# Title 25 — Mental and Physical Illness or Disability

## Chapter 25-11 — Interstate Mental Health Compact

### § 25-11-01. Enactment of interstate compact on mental health.

The interstate compact on mental health is hereby enacted into law and entered into by this
state with all other states legally joined therein in the form substantially as follows:
The party states find that the proper and expeditious treatment of the mentally ill and
mentally deficient can be facilitated by cooperative action, to the benefit of the patients, their
families, and society as a whole. Further, the party states find that the necessity of and
desirability for furnishing such care and treatment bears no primary relation to the residence or
citizenship of the patient but that, on the contrary, the controlling factors of community safety
and humanitarianism require that facilities and services be made available for all who are in
need of them. Consequently, it is the purpose of this compact and of the party states to provide
the necessary legal basis for the institutionalization or other appropriate care and treatment of
the mentally ill and mentally deficient under a system that recognizes the paramount importance
of patient welfare and to establish the responsibilities of the party states in terms of such
welfare.
As used in this compact:
1. "After-care" means care, treatment, and services provided a patient, as defined herein,
on convalescent status or conditional release.
2. "Institution" means any hospital or other facility maintained by a party state or political
subdivision thereof for the care and treatment of mental illness or mental deficiency.
3. "Mental deficiency" means mental deficiency as defined by appropriate clinical
authorities to such extent that a person so afflicted is incapable of managing the
person's self and affairs, but shall not include mental illness as defined herein.
4. "Mental illness" means mental disease to such extent that a person so afflicted
requires care and treatment for the person's own welfare, or the welfare of others, or of
the community.
5. "Patient" means any person subject to or eligible as determined by the laws of the
sending state, for institutionalization or other care, treatment, or supervision pursuant
to the provisions of this compact.
6. "Receiving state" means a party state to which a patient is transported pursuant to the
provisions of the compact or to which it is contemplated that a patient may be so sent.
7. "Sending state" means a party state from which a patient is transported pursuant to
the provisions of the compact or from which it is contemplated that a patient may be so
sent.
8. "State" means any state, territory, or possession of the United States, the District of
Columbia, and the Commonwealth of Puerto Rico.
1. Whenever a person physically present in any party state shall be in need of
institutionalization by reason of mental illness or mental deficiency, the person shall be
eligible for care and treatment in an institution in that state irrespective of the person's
residence, settlement, or citizenship qualifications.
2. The provisions of paragraph 1 of this article to the contrary notwithstanding, any
patient may be transferred to an institution in another state whenever there are factors
based upon clinical determinations indicating that the care and treatment of said
patient would be facilitated or improved thereby. Any such institutionalization may be
for the entire period of care and treatment or for any portion or portions thereof. The
factors referred to in this paragraph shall include the patient's full record with due
regard for the location of the patient's family, character of the illness and probable
duration thereof, and such other factors as shall be considered appropriate.
3. No state shall be obliged to receive any patient pursuant to the provisions of
paragraph 2 of this article unless the sending state has given advance notice of its
intention to send the patient; furnished all available medical and other pertinent

