# Title 25 — Mental and Physical Illness or Disability

## Chapter 25-04 — Care of Developmentally Disabled

### § 25-04-00.1. Definitions.

For the purposes of this chapter:
1. "Department" means the department of health and human services.
2. "Eligible" means an individual has been deemed eligible by the department for
developmental disability services.
3. "Individual served" is an eligible individual who is a legal resident of the state of North
Dakota and is receiving services from the life skills and transition center.
4. "Noneligible" means a minor who is a legal resident of the state and has not been
deemed eligible by the department for developmental disability services.
5. "Nonresident individual served" includes:
a. Any individual served by the life skills and transition center who is under eighteen
years old and whose responsible relative is not a bona fide resident of this state.
b. Any enrolled member of a federally recognized Indian tribe for whom the United
States government has, through its statutes and regulations, a responsibility for
their care.
6. "Nonresident responsible relative" includes the nonresident spouse, father, or mother
of the individual served. It includes the bureau of Indian affairs in those cases involving
an enrolled member of a federally recognized Indian tribe for whom the United States
government has, through its statutes and regulations, a responsibility for their care.
7. "Nonresidential services" means rehabilitative services and supports that are provided
in a family home or community setting.
8. "Residential services" are specialized services and supports provided at the life skills
and transition center facility which include both room and board and rehabilitative
services in accordance with an individual's care and support plan. Residential services
provided at the life skills and transition center are available to address an individual's
needs for stabilization.
### § 25-04-01. Life skills and transition center - Name - Administration and control.

A facility for individuals with developmental disabilities must be maintained at or near the
city of Grafton in Walsh County. The facility must be known and designated as the life skills and
transition center. The department has administrative authority and control of the life skills and
transition center.
### § 25-04-01.1. Life skills and transition center to be substituted for developmental center

at westwood park, Grafton.
The legislative council shall delete, where appropriate, "developmental center at westwood
park, Grafton", "developmental center", or any derivatives of those terms, which when used in
context indicate an intention to refer to those terms, wherever they appear in the North Dakota
Century Code, in supplements to the North Dakota Century Code, and in the North Dakota
Administrative Code, and to insert in lieu of each deletion "life skills and transition center" or an
appropriate derivative of that phrase. These changes are to be made when any volume or
supplement of the North Dakota Century Code is being reprinted. Life skills and transition center
is to be substituted for, shall take any action previously to be taken by, and shall perform any
duties previously to be performed by the developmental center at westwood park, Grafton.
### § 25-04-02. Purpose of life skills and transition center.

(Effective through June 30, 2027)
1. The purpose of the life skills and transition center is to serve as a specialty care and
support resource for eligible individuals with developmental disabilities who are
experiencing crisis or who would benefit from stabilization, and to work together with
parent, guardian, or legal custodian and care teams to identify opportunities for each
individual served to live in a family home or community setting of their choice when
possible.

2. The life skills and transition center must be maintained to provide care, treatment,
training, rehabilitation, and supervision for eligible individuals. For this purpose the
department may introduce and establish such rehabilitative and support services as, in
its judgment, will best prepare the individuals served to live in the most integrated,
independent setting possible.
3. The life skills and transition center may provide both residential services and
nonresidential services and effectuate its powers and duties to best serve eligible
individuals who may benefit from those activities.
4. Upon approval of the commissioner of the department or designee and in the opinion
of the superintendent of the life skills and transition center, the life skills and transition
center may provide:
a. Residential services or nonresidential services and effectuate its powers and
duties to best serve noneligible individuals who are experiencing crisis or who
would benefit from stabilization and may benefit from those activities; or
b. Consultation services to public and private providers serving noneligible
individuals.
Purpose of life skills and transition center. (Effective after June 30, 2027)
1. The purpose of the life skills and transition center is to serve as a specialty care and
support resource for eligible individuals with developmental disabilities who are
experiencing crisis or who would benefit from stabilization, and to work together with
parent, guardian, or legal custodian and care teams to identify opportunities for each
individual served to live in a family home or community setting of their choice when
possible.
2. The life skills and transition center must be maintained to provide care, treatment,
training, rehabilitation, and supervision for eligible individuals. For this purpose the
department may introduce and establish such rehabilitative and support services as, in
its judgment, will best prepare the individuals served to live in the most integrated,
independent setting possible.
3. The life skills and transition center may provide both residential services and
nonresidential services and effectuate its powers and duties to best serve eligible
individuals who may benefit from those activities.
### § 25-04-02.1. Accreditation of life skills and transition center.

