Care and Treatment of Persons with Mental Health Disorders

C.R.S. tit. 27, art. 65
in effect

C.R.S. § 27-65-101 Legislative declaration

27-65-101. Legislative declaration. (1) The general assembly declares that the purposes of this article 65 are: (a) To secure for each person with a mental health disorder such care and treatment suited to the person's needs and to ensure that the care and treatment are skillfully and humanely administered with full respect for the person's dignity and personal integrity; (b) To deprive a person of the person's liberty for purposes of care or treatment only when less restrictive alternatives are unavailable and only when the person's safety or the safety of others is endangered; (c) To provide the fullest possible measure of privacy, dignity, and other rights to persons undergoing care and treatment for a mental health disorder; (d) To encourage the use of voluntary, rather than coercive, measures to provide care and treatment for mental health disorders and to provide the care and treatment in the least restrictive setting; (e) To provide appropriate information to family members concerning the location and fact of admission of a person with a mental health disorder to inpatient or residential care and treatment; (f) To encourage the appropriate participation of family members in the care and treatment of a person with a mental health disorder and, when appropriate, to provide information to family members in order to facilitate that participation; and (g) To facilitate the recovery and resiliency of each person who receives care and treatment pursuant to this article 65. (2) To carry out these purposes, the provisions of this article 65 must be liberally construed.