records concerning the patient; given the qualified medical or other appropriate clinical
authorities of the receiving state an opportunity to examine the patient if said
authorities so wish; and unless the receiving state shall agree to accept the patient.
4. In the event that the laws of the receiving state establish a system of priorities for the
admission of patients, an interstate patient under this compact shall receive the same
priority as a local patient and shall be taken in the same order and at the same time
that the person would be taken if the person was a local patient.
5. Pursuant to this compact, the determination as to the suitable place of
institutionalization for a patient may be reviewed at any time and such further transfer
of the patient may be made as seems likely to be in the best interest of the patient.
1. Whenever, pursuant to the laws of the state in which a patient is physically present, it
shall be determined that the patient should receive after-care or supervision, such care
or supervision may be provided in a receiving state. If the medical or other appropriate
clinical authorities having responsibility for the care and treatment of the patient in the
sending state shall have reason to believe that after-care in another state would be in
the best interest of the patient and would not jeopardize the public safety, they shall
request the appropriate authorities in the receiving state to investigate the desirability
of affording the patient such after-care in said receiving state, and such investigation
shall be made with all reasonable speed. The request for investigation shall be
accompanied by complete information concerning the patient's intended place of
residence and the identity of the person in whose charge it is proposed to place the
patient, the complete medical history of the patient, and such other documents as may
be pertinent.
2. If the medical or other appropriate clinical authorities having responsibility for the care
and treatment of the patient in the sending state and the appropriate authorities in the
receiving state find that the best interest of the patient would be served thereby, and if
the public safety would not be jeopardized thereby, the patient may receive after-care
or supervision in the receiving state.
3. In supervising, treating, or caring for a patient on after-care pursuant to the terms of
this article, a receiving state shall employ the same standards of visitation,
examination, care, and treatment that it employs for similar local patients.
Whenever a dangerous or potentially dangerous patient escapes from an institution in any
party state, that state shall promptly notify all appropriate authorities within and without the
jurisdiction of the escape in a manner reasonably calculated to facilitate the speedy
apprehension of the escapee. Immediately upon the apprehension and identification of any such
dangerous or potentially dangerous patient, that patient shall be detained in the state where
found pending disposition in accordance with law.
The duly accredited officers of any state party to this compact, upon the establishment of
their authority and the identity of the patient, shall be permitted to transport any patient being
moved pursuant to this compact through any and all states party to this compact, without
interference.
1. No person shall be deemed a patient of more than one institution at any given time.
Completion of transfer of any patient to an institution in a receiving state shall have the
effect of making the person a patient of the institution in the receiving state.
2. The sending state shall pay all costs of and incidental to the transportation of any
patient pursuant to this compact, but any two or more party states may, by making a
specific agreement for that purpose, arrange for a different allocation of costs as
among themselves.
3. No provision of this compact shall be construed to alter or affect any internal
relationships among the departments, agencies, and officers of and in the government
of a party state, or between a party state and its subdivisions, as to the payment of
costs, or responsibilities therefor.

4. Nothing in this compact shall be construed to prevent any party state or subdivision
thereof from asserting any right against any person, agency, or other entity in regard to
costs for which such party state or subdivision thereof may be responsible pursuant to
any provision of this compact.
5. Nothing in this compact shall be construed to invalidate any reciprocal agreement
between a party state and a nonparty state relating to institutionalization, care, or
treatment of the mentally ill or mentally deficient, or any statutory authority pursuant to
which such agreements may be made.
1. Nothing in this compact shall be construed to abridge, diminish, or in any way impair
the rights, duties, and responsibilities of any patient's guardian on the guardian's own
behalf or in respect of any patient for whom the guardian may serve, except that when
the transfer of any patient to another jurisdiction makes advisable the appointment of a
supplemental or substitute guardian, any court of competent jurisdiction in the
receiving state may make such supplemental or substitute appointment and the court
which appointed the previous guardian shall upon being duly advised of the new
appointment, and upon the satisfactory completion of such accounting and other acts
as such court may by law require, relieve the previous guardian of power and
responsibility to whatever extent shall be appropriate in the circumstances; provided,
however, that in the case of any patient having settlement in the sending state, the
court of competent jurisdiction in the sending state shall have the sole discretion to
relieve a guardian appointed by it or continue the guardian's power and responsibility,
whichever it shall deem advisable. The court in the receiving state may, in its
discretion, confirm or reappoint the person or persons previously serving as guardian
in the sending state in lieu of making a supplemental or substitute appointment.
2. The term "guardian" as used in paragraph 1 of this article shall include any guardian,
trustee, legal committee, conservator, or other person or agency however
denominated who is charged by law with power to act for or responsibility for the
person or property of a patient.
1. No provision of this compact except article V shall apply to any person institutionalized
while under sentence in a penal or correctional institution or while subject to trial on a
criminal charge, or whose institutionalization is due to the commission of an offense for
which, in the absence of mental illness or mental deficiency, said person would be
subject to incarceration in a penal or correctional institution.
2. To every extent possible, it shall be the policy of states party to this compact that no
patient shall be placed or detained in any prison, jail, or lockup, but such patient shall,
with all expedition, be taken to a suitable institutional facility for mental illness or
mental deficiency.
1. Each party state shall appoint a "compact administrator" who, on behalf of the person's
state, shall act as general coordinator of activities under the compact in the person's
state and who shall receive copies of all reports, correspondence, and other
documents relating to any patient processed under the compact by the person's state
either in the capacity of sending or receiving state. The compact administrator or the
compact administrator's duly designated representative shall be the official with whom
other party states shall deal in any matter relating to the compact or any patient
processed thereunder.
2. The compact administrators of the respective party states shall have power to
promulgate reasonable rules and regulations to carry out more effectively the terms
and provisions of this compact.
The duly constituted administrative authorities of any two or more party states may enter
into supplementary agreements for the provision of any service or facility or for the maintenance
of any institution on a joint or cooperative basis whenever the states concerned shall find that
such agreements will improve services, facilities, or institutional care and treatment in the fields

