other than the owner-operator.
d. A cigar lounge that permits the smoking of cigars and pipe tobacco purchased on
the premises, but may not permit the smoking of any other product on the
premises.
(1) An applicant for a certificate to operate a cigar lounge shall report to the
tax commissioner, on a form prescribed by the commissioner, that the
premises in which the cigar lounge will be operated has a humidor; is

enclosed by solid walls or windows, a ceiling, and a solid door; and is
equipped with a ventilation system by which exhausted air is not recirculated
to nonsmoking areas and smoke is not backstreamed into nonsmoking
areas. The commissioner may not require an applicant to report information
regarding income from the sale of cigars and pipe tobacco in an initial
application. Upon receipt of a report asserting compliance with this
paragraph, the commissioner shall issue the applicant a certificate to
operate a cigar lounge.
(2) A cigar lounge asserting the lounge meets the requirements of paragraph 1
shall report to the tax commissioner before February first of each year
following a full calendar year of operation, on a form prescribed by the
commissioner, the revenue from the previous calendar year generated from
the sale of cigars and pipe tobacco as a percentage of annual gross income
from receipts or sales. Upon receipt of a report asserting the cigar lounge
generates fifteen percent or more of the business's annual gross income
from receipts or sales from the sale of cigars and pipe tobacco, the
commissioner shall renew the annual certificate. The commissioner is not
required to confirm the accuracy of information reported but may not renew
a certificate absent supporting documentation from the lounge.
(3) Information reported to the commissioner under this subdivision is subject to
the confidentiality provisions of section 57-39.2-23.
(4) For purposes of this subdivision:
(a) "Cigar" means an individual roll of tobacco which has a wrapper or
cover of whole leaf tobacco; does not contain filler other than tobacco
filler; does not contain binder other than tobacco binder; does not
contain additives other than water; does not contain a filter, tip, or
nontobacco mouthpiece; weighs at least six pounds per thousand
count; and is made by hand, except to allow for the use of a manually
operated machine to assist in bunching, rolling, and binding.
(b) "Cigar lounge" means a business dedicated, in whole or in part, to the
smoking of cigars and pipe tobacco, which has a valid certificate
issued by the tax commissioner.
(c) "Pipe tobacco" has the meaning provided in section 57-36-01.
4. Smoking as part of a traditional American Indian spiritual or cultural ceremony is not
prohibited.
5. No person or employer shall discharge, refuse to hire, or in any manner retaliate
against an employee, applicant for employment, or other person because that person
asserts or exercises any rights afforded by this section or reports or attempts to
prosecute a violation of this section. An employee who works in a setting where an
employer allows smoking does not waive or surrender any legal rights the employee
may have against the employer or any other party. Violations of this subsection shall
be a class B misdemeanor.
6. This section may not be interpreted or construed to permit smoking where it is
otherwise restricted by other applicable laws.
7. Notwithstanding any other provision of this chapter, an owner, operator, manager or
other person in control of an establishment, facility, or outdoor area may declare that
entire establishment, facility, or outdoor area as a nonsmoking place.
### § 23-12-10.1. Responsibility of proprietors.

Repealed by S.L. 2005, ch. 239, § 7.
### § 23-12-10.2. Complaints and enforcement - City and county ordinances and home rule

charters
1. State agencies with statutory jurisdiction over a state-owned building or office shall
enforce section 23-12-10. These agencies include the fire marshal department,

department of health and human services, legislative council, and office of
management and budget.
2. A city or county ordinance, a city or county home rule charter, or an ordinance adopted
under a home rule charter may not provide for less stringent provisions than those
provided under sections 23-12-09 through 23-12-11. Nothing in this Act shall preempt
or otherwise affect any other state or local tobacco control law that provides more
stringent protection from the hazards of secondhand smoke. This subsection does not
preclude any city or county from enacting any ordinance containing penal language
when otherwise authorized to do so by law.
3. The provisions of this Act shall be enforced by state's attorneys who may ask the North
Dakota attorney general to adopt administrative rules to ensure compliance with this
Act. State and local law enforcement agencies may apply for injunctive relief to
enforce provisions of this Act.
### § 23-12-10.3. Exceptions - Medical necessity.

Repealed by I.M. approved November 6, 2012, S.L. 2013, ch. 510, § 7.
### § 23-12-10.4. Responsibility of proprietors - Reimbursement of costs of compliance.