C.R.S. § 27-65-102 Definitions

27-65-102. Definitions. As used in this article 65, unless the context otherwise requires: (1) "Acute treatment unit" means a facility or a distinct part of a facility for short-term psychiatric care, which may include treatment for substance use disorders, that provides a total, twenty-four-hour, therapeutically planned and professionally staffed environment for persons who do not require inpatient hospitalization but need more intense and individual services than are available on an outpatient basis, such as crisis management and stabilization services. (2) "Behavioral health administration" or "BHA" means the behavioral health administration established in section 27-60-203. (3) "Behavioral health crisis" means a significant disruption in a person's mental or emotional stability or functioning resulting in an urgent need for immediate assessment and treatment to prevent a serious deterioration in the person's mental or physical health. (4) "Behavioral health crisis response team" means a mobile team that responds to people in the community who are in a behavioral health crisis and includes at least one licensed or bachelor-degree-level behavioral health worker. A "behavioral health crisis response team" includes, but is not limited to, a co-responder model, mobile crisis response unit, or a community response team. (5) "Behavioral health entity" has the same meaning as set forth in section 27-50-101. (6) "Certified peace officer" means any certified peace officer as described in section 16-2.5-102. (7) "Commissioner" means the commissioner of the behavioral health administration established in section 27-60-203. (8) "Court" means any district court of the state of Colorado and the probate court in the city and county of Denver. (9) "Court-ordered evaluation" means an evaluation ordered by a court pursuant to section 27-65-106. (10) "Danger to the person's self or others" means: (a) A person poses a substantial risk of physical harm to the person's self as manifested by evidence of recent threats of or attempts at suicide or serious bodily harm to the person's self; or (b) A person poses a substantial risk of physical harm to another person or persons, as manifested by evidence of recent homicidal or other violent behavior by the person in question, or by evidence that others are placed in reasonable fear of violent behavior and serious physical harm to them, as evidenced by a recent overt act, attempt, or threat to do serious physical harm by the person in question. (11) "Department" means the department of human services. (12) "Emergency medical services facility" means a general hospital with an emergency department or a freestanding emergency department, as defined in section 25-1.5-114 (5). An emergency medical services facility is not required to be, but may elect to become, a facility designated or approved by the commissioner. (13) "Emergency medical services provider" has the same meaning as set forth in section 25-3.5-103 (8). (14) Repealed. (15) "Facility" means a public hospital or a licensed private hospital, behavioral health entity, institution, or residential child care facility that provides treatment for persons with mental health disorders. (16) "Family member" means a spouse, partner in a civil union, as defined in section 14-15-103 (5), parent, adult child, or adult sibling of a person with a mental health disorder. aled. (15) "Facility" means a public hospital or a licensed private hospital, behavioral health entity, institution, or residential child care facility that provides treatment for persons with mental health disorders. (16) "Family member" means a spouse, partner in a civil union, as defined in section 14-15-103 (5), parent, adult child, or adult sibling of a person with a mental health disorder. (17) "Gravely disabled" means a condition in which a person, as a result of a mental health disorder, is incapable of making informed decisions about or providing for the person's essential needs without significant supervision and assistance from other people. As a result of being incapable of making these informed decisions, a person who is gravely disabled is at risk of substantial bodily harm, dangerous worsening of any concomitant serious physical illness, significant psychiatric deterioration, or mismanagement of the person's essential needs that could result in substantial bodily harm. A person of any age may be "gravely disabled", but the term does not include a person whose decision-making capabilities are limited solely by the person's developmental disability. (18) "Hospitalization" means twenty-four-hour out-of-home placement for treatment in a facility for a person with a mental health disorder. (19) "Independent professional person" means a professional person who evaluates a minor's condition as an independent decision-maker and whose recommendations are based on the standard of what is in the best interest of the minor. The professional person may be associated with the admitting facility if the professional person is free to independently evaluate the minor's condition and need for treatment and has the authority to refuse admission to any minor who does not satisfy the statutory standards specified in section 27-65-104 (2). (20) "Intervening professional" means a person who is one of the following: (a) A professional person; (b) A physician assistant licensed pursuant to section 12-240-113; (c) An advanced practice registered nurse, as defined in section 12-255-104 (1); (d) A registered professional nurse, as defined in section 12-255-104 (11), who has specific mental health training as identified by the BHA; (e) A clinical social worker licensed pursuant to part 4 of article 245 of title 12; (f) A marriage and family therapist licensed pursuant to part 5 of article 245 of title 12; (g) A professional counselor licensed pursuant to part 6 of article 245 of title 12; or (h) An addiction counselor licensed pursuant to part 8 of article 245 of title 12. (21) "Lay person" means a person identified by another person who is detained on an involuntary emergency mental health hold pursuant to section 27-65-106, certified for short-term treatment pursuant to section 27-65-109, or certified for long-term care and treatment pursuant to section 27-65-110 who is authorized to participate in activities related to the person's involuntary emergency mental health hold, short-term treatment, or long-term treatment, including court appearances, discharge planning, and grievances. The person may rescind the lay person's authorization at any time. (22) "Mental health disorder" includes one or more substantial disorders of the cognitive, volitional, or emotional processes that grossly impairs judgment or capacity to recognize reality or to control behavior. An intellectual or developmental disability is insufficient to either justify or exclude a finding of a mental health disorder pursuant to the provisions of this article 65. at any time. (22) "Mental health disorder" includes one or more substantial disorders of the cognitive, volitional, or emotional processes that grossly impairs judgment or capacity to recognize reality or to control behavior. An intellectual or developmental disability is insufficient to either justify or exclude a finding of a mental health disorder pursuant to the provisions of this article 65. (23) "Minor" means a person under eighteen years of age; except that the term does not include a person who is fifteen years of age or older who is living separately and apart from the person's parent or legal guardian and is managing the person's own financial affairs, regardless of the person's source of income, or who is married and living separately and apart from the person's parent or legal guardian. (24) "Patient representative" means a person designated by a mental health facility to process patient complaints or grievances or to represent patients who are minors pursuant to section 27-65-104 (4). (25) "Petitioner" means any person who files any petition in any proceeding in the interest of any person who allegedly has a mental health disorder or is allegedly gravely disabled. (26) "Physician" means a person licensed to practice medicine in this state. (27) "Professional person" means a person licensed to practice medicine in this state, a psychologist licensed to practice in this state, or a person licensed and in good standing to practice medicine in another state or a psychologist licensed to practice and in good standing in another state who is providing medical or clinical services at a treatment facility in this state that is operated by the armed forces of the United States, the United States public health service, or the United States department of veterans affairs. (28) "Residential child care facility" has the same meaning as set forth in section 26-6-903 (29). A residential child care facility may be eligible for designation by the commissioner pursuant to this article 65. (29) "Respondent" means either a person alleged in a petition filed pursuant to this article 65 to have a mental health disorder or be gravely disabled or a person certified pursuant to the provisions of this article 65. (30) "Screening" means a review of all petitions, to consist of an interview with the petitioner and, whenever possible, the respondent; an assessment of the problem; an explanation of the petition to the respondent; and a determination of whether the respondent needs and, if so, will accept on a voluntary basis, a comprehensive evaluation, treatment, referral, and other appropriate services, either on an inpatient or an outpatient basis. (31) "Secure transportation provider" means a provider licensed pursuant to section 25-3.5-310 to provide public or private secure transportation services.