The department may request appropriations and resources sufficient to allow for
maintenance of the life skills and transition center's accreditation by the accreditation council on
services for people with developmental disabilities or certification by the centers for Medicare
and Medicaid services or, if deemed necessary, by similar accrediting and certifying
organizations and agencies possessing standards applicable to an individual with a
developmental disability and disciplines needed to provide quality services to individuals served.
### § 25-04-02.2. Institutional sale of services - Budget section approval.

Subject to approval of the legislative assembly or the budget section if the legislative
assembly is not in session, the life skills and transition center may provide any service not
otherwise authorized by law under contract with a governmental or nongovernmental person.
The life skills and transition center shall determine the rates for services provided. The
legislative assembly or the budget section may approve the provision of a service under this
section only after determining the service is not otherwise being provided by either the private or
public sector. Any request considered by the budget section must comply with section
54-35-02.9.
### § 25-04-03. Qualifications of superintendent.

The superintendent of the life skills and transition center must be a skilled administrator with
professional training and experience relating to the needs of individuals with developmental
disabilities. All employees must be appointed and removed by the superintendent or by the
superintendent's designee. The salaries of all employees shall be fixed by the superintendent or

the superintendent's designee within the limits of the legislative appropriations made for such
purpose.
### § 25-04-03.1. Biennial report - Assistant superintendent.

Repealed by S.L. 1989, ch. 338, § 6.
### § 25-04-04. Who may receive benefits of life skills and transition center.

1. Subject to this chapter and to any rules adopted by the department, the benefits of the
life skills and transition center may be received only by:
a. Eligible individuals who may benefit from services provided by the life skills and
transition center who, in the opinion of the superintendent of the life skills and
transition center are of suitable age and capacity to receive care, treatment,
training, rehabilitation, or supervision by the life skills and transition center or
whose disabilities prevent them from receiving training and instruction in the
public schools;
b. Eligible individuals who, in the opinion of the superintendent of the life skills and
transition center, may benefit from services provided by the life skills and
transition center and who are in need of stabilization supports and cannot be
properly cared for in their family home or other available community settings;
c. Eligible individuals who, in the opinion of the superintendent of the life skills and
transition center, may benefit from either residential services or nonresidential
services provided by the life skills and transition center; or
d. Noneligible individuals who, upon approval of the commissioner of the
department or designee and in the opinion of the superintendent of the life skills
and transition center, may benefit from:
(1) Residential services for up to ninety days, unless an extension is granted for
an additional ninety days by the superintendent of the life skills and
transition center to facilitate effective transition;
(2) Nonresidential services provided by the life skills and transition center; or
(3) Consultation services to public and private providers serving noneligible
individuals.
2. Residents and nonresidents of this state may receive services from the life skills and
transition center. Residents of this state and minors with developmental disabilities
must be given priority in receiving services from the life skills and transition center.
### § 25-04-04.1. Program management for an individual.

The department shall ensure active program management is maintained for individuals
served and noneligible individuals receiving residential services at the life skills and transition
center.
### § 25-04-05. Qualifications for accessing services provided by life skills and transition

center - Educational or related services without charge for individuals twenty-one years
of age and under.
1. The superintendent of the life skills and transition center may admit an eligible or
noneligible individual to the life skills and transition center for residential services
based on consideration of the following factors:
a. Ability of the life skills and transition center to provide the appropriate level of care
based on the individual's need.
b. Health and safety considerations for both the individual served and other
individuals currently being served by the life skills and transition center.
c. The individual may be admitted without exceeding the resident capacity of the
facility as specified in the professional standards of the department.
d. A noneligible individual may not receive residential services to the exclusion of an
eligible individual, unless the noneligible individual is receiving residential