1. The owner, operator, manager, or other person in control of a public place or place of
employment where smoking is prohibited by this Act shall:
a. Clearly and conspicuously post no smoking signs or the international no smoking
symbol in that place.
b. Clearly and conspicuously post at every entrance to that place a sign stating that
smoking is prohibited.
c. Remove all ashtrays from any area where smoking is prohibited, except for
ashtrays displayed for sale and not for use on the premises and ashtrays that are
factory-installed in vehicles.
d. By December 6, 2012, communicate to all existing employees and to all
prospective employees upon their application for employment that smoking is
prohibited in that place.
e. For places under his or her control, direct a person who is smoking in violation of
this Act to extinguish the product being smoked. If the person does not stop
smoking, the owner, operator, manager, or employee shall refuse service and
shall immediately ask the person to leave the premises. If the person in violation
refuses to leave the premises, the owner, operator, manager, or employee shall
immediately report the violation to an enforcement agency identified in this Act.
The refusal of the person to stop smoking or leave the premises in response to
requests made under this section by an owner, operator, manager, or employee
shall not constitute a violation of the Act by the owner, operator, manager, or
employee.
2. The owner, operator, manager, or other person in control of a public place or place of
employment where smoking is prohibited by this chapter may request from the
department of health and human services the signs necessary to comply with the
signage requirements of subsection 1.
### § 23-12-10.5. Construction and severability.

This Act shall be construed liberally so as to further its purposes. The provisions of this Act
are declared to be severable. If any provision, clause, sentence, or paragraph of this Act, or its
application to any person or circumstances, shall be held invalid, that invalidity shall not affect
the other provisions of this Act that can be given without the invalid provision or applications.
### § 23-12-11. Penalty.

1. An individual who smokes in an area in which smoking is prohibited under section

2. Except as otherwise provided in subsection 5 of section 23-12-10, an owner or other
person with general supervisory responsibility over a public place or place of
employment who willfully fails to comply with section 23-12-10 is guilty of an infraction,
subject to a fine not to exceed one hundred dollars for the first violation, to a fine not to
exceed two hundred dollars for a second violation within one year, and a fine not to
exceed five hundred dollars for each additional violation within one year of the
preceding violation.
3. In addition to the fines established by this section, violation of this Act by a person who
owns, manages, operates, or otherwise controls a public place or place of employment
may result in the suspension or revocation of any permit or license issued to the
person for the premises on which the violation occurred.
4. Violations of this Act are declared to be a public nuisance that may be abated by
restraining order, preliminary or permanent injuntion, or other means provided by law.
5. Each day on which a violation of this Act occurs shall be considered a separate and
distinct violation.
### § 23-12-12. Federal Health Care Quality Improvement Act of 1986 applicable in North

Dakota.
Pursuant to the Health Care Quality Improvement Act of 1986 [Pub. L. 99-660, Title IV;
100 Stat. 3784; 42 U.S.C. 11101 et seq.], providing for a limitation on damages for professional
review actions, the provisions of that Act are effective in this state.
### § 23-12-13. Individuals authorized to provide informed consent to health care for

incapacitated patients and minors - Priority.
1. For purposes of this section:
a. "Incapacitated patient" means an adult unable to understand and appreciate the
nature and consequence of a health care decision, including the benefits, harms,
and reasonable alternatives to proposed health care, and unable to communicate
a health care decision, as certified by the patient's attending physician,
psychiatrist, or psychologist and filed in the patient's medical record.
b. "Minor" means an individual under eighteen years of age.
2. Unless a court of competent jurisdiction determines otherwise, individuals in the
following classes and in the following order of priority may provide informed consent to
health care on behalf of an incapacitated patient:
a. A health care agent appointed through a health care directive under chapter
23-06.5 or a similar instrument executed in another jurisdiction in accordance with
the law in that jurisdiction;
b. An appointed guardian or custodian of the patient under chapter 30.1-28 or a
similar instrument executed in another jurisdiction in accordance with the law in
that jurisdiction;
c. A spouse of the patient who has maintained significant contact with the patient;
d. A child of the patient who is at least eighteen years of age and who has
maintained significant contact with the patient;
e. A parent of the patient, including a stepparent who has maintained significant
contact with the patient;
f. An adult sibling of the patient who has maintained significant contact with the
patient;
g. A grandparent of the patient who has maintained significant contact with the
patient;
h. A grandchild of the patient who is at least eighteen years of age and who has
maintained significant contact with the patient;
i. A close relative or friend of the patient who is at least eighteen years of age and
who has maintained significant contact with the patient; or
j. An interdisciplinary team consisting of at least three health care professionals.
(1) An interdisciplinary team may include an employee or agent of a health care
provider treating an incapacitated patient, including a member of the ethics