C.R.S. § 27-65-103 Voluntary applications for mental health services

27-65-103. Voluntary applications for mental health services. (1) Nothing in this article 65 in any way limits the right of any person to make a voluntary application at any time to any public or private agency or professional person for mental health services, either by direct application in person or by referral from any other public or private agency or professional person. Subject to section 15-14-316 (4), a ward, as defined in section 15-14-102 (15), may be admitted to a hospital or institutional care and treatment for a mental health disorder with the guardian's consent for as long as the ward agrees to such care and treatment. The guardian shall immediately notify in writing the court that appointed the guardian of the admission. (2) For the purpose of this article 65, the treatment by prayer in the practice of the religion of any church that teaches reliance on spiritual means alone for healing is considered a form of treatment. (3) The medical and legal status of all voluntary patients receiving treatment for mental health disorders in inpatient or custodial facilities must be reviewed at least once every six months. (4) Voluntary patients are afforded all the rights and privileges customarily granted by hospitals to their patients. (5) (a) If at any time during an emergency mental health hold of a person who is confined involuntarily the facility staff requests the person to sign in voluntarily and the person elects to do so, the following advisement shall be given orally and in writing and an appropriate notation shall be made in the person's medical record by the professional person or the professional person's designated agent: NOTICE The decision to sign in voluntarily should be made by you alone and should be free from any force or pressure implied or otherwise. If you do not feel that you are able to make a truly voluntary decision, you may continue to be held at the hospital involuntarily. As an involuntary patient, you will have the right to protest your confinement and request a hearing before a judge. (b) This subsection (5) does not apply to a person on an emergency mental health hold in an emergency medical services facility.

C.R.S. § 27-65-104 Voluntary applications for mental health services - treatment of minors - definition