services before the life skills and transition center receives an application to admit
an eligible individual for residential services.
2. The superintendent of the life skills and transition center may approve an eligible or
noneligible individual for nonresidential services provided by the life skills and
transition center if all of the following conditions have been met:
a. Application has been made on behalf of the individual by a department
developmental disabilities program manager, a parent, guardian, or legal
custodian, in accordance with procedures established by the department.
b. Information has been submitted to the life skills and transition center which allows
the superintendent to determine that the eligible or noneligible individual would
benefit from:
(1) Nonresidential stabilization services offered by the life skills and transition
center for the purpose of avoiding institutionalization or further
destabilization of the individual's living situation; or
(2) Consultation services to public and private providers serving noneligible
individuals.
3. Notwithstanding any other provision of this chapter, no eligible individual served,
twenty-one years of age or under, no noneligible individual, eighteen years of age or
under, or the estate or the parent of such individual, may be charged for educational or
related services provided at the life skills and transition center. Except as provided in
subsection 4, the department has prior claim on all benefits accruing to such
individuals served or noneligible individuals for medical and medically related services
under entitlement from the federal government, medical or hospital insurance
contracts, workforce safety and insurance, or medical care and disability programs.
For purposes of this subsection, "related services" means transportation and such
developmental, corrective, and other supportive services, as determined by the
department of public instruction, as are required to assist an individual with a disability
to benefit from special education. The cost of related services other than medical and
medically related services must be paid by the life skills and transition center, the
school district of residence of the child with a disability, and other appropriate state
agencies and political subdivisions of this state. The department of public instruction,
the department, the school district of residence, and other appropriate state agencies
and political subdivisions, as determined by the department of public instruction, shall
determine and agree to that portion of related services, other than medical and
medically related services, for which each agency and political subdivision is liable.
The department of public instruction may adopt rules necessary to implement this
section.
4. Parents of an eligible individual, who is twenty-one years of age or under, are not
required to file, assist in filing, agree to filing, or assign an insurance claim when filing
the claim would pose a realistic threat that the parents would suffer a financial loss not
incurred by similarly situated parents of children with disabilities. Financial losses do
not include incidental costs such as the time needed to file or assist in filing an
insurance claim or the postage needed to mail the claim. Financial losses include:
a. A decrease in available lifetime coverage or any other benefit under an insurance
policy.
b. An increase in premiums or the discontinuation of a policy.
c. An out-of-pocket expense such as the payment of a deductible amount incurred
in filing a claim unless the life skills and transition center pays or waives the
out-of-pocket expense.
### § 25-04-05.1. Transfer of individuals - Visiting privileges - Release and placement of

individuals.
1. The superintendent of the life skills and transition center shall have the right of
temporary transfer of any individual served or noneligible individual, at the life skills
and transition center, to an appropriate hospital or other specialized facility when in the

superintendent's opinion the immediate health and safety of the individual or the
immediate health and safety of others requires the transfer.
2. Subject to reasonable rules for the orderly operation of the life skills and transition
center, any parent, guardian, or legal custodian of the individual served or noneligible
individual shall have the right of visiting and communicating with the individual served
or noneligible individual and authorizing visits and communications with others.
3. The superintendent may authorize the temporary discharge of any individual served or
noneligible individual to the custody of the individual served's or noneligible individual's
parent, guardian, or legal custodian of the individual, or to another person designated
by the parent, guardian, or legal custodian. In the absence of such authorization, any
parent, guardian, or legal custodian of the individual served may formally request, in
writing, the individual served's temporary discharge. The discharge must be granted at
the earliest reasonable opportunity, but not more than thirty days after receipt of a
written application. If a discharge is, or would be, effected contrary to the advice of the
superintendent based on a recent comprehensive evaluation of the individual, the
superintendent shall so advise the parent, guardian, or legal custodian in writing.
4. The superintendent may arrange for the suitable placement of:
a. An individual served outside the life skills and transition center and to discharge
the individual served, provided placement has been preceded by a
comprehensive evaluation. No such placement of an individual served may be
effected until all reasonable efforts have been made to consult with the individual
served's care team and parent, guardian, or legal custodian of the individual
served; and
b. A noneligible individual outside the life skills and transition center or to discharge
the noneligible individual.
### § 25-04-05.2. San haven - Transportation costs - Payment limited.

