# Title 43 — Occupations and Professions

## Chapter 43-60 — Genetic Counseling

### § 43-60-01. Definitions.

In this chapter:
1. "ABGC" means the American board of genetic counseling.
2. "ABMG" means the American board of medical genetics.
3. "Board" means the North Dakota board of medicine.
4. "Genetic counseling" means a communication process, conducted by appropriately
trained individuals which includes:
a. Assisting an individual, the individual's family, a health care provider, or the public
with comprehending the issues inherent to genetic counseling. Such assistance
may include:
(1) Appreciating the medical, psychological, and social implications of a
disorder, including features, variability, usual course, and management
options;
(2) Learning how genetic factors contribute to the disorder and affect the
chance for recurrence of the condition in other family members;
(3) Understanding available options for coping with, preventing, or reducing the
chance of occurrence or recurrence of a condition;
(4) Selecting the most appropriate, accurate, and cost-effective methods to
determine risk for genetic conditions and diseases; and
(5) Understanding genetic tests, including diagnostic genetic tests, screening
tests, or predispositional genetic tests; coordinating testing for inherited
disorders; and explaining complex genetic test results;
b. Assessing the likelihood of the occurrence or recurrence of an abnormality in the
pregnancy in structure, function, or metabolism or of any potentially inherited or
genetically influenced condition. Such assessment may include the following:
(1) Obtaining and analyzing a complete health history of an individual and the
individual's family;
(2) Reviewing pertinent medical records;
(3) Evaluating the risks from exposure to possible mutagens or teratogens; and
(4) Discussing genetic testing or other evaluations to identify a condition or
determine the carrier status of one or more family members; and
c. Facilitating an individual's or family's:
(1) Exploration of the perception of risk and burden associated with a genetic
disorder;
(2) Decisionmaking regarding testing or medical interventions consistent with
the individual's or family's beliefs, goals, needs, or resources or with the
individual's or family's cultural, ethical, or moral views; and
(3) Adjustment and adaptation to the condition or the genetic risk by addressing
needs for psychological, social, and medical support.
5. "Genetic counselor" means an individual licensed under this chapter to engage in the
practice of genetic counseling.
6. "Supervision" means ongoing direct clinical review for the purposes of training or
teaching, by a supervisor approved by the board who monitors the performance or an
individual's supervised interaction with a client and provides regular documented
face-to-face consultation, guidance, and instructions with respect to the clinical skills
and competencies of the supervised individual. This supervision may be by personal
contact or indirect contact by telecommunication.
### § 43-60-02. Practice of genetic counseling - Exemptions.

1. A person may not engage in the practice of genetic counseling, act or represent to be
a genetic counselor, or use such titles as genetic counselor, licensed genetic
counselor, gene counselor, genetic associate, or any words, letters, abbreviations, or
insignia, such as certified genetic counselor or CGC, indicating or implying that person

is a genetic counselor, unless the person is an individual who holds a license or
temporary license issued by the board under this chapter and otherwise complies with
the provisions of this chapter. An individual who is exempt from the licensure
requirements of this chapter may not use a title indicating or implying the individual is a
genetic counselor.
2. Genetic testing may be ordered by a licensed genetic counselor or in coordination with
a North Dakota licensed health care provider acting within the provider's scope of
practice and privileged to do so. Nothing in this chapter authorizes a genetic counselor
to practice medicine, including treatment or medical management of a patient. If, in the
course of providing genetic counseling to a client, a genetic counselor finds any
indication of a disease or condition that requires medical assessment or treatment, the
genetic counselor shall refer the client to a provider licensed to practice medicine.
3. The following individuals may engage in the practice of genetic counseling without
being licensed under this chapter:
a. A licensed health care professional practicing within the professional's scope of
practice;
b. A student or intern from a board-recognized school;
c. An individual trained as a Ph.D. medical geneticist;
d. A consultant from another state who is board-certified by the ABGC or the ABMG,
for the limited purpose of consulting with a genetic counselor;
e. An employee of the department of health and human services in the provision of
education regarding single gene conditions, including sickle cell, cystic fibrosis,
and hemoglobinopathies; and
f. An individual acting within the scope of religious ministerial duties.
### § 43-60-03. Application for licensure.

1. An applicant for licensure under this chapter shall pay any filing fee and file an
application, on forms provided by the board, to the satisfaction of the board that the
applicant is of good moral character and satisfies all of the requirements of this
chapter, including:
a. Education at one of the following levels:
(1) Master of science degree from a genetic counseling training program that is
accredited by the ABGC or an ABGC-approved equivalent organization and
approved by the board; or
(2) Doctoral degree from a medical genetics training program that is accredited
by the ABMG and approved by the board; and
b. Successful completion of all requirements of the certification examination within a
period not to exceed five years from initial examination to successful completion
and with no more than three attempts unless an exception is approved by rule
adopted by the board;
c. Physical, mental, and professional capability for the practice of genetic
counseling in a manner acceptable to the board; and
d. A history free of any finding by the board, by any other state licensing board, or
by any court of competent jurisdiction which would constitute grounds for
disciplinary action under this chapter. The board may modify this restriction for
cause.
2. In compliance with chapter 43-17, the board may refuse to grant a license under this
chapter if any of the license requirements are not met.
### § 43-60-04. Temporary license.