27-65-104. Voluntary applications for mental health services - treatment of minors - definition. (1) Notwithstanding any other provision of law, a minor who is fifteen years of age or older, whether with or without the consent of a parent or legal guardian, may consent to receive mental health services to be rendered by a facility, a professional person, or mental health professional licensed pursuant to part 3, 4, 5, 6, or 8 of article 245 of title 12 in any practice setting. Such consent is not subject to disaffirmance because of minority. The professional person or licensed mental health professional rendering mental health services to a minor may, with or without the consent of the minor, advise the minor's parent or legal guardian of the services given or needed. (2) A minor who is fifteen years of age or older or a minor's parent or legal guardian, on the minor's behalf, may make a voluntary application for hospitalization. An application for hospitalization on behalf of a minor who is under fifteen years of age and who is a ward of the department must not be made unless a guardian ad litem has been appointed for the minor or a petition for the same has been filed with the court by the agency having custody of the minor; except that such an application for hospitalization may be made under emergency circumstances requiring immediate hospitalization, in which case the agency shall file a petition for appointment of a guardian ad litem within seventy-two hours after application for admission is made, and the court shall immediately appoint a guardian ad litem. Procedures for hospitalization of a minor may proceed pursuant to this section once a petition for appointment of a guardian ad litem has been filed, if necessary. Whenever an application for hospitalization is made, an independent professional person shall interview the minor and conduct a careful investigation into the minor's background, using all available sources, including, but not limited to, the minor's parents or legal guardian, the minor's school, and any other social service agencies. Prior to admitting a minor for hospitalization, the independent professional person shall make the following findings: (a) That the minor has a mental health disorder and is in need of hospitalization; (b) That a less restrictive treatment alternative is inappropriate or unavailable; and (c) That hospitalization is likely to be beneficial. (3) An interview and investigation by an independent professional person is not required for a minor who is fifteen years of age or older and who, upon the recommendation of the minor's treating professional person, seeks voluntary hospitalization with the consent of the minor's parent or legal guardian. In order to assure that the minor's consent to such hospitalization is voluntary, the minor shall be advised, at or before the time of admission, of the minor's right to refuse to sign the admission consent form and the minor's right to revoke the minor's consent at a later date. If a minor admitted pursuant to this subsection (3) subsequently revokes the minor's consent after admission, a review of the minor's need for hospitalization pursuant to subsection (4) of this section must be initiated immediately. (4) (a) The need for continuing hospitalization of all voluntary minor patients must be formally reviewed at least every two months. Review pursuant to this subsection (4) must fulfill the requirement specified in section 19-1-115 (8) when the minor is fifteen years of age or older and consenting to hospitalization. (b) The review must be conducted by an independent professional person who is not a member of the minor's treating team; or, if the minor, the minor's physician, and the minor's parent or legal guardian do not object to the need for continued hospitalization, the review required pursuant to this subsection (4) may be conducted internally by the hospital staff. r and consenting to hospitalization. (b) The review must be conducted by an independent professional person who is not a member of the minor's treating team; or, if the minor, the minor's physician, and the minor's parent or legal guardian do not object to the need for continued hospitalization, the review required pursuant to this subsection (4) may be conducted internally by the hospital staff. (c) The independent professional person shall determine whether the minor continues to meet the criteria specified in subsection (2) of this section and whether continued hospitalization is appropriate and shall, at a minimum, conduct an investigation pursuant to subsection (2) of this section. (d) Ten days prior to the review, the patient representative at the mental health facility shall notify the minor of the date of the review and shall assist the minor in articulating to the independent professional person the minor's wishes concerning continued hospitalization. (e) Nothing in this section limits a minor's right to seek release from the facility pursuant to any other provision of law. (5) Every six months the review required pursuant to subsection (4) of this section shall be conducted by an independent professional person who is not a member of the minor's treating team and who has not previously reviewed the minor pursuant to subsection (4) of this section. (6) (a) When a minor does not consent to or objects to continued hospitalization, the need for such continued hospitalization must, within ten days, be reviewed pursuant to subsection (4) of this section by an independent professional person who is not a member of the minor's treating team and who has not previously reviewed the minor pursuant to this subsection (6). The minor shall be informed of the results of the review within three days after the review's completion. If the conclusion reached by the professional person is that the minor no longer meets the standards for hospitalization specified in subsection (2) of this section, the minor must be discharged. (b) If, twenty-four hours after being informed of the results of the review specified in subsection (6)(a) of this section, a minor continues to affirm the objection to hospitalization, the director of the facility or the director's duly appointed representative shall advise the minor that the minor has the right to retain and consult with an attorney at any time and that the director or the director's duly appointed representative shall file, within three days after the request of the minor, a statement requesting an attorney for the minor or, if the minor is under fifteen years of age, a guardian ad litem. The minor; the minor's attorney, if any; and the minor's parent, legal guardian, or guardian ad litem, if any, shall be given written notice that a hearing upon the recommendation for continued hospitalization may be had before the court or a jury upon written request directed to the court pursuant to subsection (6)(d) of this section. (c) Whenever the statement requesting an attorney is filed with the court, the court shall ascertain whether the minor has retained counsel, and, if the minor has not, the court shall, within three days, appoint an attorney to represent the minor, or if the minor is under fifteen years of age, a guardian ad litem. Upon receipt of a petition filed by the guardian ad litem, the court shall appoint an attorney to represent the minor under fifteen years of age. th the court, the court shall ascertain whether the minor has retained counsel, and, if the minor has not, the court shall, within three days, appoint an attorney to represent the minor, or if the minor is under fifteen years of age, a guardian ad litem. Upon receipt of a petition filed by the guardian ad litem, the court shall appoint an attorney to represent the minor under fifteen years of age. (d) (I) The minor or the minor's attorney or guardian ad litem may, at any time after the minor has continued to affirm the minor's objection to hospitalization pursuant to subsection (6)(b) of this section, file a written request that the recommendation for continued hospitalization be reviewed by the court or that the treatment be on an outpatient basis. If review is requested, the court shall hear the matter within ten days after the request, and the court shall give notice of the time and place of the hearing to the minor; the minor's attorney, if any; the minor's parents or legal guardian; the minor's guardian ad litem, if any; the independent professional person; and the minor's treating team. The hearing must be held in accordance with section 27-65-113; except that the court or jury shall determine that the minor is in need of care and treatment if the court or jury makes the following findings: (A) That the minor has a mental health disorder and is in need of hospitalization; (B) That a less restrictive treatment alternative is inappropriate or unavailable; and (C) That hospitalization is likely to be beneficial. (II) At the conclusion of the hearing, the court may enter an order confirming the recommendation for continued hospitalization, discharge the minor, or enter any other appropriate order. (e) For purposes of this subsection (6), "objects to hospitalization" means that a minor, with the necessary assistance of hospital staff, has written the minor's objections to continued hospitalization and has been given an opportunity to affirm or disaffirm such objections forty-eight hours after the objections are first written. (f) A minor may not again object to hospitalization pursuant to this subsection (6) until ninety days after conclusion of proceedings pursuant to this subsection (6). (g) In addition to the rights specified in section 27-65-119 for persons receiving evaluation, care, or treatment, a written notice specifying the rights of minor children under this section must be given to each minor upon admission to hospitalization. (7) A minor who no longer meets the standards for hospitalization specified in subsection (2) of this section must be discharged.