Repealed by S.L. 1989, ch. 338, § 6.
### § 25-04-06. Juvenile court order for assessment of dependent, neglected, or delinquent

child with developmental disability - Appeal.
1. In any proceeding instituted in juvenile court, the court may make an order for
assessment of the child by the life skills and transition center for developmental
disability determination whenever it appears to the satisfaction of the court that the
child involved in the proceeding is:
a. Dependent and eligible for services at the life skills and transition center;
b. Neglected and eligible for services at the life skills and transition center; or
c. Delinquent and eligible for services at the life skills and transition center.
2. If it is ascertained as a result of such assessment that the child is eligible for
residential services offered at the life skills and transition center and the child qualifies
for accessing services from the life skills and transition center in accordance with
section 25-04-04 and subsection 1 of section 25-04-05, a report to such effect must be
made by the authorities of the life skills and transition center to the court. The court
thereupon shall make an order fixing a time for a hearing upon the report showing the
child to be eligible and qualifying for accessing services offered at the life skills and
transition center. Notice of the hearing must be given to the parents, custodian, or
guardian of such child in the manner prescribed by law for the giving of notice in other
proceedings in juvenile court. Upon such hearing, the court shall make such order as it
may deem proper. Any parent, custodian, guardian, or other person charged with the
control of such child may take an appeal from the order made by the court in the
manner now prescribed by law for the taking of appeals from decisions of the juvenile
court. Admission to residential services at the life skills and transition center must
follow the procedures established by the department and in accordance with section
accomplished without admission for residential services or transportation to the life
skills and transition center.

### § 25-04-07. Disabled defendants.

Repealed by S.L. 1991, ch. 121, § 5.
### § 25-04-08. Discharge of an individual from life skills and transition center.

An individual who receives residential services at the life skills and transition center must be
discharged if any one of the following conditions are present:
1. The superintendent of the life skills and transition center, on the basis of a
comprehensive evaluation and in consultation with the individual served's parent,
guardian, legal custodian, or care team, finds that the care, treatment, training,
rehabilitation, and supervision offered by the life skills and transition center are no
longer needed.
2. The parent, guardian, or legal custodian who voluntarily admitted the individual served
to residential services at the life skills and transition center and who retains legal
custody makes a written request for discharge.
3. The individual served is admitted on indefinite transfer to a hospital, school, or other
facility, or a protective service under the jurisdiction of another state, or another agency
or department of this state.
4. A court of competent jurisdiction orders the discharge of the individual served.
5. The superintendent makes a determination that the noneligible individual no longer
qualifies for accessing services provided by the life skills and transition center.
### § 25-04-08.1. Notification before discharge.

Before discharge the superintendent of the life skills and transition center shall meet with
the parent, guardian, legal custodian, or care team of the:
1. Individual served to be discharged, or with the court that ordered the individual served
to receive services at the life skills and transition center pursuant to section 25-04-06.
2. Noneligible individual to be discharged.
### § 25-04-09. Expense for care of inmates to be charge upon county - County to remit to

state treasurer.
Repealed by S.L. 1961, ch. 211, § 9.
### § 25-04-10. Transfer of inmate of state school when person legally responsible for

support moves to another state.
Repealed by S.L. 1961, ch. 211, § 9.
### § 25-04-11. Disposition of individual who is not a legal resident.

If an individual who has no legal residence in this state is subject to admission to the life
skills and transition center, by order of a court pursuant to section 25-04-06, such individual
must be admitted, at the expense of the county, to the life skills and transition center in the
same manner as a resident of this state who is found to be in need of services offered at the life
skills and transition center, and the superintendent of the life skills and transition center shall
then arrange for the transportation of such individual to the place where the individual belongs.
The department shall ascertain the place where such individual belongs when the same
conveniently can be done.
### § 25-04-11.1. Admission and disposition of nonresidents - Reciprocal agreements.

If an individual who has no legal residence in this state or whose residence is unknown is
found to be an eligible individual requiring care, treatment, training, rehabilitation, or supervision
from the life skills and transition center, the individual to be served must be admitted to the life
skills and transition center in the same manner, and accompanied by the same documents, as
in the case of a resident of this state. The department shall immediately inquire as to the
residence of the individual or the individual's responsible relatives, and, if the residence is found
to be in another state or country, the department shall arrange for transportation of the individual
to the place of legal residence or legal settlement unless the individual can be accommodated at

the life skills and transition center without depriving a North Dakota resident of care and
treatment at the life skills and transition center and adequate costs of care are paid for within a
reasonable time, or unless a reciprocal agreement has been entered into with another state
regarding the care and commitment of the nonresident. The department may enter into
reciprocal agreements with other states regarding the mutual exchange, return, and
transportation of individuals who are within one state but have legal residence or legal
settlement in another state. The agreements may not contain any provision conflicting with any
law of this state.
### § 25-04-11.2. Liability for care and treatment of nonresident individuals served.