committee, provided a member of the team is not directly involved with the
treatment of the incapacitated patient.
(2) If consent is provided under this subdivision, a health care provider shall
continue good-faith efforts to identify and locate an individual in a preceding
level of priority.
3. Unless otherwise determined by court order, a parent may make health care decisions
for the parent's minor child. Individuals in the following classes and in the following
order of priority may provide informed consent to health care on behalf of a minor
patient if a parent is unable to provide informed consent:
a. A guardian acting under a court order specifically authorizing the guardian to
make health care decisions for the minor;
b. An appointed guardian or custodian of the minor;
c. A noncustodial parent of the minor, including a stepparent who has maintained
significant contact with the patient;
d. An adult sibling of the minor who has maintained significant contact with the
minor;
e. A grandparent of the minor who has maintained significant contact with the minor;
f. A close relative or friend of the minor who is at least eighteen years of age and
who has maintained significant contact with the minor; or
g. An interdisciplinary team consisting of at least three health care professionals.
(1) An interdisciplinary team may include an employee or agent of a health care
provider treating a minor, including a member of the ethics committee,
provided a member of the team is not directly involved with the treatment of
the minor.
(2) If consent is provided under this subdivision, a health care provider shall
continue good-faith efforts to identify and locate an individual in a preceding
level of priority.
4. A health care provider seeking informed consent for proposed health care for an
incapacitated patient or a minor who is unable to consent must make reasonable
efforts to locate and secure authorization for the health care from a competent
individual in the first or succeeding class identified in subsection 2 for an incapacitated
patient or subsection 3 for a minor. If the health care provider is unable to locate such
individual, authorization may be given by any individual in the next class in the order of
descending priority. An individual identified in subsection 2 for an incapacitated patient
or subsection 3 for a minor may not provide informed consent to health care if an
individual of higher priority has refused to give such authorization.
5. Before any individual authorized to provide informed consent under this section
exercises that authority, the individual must first determine in good faith that the
patient, if not incapacitated, would consent to the proposed health care. If such a
determination cannot be made, the decision to consent to the proposed health care
may be made only after determining that the proposed health care is in the patient's
best interests.
6. An individual authorized to provide informed consent in accordance with this section
may not provide consent for sterilization, abortion, or psychosurgery or for admission
to a state mental health facility for a period of more than forty-five days without a
mental health proceeding or other court order.
7. If a patient who is determined by a physician, psychiatrist, or psychologist to be an
incapacitated patient, or an individual interested in the patient's welfare, objects to a
determination of incapacity made in accordance with this section, a court hearing
pursuant to chapter 30.1-28 must be held to determine the issue of incapacity.
### § 23-12-14. Copies of medical records and medical bills.

1. As used in this section, "health care provider" means a licensed individual or licensed
facility providing health care services. Upon the request of a health care provider's
patient or any person authorized by a patient, the provider shall provide a free copy of
a patient's health care records to a health care provider designated by the patient or

the person authorized by the patient if the records are requested for the purpose of
transferring that patient's health care to another health care provider for the
continuation of treatment.
2. Except as provided in subsection 1, upon the request for medical records or medical
bills with the signed authorization of the patient, the health care provider shall provide
medical records and any associated medical bills either in paper or facsimile format at
a charge of no more than twenty dollars for the first twenty-five pages and seventy-five
cents per page after twenty-five pages or in an electronic, digital, or other
computerized format at a charge of thirty dollars for the first twenty-five pages and
twenty-five cents per page after twenty-five pages. This charge includes any
administration fee, retrieval fee, and postage expense.
### § 23-12-15. State agency provision of medical equipment - Policy for reuse, recycling,

or resale.
If a state agency uses state funds to provide free medical equipment to an individual, that
state agency shall establish a policy addressing the possible reuse, recycling, or resale value of
the medical equipment upon replacement of the medical equipment by that state agency or
upon disuse of the medical equipment by the individual.
### § 23-12-16. Right to breastfeed.

A woman may breastfeed her child in any location, public or private, where the woman and
child are otherwise authorized to be.
### § 23-12-17. Workplace breastfeeding policies - Infant friendly designation.

1. An employer may use the designation "infant friendly" on its promotional materials if
the employer adopts a workplace breastfeeding policy that includes the following:
a. Flexible work scheduling, including scheduling breaks and permitting work
patterns that provide time for expression of breast milk;
b. A convenient, sanitary, safe, and private location, other than a restroom, allowing
privacy for breastfeeding or expressing breast milk;
c. A convenient clean and safe water source with facilities for washing hands and
rinsing breast-pumping equipment located in the private location specified in
subdivision b; and
d. A convenient hygienic refrigerator in the workplace for the temporary storage of
the mother's breast milk.
2. The department of health and human services shall establish guidelines for employers
concerning workplace breastfeeding and infant friendly designations.
### § 23-12-18. Medical facility and provider performance reviews and ratings - Notice.

