# Title 25 — Mental and Physical Illness or Disability

## Chapter 25-03.2 — Residential Treatment Centers for Children

### § 25-03.2-01. Definitions.

In this chapter, unless the context otherwise requires:
1. "Child" or "children" means a person or persons under the age of twenty-one.
2. "Clinical supervision" means the oversight responsibility for individual treatment plans
and individual service delivery.
3. "Department" means the department of health and human services.
4. "Diagnostic assessment" means a written summary of the history, diagnosis, and
individual treatment needs of a mentally ill person using diagnostic, interview, and
other relevant assessment techniques.
5. "Individual treatment plan" means a written plan of intervention, treatment, and
services for a mentally ill person that is developed under the clinical supervision of a
mental health professional on the basis of a diagnostic assessment.
6. "Mentally ill person" has the same meaning provided for in section 25-03.1-02.
7. "Psychiatric residential treatment facility for children" means a facility or a distinct part
of a facility that provides to children a total, twenty-four hour, therapeutic environment
integrating group living, educational services, and a clinical program based upon a
comprehensive, interdisciplinary clinical assessment, and an individualized treatment
plan that meets the needs of the child and family. The services are available to
children in need of and able to respond to active psychotherapeutic intervention and
who cannot be effectively treated in their own family, in another home, or in a less
restrictive setting. The facility must meet the requirements of a psychiatric residential
treatment facility as set out in title 42, Code of Federal Regulations, part 483.352.
8. "Residential treatment" means a twenty-four hour a day program under the clinical
supervision of a mental health professional, in a community residential setting other
than an acute care hospital, for the active treatment of mentally ill persons.
9. "Serious risk of harm" means a substantial likelihood of:
a. Suicide, as manifested by current suicidal threats, attempts, or significant
depression creating immediate risk of suicide;
b. Killing or inflicting serious bodily harm to self or another person, as manifested by
current act; or
c. Substantial deterioration in physical health or substantial injury, disease, or death
based on current poor self-control or judgment.
### § 25-03.2-02. License required.

The operator of a publicly or privately operated psychiatric residential treatment facility for
children shall meet the requirements for licensure and shall secure a license from the
department.
### § 25-03.2-03. Requirements for license.

The department shall issue a license for the operation of a psychiatric residential treatment
facility for children upon a showing that:
1. The premises to be used are in fit, safe, and sanitary condition and properly equipped
to provide good care and treatment;
2. The program director of the facility holds, at a minimum, a bachelor's degree in social
work, psychology, or in a related field with professional experience working with
children suffering from mental illnesses or emotional disturbances. The executive
director of the facility must have, at a minimum, a bachelor's degree in a behavioral
science or a bachelor's degree in any field and two years of experience in
administration;
3. The staff employed by the facility is supervised by the program director and qualified
by training and experience to provide services to children suffering from mental

illnesses or emotional disturbances. The facility annually must provide training to staff
which is relevant to the needs of the client population;
4. The health, safety, and well-being of the children cared for and treated in the facility
will be properly safeguarded;
5. There are sufficient treatment, educational, recreational and leisure, and physical
facilities and services available to the children in the facility;
6. The facility will provide for a medical and psychological examination of each child
within seventy-two hours of admission and thereafter as needed by the child;
7. An interdisciplinary team will review each individual treatment plan at least monthly
and update or amend the plan to meet the needs of the child;
8. The facility develops postdischarge plans and coordinates facility services and related
community services with partial discharge plans with each child's family, school, and
community upon discharge to ensure continuity of care;
9. The facility is in compliance with requirements for psychiatric residential treatment
facilities under 42 U.S.C. 1396d [Pub. L. 89-97; 79 Stat. 351] and title 42, Code of
Federal Regulations, part 441, and with this chapter and rules adopted under this
chapter;
10. The facility has sought and obtained a criminal history record when required by this
chapter; and
11. In accordance with rules of the department, the department has determined whether a
license may be issued to a facility that has a facility operator or any individual
employed by the facility, contracted service provider of the facility, or nonemployee of
the facility, having contact with any child cared for by the facility who has a criminal
record.
### § 25-03.2-03.1. Moratorium on expansion of psychiatric residential treatment facility for

children bed capacity - Exchange of bed capacity.
1. Notwithstanding sections 25-03.2-03 and 25-03.2-08, unless a needs assessment
conducted by the department indicates a need for the licensing of additional bed
capacity, the department may not issue a license under this chapter for any additional
bed capacity for a psychiatric residential treatment facility for children above the state's
gross number of beds licensed as of June 30, 2003. This subsection does not apply to
nor prohibit the department from licensing additional bed capacity for a new psychiatric
residential treatment facility for children if the additional beds are designated for the
care of children and adolescents who are residents of other states.
2. Notwithstanding subsection 1, the department may develop a policy to:
a. Exchange qualified residential treatment program bed capacity licensed under
chapter 50-11 with psychiatric residential treatment facility bed capacity; or
b. Exchange psychiatric residential treatment facility bed capacity with qualified
residential treatment program bed capacity licensed under chapter 50-11.
### § 25-03.2-04. Conviction not bar to licensure - Exceptions.