Nonresident individuals served by the life skills and transition center and nonresident
responsible relatives of individuals served are liable for the chargeable costs of care and
treatment at the life skills and transition center.
### § 25-04-12. Electric power may be furnished to city of Dunseith from state school

power plant.
Repealed by S.L. 1961, ch. 209, § 5.
### § 25-04-13. Guardianship of person and estate - Superintendent and director of

institutions to act as guardians in lieu of court appointment or assumption by parent.
Repealed by S.L. 1973, ch. 257, § 82.
### § 25-04-13.1. Guardianship - Superintendent to act as guardian.

Repealed by S.L. 1987, ch. 326, § 2.
### § 25-04-14. Expenses chargeable against individual or individual's estate - Filing

claims.
Expenses for care and treatment of each individual served or noneligible individual by the
life skills and transition center must, if practicable, be in accordance with the cost of providing
care and treatment for the different degrees or conditions of mental and physical health and
charges may be adjusted in accordance with the individual served's or noneligible individual's
ability to pay which must include an estimate of potential future receipts, including amounts from
estates. The department shall recover from the individual served or noneligible individual or
from a discharged individual expenses chargeable for care and treatment. If any individual
served or noneligible individual is receiving social security benefits or is a veteran or a
dependent of a veteran who has received, is receiving, or is entitled to receive compensation or
pension from the veterans' administration, the expenses are a current claim against the
individual served or noneligible individual and may be recovered monthly by the department
except that any amount required by the payer of the benefits to be paid directly to the individual
served or noneligible individual must, upon approval of the department, be credited to the
individual served's or noneligible individual's personal account from any money thus received.
### § 25-04-15. Expenses chargeable against guardianship estate of individual served -

Restrictions.
The expenses chargeable by the state for the care and treatment of any individual served
over twenty-one years of age at the life skills and transition center must be charged against the
guardianship estate of such individual, if the individual has such an estate, subject to the
following restrictions:
1. No part of the estate may be taken for such purpose if the individual has dependents
within the United States dependent upon the estate for support and the taking of all or
a portion of the estate would result in undue hardship to those dependents.
2. No real property belonging to the estate may be sold during the lifetime of the
individual served except for the maintenance and support of the individual served's
dependents, unless it is shown that the sale of the property will not result in undue

hardship to those dependents, and it may be sold only upon the order of the district
court having jurisdiction of the estate, with the consent of the department.
3. No personal property belonging to the estate may be sold within five years from the
date upon which the individual was sent to the life skills and transition center unless
the property is ordered sold by the district court having jurisdiction of the estate for the
reason that the property is likely to deteriorate in value during the time herein
specified.
4. No claim may be made to recover from the estate of a former individual served of the
life skills and transition center who has left the life skills and transition center and
married and leaves a spouse or issue dependent upon such estate.
### § 25-04-15.1. Statute of limitations not bar to recovery.

No statute of limitations or similar statute or the doctrine of laches may bar the recovery of
costs of care furnished under this chapter. It is not necessary to bill currently any person for
those accounts determined to be inactive, currently uncollectible, or for which it has been
determined as provided by law that there is no present ability to pay. Current billings may be
made for amounts chargeable by law or for which it has been determined the responsible party
presently has an ability to pay, but the manner of billing may not affect the total amount due.
This section applies to claims for the cost of care furnished on or after July 1, 1961.
### § 25-04-16. Waiver of payment - Use of income tax data - Confidentiality - Definition.