of mental illness or mental deficiency. No such supplementary agreement shall be construed so
as to relieve any party state of any obligation which it otherwise would have under other
provisions of this compact.
This compact shall enter into full force and effect as to any state when enacted by it into law
and such state shall thereafter be a party thereto with any and all states legally joining therein.
1. A state party to this compact may withdraw therefrom by enacting a statute repealing
the same. Such withdrawal shall take effect one year after notice thereof has been
communicated officially and in writing to the governors and compact administrators of
all other party states. However, the withdrawal of any state shall not change the status
of any patient who has been sent to said state or sent out of said state pursuant to the
provisions of the compact.
2. Withdrawal from any agreement permitted by Article VII-2 as to costs or from any
supplementary agreement made pursuant to Article XI shall be in accordance with the
terms of such agreement.
This compact shall be liberally construed so as to effectuate the purposes thereof. The
provisions of this compact shall be severable and if any phrase, clause, sentence, or provision
of this compact is declared to be contrary to the constitution of any party state or of the United
States or the applicability thereof to any government, agency, person, or circumstance is held
invalid, the validity of the remainder of this compact and the applicability thereof to any
government, agency, person, or circumstance shall not be affected thereby. If this compact shall
be held contrary to the constitution of any state party thereto, the compact shall remain in full
force and effect as to the remaining states and in full force and effect as to the state affected as
to all severable matters.
### § 25-11-02. Compact administrator - Powers.

Pursuant to said compact, the commissioner of the department of health and human
services or designee must be the compact administrator and who, acting jointly with like officers
of other party states, may adopt rules to carry out more effectively the terms of the compact.
The compact administrator shall cooperate with all departments, agencies, and officers of and in
the government of this state and its subdivisions in facilitating the proper administration of the
compact or any supplementary agreement or agreements entered into by this state thereunder.
### § 25-11-03. Power to make supplementary agreements - Limitation.

The compact administrator is hereby authorized and empowered to enter into
supplementary agreements with appropriate officials of other states pursuant to articles VII and
XI of the compact. In the event that such supplementary agreements require or contemplate the
use of any institution or facility of this state or require or contemplate the provision of any
service by this state, no such agreement may have force or effect until approved by the head of
the department or agency under whose jurisdiction said institution or facility is operated or
whose department or agency will be charged with the rendering of such service.
### § 25-11-04. Discharge of financial obligations.

The compact administrator, subject to the approval of the state treasurer, may make or
arrange for any payments necessary to discharge any financial obligations imposed upon this
state by the compact or by any supplementary agreement entered into thereunder.
### § 25-11-05. Transfer of patients - Approval of court.

The compact administrator is hereby directed to consult with the immediate family of any
proposed transferee and, in the case of a proposed transferee from an institution in this state to
an institution in another party state, to take no final action without approval of the district court
which committed the patient, or if such patient was not committed, then without approval of the
district court serving Stutsman County.

### § 25-11-06. Transmission of copies of chapter.

Duly authorized copies of this chapter must, upon its approval, be transmitted by the
secretary of state to the governor of each state, the attorney general and the administrator of
general services of the United States, and the council of state governments.