Conviction of an offense by an owner or operator of a facility does not disqualify the
psychiatric residential treatment facility for children from licensure unless the department
determines that the offense has a direct bearing upon a person's ability to serve the public as an
owner or operator of a psychiatric residential treatment facility for children, or that, following
conviction of any offense, the person is not sufficiently rehabilitated under section 12.1-33-02.1.
### § 25-03.2-04.1. Criminal history record investigation - Fingerprinting required.

1. Each psychiatric residential treatment facility for children shall secure, from a law
enforcement agency or any other agency authorized to take fingerprints, two sets of
fingerprints and shall provide all other information necessary to secure state criminal
history record information and a nationwide background check under federal law from
a facility operator, and any individual employed by the facility, contracted service

provider of the facility, and nonemployee of the facility, having contact with any child
cared for by the facility.
2. The facility shall assure information obtained under subsection 1 is provided to the
department.
3. Upon receipt of all fingerprints and necessary information relating to a criminal history
record investigation, the department shall submit the information and fingerprints to the
bureau of criminal investigation. The department shall provide a copy of the state
criminal history record information response received from the bureau of criminal
investigation to the facility or authorized agent making the request.
4. The bureau of criminal investigation shall request a nationwide background check from
the federal bureau of investigation and, upon receipt of a response, provide the
response of the federal bureau of investigation to the department. The bureau of
criminal investigation also shall provide any criminal history record information that
may lawfully be made available under chapter 12-60 to the department.
5. Upon request by the operators of a facility or employees of a facility, a law
enforcement agency shall take fingerprints of individuals described in this section if the
request is made for purposes of this section.
6. The department shall pay the cost of securing fingerprints, any criminal history record
information made available under chapter 12-60, and a nationwide background check
for each psychiatric residential treatment facility for children.
7. An agency that takes fingerprints as provided under this section may charge a
reasonable fee to offset the costs of the fingerprinting.
8. A criminal history record investigation completed under this section may be used to
satisfy the criminal history record investigation requirements of sections 50-06-01.9,
50-06-01.10, 50-11-06.8, 50-11.3-01, and 50-12-03.2. The federal bureau of
investigation's criminal history record investigation obtained from one criminal history
record investigation purpose may not be reused to satisfy the requirements for another
federal bureau of investigation's criminal history record investigation for a different
purpose.
### § 25-03.2-05. Content of license.

The license to operate a psychiatric residential treatment facility for children must specify:
1. The name of the licensee.
2. The premises to which the license is applicable.
3. The number of children who may be received in the premises at any one time.
4. The date of expiration of the license.
### § 25-03.2-06. Admission criteria.

A child may be admitted to a psychiatric residential treatment facility for children if:
1. The child has been diagnosed by a psychiatrist or psychologist as suffering from a
mental illness or emotional disturbance;
2. The child's situation meets the definition of serious risk of harm; and
3. A less restrictive setting cannot meet the immediate treatment need.
### § 25-03.2-07. Method of providing service.

A psychiatric residential treatment facility for children shall provide for the development of
an individual treatment plan, based upon a comprehensive interdisciplinary diagnostic
assessment, which includes the role of the family, identifies the goals and objectives of the
therapeutic activities and treatment, provides a schedule for accomplishing the therapeutic
activities and treatment goals and objectives, and identifies the individuals responsible for
providing services, consistent with the individual treatment plan, to children. Clinical supervision
of the individual treatment plan must be accomplished as set forth by the department in rules.
Clinical supervision must be documented in individual treatment plans and by entries in the
child's record regarding supervisory activity.

### § 25-03.2-08. Revocation or denial of license.

The department may revoke a license or deny an application for a license under this
chapter if:
1. Any requirement and condition of this chapter for the issuance of a license is not met,
or has ceased to be met;
2. The license was issued or requested upon fraudulent or untrue representations;
3. The owner or operator has violated any rule of the department; or
4. The owner, operator, or an employee of the facility is or has been found guilty of an
offense determined by the department to have a direct bearing on the person's ability
to serve as an owner, operator, or employee, or the department determines, following
conviction of an offense, that the person is not sufficiently rehabilitated under section
12.1-33-02.1.
### § 25-03.2-09. Hearing on denial or revocation of license.

In any case in which the department determines that a license should be revoked or an
application for a license should be denied, written reasons for the revocation or denial must be
provided to the licensee or applicant. The licensee or applicant is entitled to a hearing before the
department if a hearing is requested within ten days after the charges are provided.
### § 25-03.2-10. Department may adopt rules.

The department may adopt rules for the conduct of psychiatric residential treatment facilities
for children and shall adopt rules defining which professionals may provide clinical supervision
and review, and may develop, update, and sign an individual treatment plan within a psychiatric
residential treatment facility for children.