1. The board may issue a temporary license to an applicant who pays the temporary
license fee and meets all the qualifications for licensure, except the successful
completion of the certification examination if the applicant submits evidence to the
board that the applicant is a candidate accepted to write the certification examination.
2. A temporary licensee shall take the certification examination within eighteen months of
obtaining the temporary license. If a temporary licensee fails the first sitting of the

certification examination or the temporary license expires, the temporary licensee may
reapply for another temporary license. A temporary license may not be issued or
reissued if the applicant failed the certification examination three times.
3. A temporary license expires on the occurrence of the following:
a. Issuance of a regular license;
b. Failure to pass the board-approved examination; or
c. Expiration of the term for which the temporary license was issued.
4. A temporary licensee's practice is limited to practice under the supervision of a
licensed genetic counselor or under the supervision of a physician approved by the
board if that physician has a current ABMG certification in clinical genetics.
### § 43-60-05. License renewal.

A license issued under this chapter must be renewed annually on a date designated by the
board. The board shall renew a license upon payment of the renewal fee, submission of a
renewal application in a form approved by the board, and submission of evidence satisfactory to
the board of the applicant's current certification by the ABGC or ABMG.
### § 43-60-06. Board duties.

The board shall adopt rules pertaining to fees, licensure, investigations, and disciplinary
proceedings.
### § 43-60-06.1. Criminal history record checks.

The board may require an applicant for licensure or a licensee who is the subject of a
disciplinary investigation to submit to a statewide and nationwide criminal history record check.
The nationwide criminal history record check must be conducted in the manner provided by
section 12-60-24. All costs associated with the criminal history record check are the
responsibility of the licensee or applicant.
### § 43-60-07. Disciplinary actions.

1. The board may cancel, revoke, suspend, or restrict the license of a genetic counselor;
may issue public reprimands; and may issue fines, not to exceed one thousand
dollars, if the board is satisfied by proof by a preponderance of the evidence, in
compliance with chapter 43-17, of any of the following grounds for disciplinary action:
a. The use of any false, fraudulent, or forged statement or document or the use of
any fraudulent, deceitful, dishonest, or immoral practice in connection with any of
the licensing requirements.
b. The making of false or misleading statements by a genetic counselor about the
counselor's skill.
c. The conviction of any misdemeanor determined by the board to have a direct
bearing upon the genetic counselor's ability to serve the public as a practitioner of
genetic counseling.
d. The conviction of a felony, if the requirements of section 12.1-33-02.1 are met.
e. Habitual use of alcohol or drugs.
f. Physical or mental disability materially affecting the ability to perform the duties of
a genetic counselor in a competent manner.
g. The performance of any dishonorable, unethical, or unprofessional conduct likely
to deceive, defraud, or harm the public.
h. Obtaining any fee by fraud, deceit, or misrepresentation.
i. Aiding or abetting the practice of genetic counseling by an unlicensed,
incompetent, or impaired person.
j. The violation of any provision of this chapter or the rules adopted by the board or
the violation of any action, stipulation, condition, or agreement imposed by the
board or the board's investigative panels.
k. The practice of genetic counseling under a false or assumed name.

l. The advertising for the practice of genetic counseling in an untrue or deceptive
manner.
m. The willful or negligent violation of the confidentiality between genetic counselor
and patient, except as required by law.
n. Gross negligence in the practice of genetic counseling.
o. Sexual abuse, misconduct, or exploitation related to the genetic counselor's
practice of genetic counseling.
p. The use of any false, fraudulent, or deceptive statement in any document
connected with the practice of genetic counseling.
q. The imposition by another state or jurisdiction of disciplinary action against a
license or other authorization to practice genetic counseling based upon acts or
conduct by the genetic counselor which would constitute grounds for disciplinary
action as set forth in this section. A certified copy of the record of the action taken
by the other state or jurisdiction is conclusive evidence of that action.
r. The failure to furnish the board or the board's investigative panel or the board's or
investigative panel's investigators or representatives information legally
requested by the board or the investigative panel.
2. The board shall keep a record of all the board's proceedings in the matter of
suspending, revoking, or refusing licenses together with the evidence offered.
3. The board shall deposit in the general fund any fines collected under this section.
### § 43-60-08. Reinstatement and renewal.

Upon application, the board may reinstate or renew a license of an applicant whose license
has been canceled, suspended, or revoked. The board may establish the protocol for
reinstatement and renewal under this section and may impose conditions for reinstatement and
renewal.
### § 43-60-09. Genetic counselor advisory committee.

1. The board shall appoint a genetic counselor advisory committee composed of at least
one genetic counselor and at least two physicians licensed under chapter 43-17.
Except for initial appointments, each committee member shall serve a term of three
years. The term of initial appointees must be staggered so that expiration of terms is
evenly distributed. A committee member may not be appointed to more than three
consecutive full terms. If a vacancy occurs, the board shall appoint an individual to fill
the unexpired term.
2. The advisory committee shall meet as necessary to conduct business, but at least
annually. The advisory committee shall make recommendations to the board regarding
board rules adopted under this chapter.
### § 43-60-10. Penalty.

It is a class B misdemeanor to knowingly violate this chapter.