1. If a medical facility or provider in this state has a performance review that results in the
receipt of a rating, and at any time pays a fee to the person completing the rating, the
medical facility or provider shall include a public notice in any promotional or marketing
activities referring to the rating information stating that the medical facility or provider
made a payment and stating the amount of that payment made to the person
performing the rating.
2. Subsection 1 does not apply to a performance review required to maintain licensure or
accreditation by governmental or third-party payers or to maintain accreditation by a
quality assurance organization.
### § 23-12-19. Voluntary participation in the health information organization - Prohibition

on withholding care or benefits.
1. As used in this section:
a. "Health information organization" means the health information exchange created
under chapter 54-59.

b. "Individually identifiable health information" has the meaning set forth in title 45,
Code of Federal Regulations, section 160.103.
2. An individual may opt-out of participating in the health information organization by
providing notice to the organization. If an individual chooses to opt-out of participating
in the health information organization, the individual's individually identifiable health
information may not be accessed by search by a health insurer, government health
plan, or health care provider other than the provider who originally created or ordered
the creation of the individually identifiable health information.
3. In opting out of participating in the health information organization under this section,
the individual must have the option of:
a. Opting out of participating; or
b. Conditionally opting out, in which case the accessibility of the individual's
individually identifiable health information is limited to access by a health care
provider who determines access is required by a medical emergency.
4. An individual's decision to opt-out of participating in the health information
organization:
a. May be changed at any time by the individual by providing written notice to the
health information organization.
b. Does not prohibit use or disclosure of individually identifiable health information
which is required by law.
5. A health care provider, health insurer, or government health plan may not withhold
coverage or care from an individual nor may a health insurer deny an individual a
health insurance benefit plan based solely on that individual's choice to participate or
to opt-out of the health information organization.
### § 23-12-20. COVID-19 vaccination and infection information.

1. Neither a state government entity nor any of its political subdivisions, agents, or
assigns may:
a. Require documentation, whether physical or electronic, for the purpose of
certifying or otherwise communicating the following before providing access to
property, funds, or services:
(1) An individual's COVID-19 vaccination status or vaccination status for a
vaccine that is under emergency use authorization from the federal food and
drug administration;
(2) The presence of COVID-19 pathogens, antigens, or antibodies; or
(3) An individual's COVID-19 post-transmission recovery status;
b. Otherwise publish or share an individual's COVID-19 vaccination record or similar
health information, except as specifically authorized by the individual or otherwise
authorized by statute; or
c. Require a private business to obtain documentation, whether physical or
electronic, for purposes of certifying or otherwise communicating the following
before employment or providing access to property, funds, or services based on:
(1) An individual's COVID-19 vaccination status or vaccination status for a
vaccine that is under emergency use authorization from the federal food and
drug administration;
(2) The presence of COVID-19 pathogens, antigens, or antibodies; or
(3) An individual's COVID-19 post-transmission recovery status.
2. Subsection 1 does not apply to the department of corrections and rehabilitation, a
correctional facility as defined under section 12-44.1-01, the state hospital, or a public
health unit.
3. A private business located in this state or doing business in this state may not require
a patron, client, or customer in this state to provide any documentation certifying
COVID-19 vaccination or vaccination authorized by the federal food and drug
administration under emergency use authorization, the presence of COVID-19
pathogens, antigens, or antibodies, or COVID-19 post-transmission recovery to gain
access to, entry upon, or services from the business. This subsection does not apply

to a developmental disability residential facility or a health care provider, including a
long-term care provider, basic care provider, and assisted living provider. As used in
this subsection, a private business does not include a nonprofit entity that does not sell
a product or a service.
4. This section may not be construed to interfere with an individual's rights to access that
individual's own personal health information or with a person's right to access personal
health information of others which the person otherwise has a right to access.
5. Subsection 1 is not applicable to the state board of higher education, the university
system, or institutions under the control of the state board of higher education to the
extent the entity has adopted policies and procedures governing the type of
documentation required, the circumstances under which such documentation may be
shared, and exemptions from providing such documentation.
6. This section is not applicable during a public health disaster or emergency declared in
accordance with chapter 37-17.1.
7. As used in this section, the term "COVID-19" means severe acute respiratory
syndrome coronavirus 2 identified as SARS-CoV-2 and any mutation or viral
fragments of SARS-CoV-2.
### § 23-12-21. International health regulations.

A health-related regulation of an international health organization is not enforceable in this
state unless enacted through legislation or a signed executive order.
### § 23-12-22. Vaccine adverse event data - Website.

The department of health and human services shall prominently display, on a website
maintained by the department, a link to the federal vaccine adverse event reporting system,
along with instructions on how to report an adverse event and how to access state-specific data.
The department may compile its own data for use on this website.
### § 23-12-23. Required vaccine - Opt-out procedure.

1. Notwithstanding any other provision of law, a state agency, political subdivision, or any
other government entity may not require an individual to take or receive a vaccine or
similar product used to prevent a disease, unless there is a procedure made available
for an opt-out for health, religious, or philosophical reasons.
2. For a school, day care center, child care facility, head start program, or nursery school,
section 23-07-17.1 must be followed for vaccines and vaccine opt-out procedures.