1. Except with respect to services provided and duties effectuated for persons other than
individuals served by the life skills and transition center who are developmentally
disabled, and except with respect to services provided and duties effectuated under
subsection 2 of section 25-04-02, the individual served, former individual served,
parent of an individual served or former individual served under age eighteen,
personal representative, or guardian may make application to the supervising
department to pay less than the costs or none of the costs incurred by the state for the
individual served's care and treatment at the life skills and transition center. An
application from an individual served, former individual, personal representative, or
guardian must be accompanied by proof of the individual served's or the estate of the
individual served's inability to pay. An application from a parent of an individual served
or former individual served must be accompanied by proof that the parent has applied
for or cooperated fully in an application for medical and medically related services
under entitlement from the federal government, medical or hospital insurance
contracts, workforce safety and insurance, or medical care and disability programs for
provision of services to the individual served, and has assured the contribution of
those services, compensation, and contract and program benefits to meet the cost of
care provided to the individual served by the life skills and transition center. A waiver
must be granted upon receipt of an application from such a parent, which is complete
and supported by the required proofs and is effective for so long as the parent
continues to apply for or cooperate fully in applications for services, compensation,
and contract and program benefits, and continues to assure the contribution of those
services, compensation, and benefits to meet the costs of care. A waiver, once granted
with respect to an individual served under age eighteen, extinguishes any debt that
would otherwise be owed by the individual served, the individual served's parents, or
the individual served's estate with respect to care and treatment furnished during times
the waiver is effective.
2. Upon receipt of such application, the department shall direct the human service zone
of the county from which the individual served was admitted to determine whether the
application is complete and supported by the required proofs. The department shall
approve, reject, or amend the determination made by the human service zone. The
determination made by the department may be appealed to the district court of the
county of residence of the individual served.
3. Any individual served, former individual served, parent of an individual served or
former individual served, guardian, or personal representative who seeks relief from

the payment of the cost of care and treatment by filing an application for relief of
payment shall do so with the understanding that the department may, in its discretion,
and to its satisfaction, verify any statement made in such application for relief of
payment by a request for information from financial institutions, including commercial
banks, and from other sources likely to possess verifying information. Notwithstanding
the provisions of section 57-38-57, this verification may include a review of such
applicant's state income tax return or any other document or report submitted to or
held by any office or department of the state of North Dakota or any of its political
subdivisions.
4. When any official or employee of the life skills and transition center who, pursuant to
subsection 1, obtains income tax information or other tax information from the state tax
commissioner the confidentiality of which is protected by law, such official or employee
may not divulge such information except to the extent necessary for the administration
of this chapter or when otherwise directed by judicial order or when otherwise provided
by law.
### § 25-04-17. Reduction or writeoff of accounts - Report to legislative audit and fiscal

review committee.
The department may authorize the reduction or writeoff of an individual served's or
noneligible individual's past-due account from the life skills and transition center's financial
records upon determining that the account is not collectible. The department, by September first
after the close of each fiscal year, shall present a detailed report to the legislative audit and
fiscal review committee on the status of accounts receivable for that fiscal year. The report must
include:
1. An aging by individual classification of accounts remaining unpaid.
2. The amounts by individual classification by which accounts were reduced or written off
for reasons other than payment during that fiscal year.
### § 25-04-18. Limitations of this chapter.

The provisions of this chapter may not be construed to limit or broaden the plaintiff class as
defined by order of the United States district court for the district of North Dakota entered on
January 13, 1981, in civil number A1-80-141.
### § 25-04-19. Quality assurance review committees - Reports - Immunity.

Any information, data, report, or record generated by or made available to an internal quality
assurance review committee of the life skills and transition center or members thereof is
confidential and may be used by the committee and the members thereof only in the exercise of
the proper functions of the committee. The proceedings and records of the committee and the
members thereof are not subject to subpoena or discovery or introduction into evidence in any
civil action arising out of any matter under consideration by the committee. Any information,
document, or record otherwise available from original sources is not immune from discovery or
use in any civil action merely because it was presented during the proceedings of the
committee, nor may any person who testified before the committee or who is a member of it be
prevented from testifying as to matters within that person's knowledge, but a witness cannot be
asked about that witness's testimony before the committee. This section does not relieve any
person of any liability incurred as a result of furnishing health care to the resident. No person
furnishing information, data, reports, or records to the committee with respect to any resident of
the life skills and transition center is, by reason of furnishing the information, data, reports, or
records, liable in damages to any resident, or answerable for willful violation of a privileged or
confidential communication. No member of the committee is liable in damages to any person for
any action taken or recommendation made within the scope of the functions of the committee if
the committee member acts without malice and in the reasonable belief that the action or
recommendation is warranted by the facts known to the member.

### § 25-04-20. Westwood park assets management committee.

Repealed by S.L. 1999, ch. 34, § 39.