C.R.S. § 27-65-105 Rights of respondents

27-65-105. Rights of respondents. Unless specifically stated in an order by the court, a respondent does not forfeit any legal right or suffer legal disability by reason of the provisions of this article 65.

C.R.S. § 27-65-106 Emergency mental health hold - screening - court-ordered evaluation - discharge instructions - respondent's rights

27-65-106. Emergency mental health hold - screening - court-ordered evaluation - discharge instructions - respondent's rights. (1) An emergency mental health hold may be invoked under one of the following conditions: (a) (I) When a certified peace officer has probable cause to believe a person has a mental health disorder and, as a result of the mental health disorder, is an imminent danger to the person's self or others or is gravely disabled, the certified peace officer may take the person into protective custody and transport the person to a facility designated by the commissioner for an emergency mental health hold. If such a facility is not available, the certified peace officer may transport the person to an emergency medical services facility. The certified peace officer may request assistance from a behavioral health crisis response team for assistance in detaining and transporting the person or an emergency medical services provider in transporting the person; or (II) When an intervening professional reasonably believes that a person appears to have a mental health disorder and, as a result of the mental health disorder, appears to be an imminent danger to the person's self or others or appears to be gravely disabled, the intervening professional may cause the person to be taken into protective custody and transported to a facility designated by the commissioner for an emergency mental health hold. If such a facility is not available, the certified peace officer may transport the person to an emergency medical services facility. The intervening professional may request assistance from a certified peace officer, a secure transportation provider, or a behavioral health crisis response team for assistance in detaining and transporting the person, or assistance from an emergency medical services provider in transporting the person. (b) (I) When a person petitions the court in the county in which the respondent resides or is physically present requesting an evaluation of the respondent's condition and alleging that the respondent appears to have a mental health disorder and, as a result of the mental health disorder, appears to be a danger to the respondent's self or others or appears to be gravely disabled. (II) Any person who files a malicious or false petition for an evaluation of a respondent pursuant to this section is subject to criminal prosecution. (2) When a person is taken into custody pursuant to subsection (1) of this section, the person must not be detained in a jail, lockup, or other place used for the confinement of persons charged with or convicted of penal offenses. Unless otherwise required by law, a certified peace officer may transport the person to an emergency medical services facility or facility designated by the commissioner even if a warrant has been issued for the person's arrest if the certified peace officer believes it is in the best interest of the person. The person must not be held on an emergency mental health hold for longer than seventy-two hours after the hold is placed or ordered. Nothing in this section prohibits an emergency medical services facility from involuntarily holding the person in order to stabilize the person as required pursuant to the federal "Emergency Medical Treatment and Labor Act", 42 U.S.C. sec. 1395dd, or if the treating professional determines that the individual's physical or mental health disorder impairs the person's ability to make an informed decision to refuse care and the provider determines that further care is indicated. voluntarily holding the person in order to stabilize the person as required pursuant to the federal "Emergency Medical Treatment and Labor Act", 42 U.S.C. sec. 1395dd, or if the treating professional determines that the individual's physical or mental health disorder impairs the person's ability to make an informed decision to refuse care and the provider determines that further care is indicated. (3) When a person is placed on an emergency mental health hold pursuant to subsection (1) of this section and is presented to an emergency medical services facility or a facility designated by the commissioner, the facility shall require a BHA-approved application in writing, stating the circumstances under which the person's condition was called to the attention of the intervening professional or certified peace officer and further stating sufficient facts, obtained from the intervening professional's or certified peace officer's personal observations or obtained from others whom the intervening professional or certified peace officer reasonably believes to be reliable, to establish that the person has a mental health disorder and, as a result of the mental health disorder, is an imminent danger to the person's self or others or is gravely disabled. The application must indicate when the person was taken into custody and who brought the person's condition to the attention of the intervening professional or certified peace officer. A copy of the application must be furnished to the person being evaluated, and the application must be retained in accordance with section 27-65-123 (4). (4) (a) The petition for a court-ordered evaluation filed pursuant to subsection (1)(b) of this section must contain the following: (I) The name and address of the petitioner and the petitioner's interest in the case; (II) The name of the respondent for whom evaluation is sought, and, if known to the petitioner, the address, age, gender, marital status, occupation, and any animals or dependent children in the respondent's care; (III) Allegations of fact indicating that the respondent may have a mental health disorder and, as a result of the mental health disorder, be a danger to the respondent's self or others or be gravely disabled and showing reasonable grounds to warrant an evaluation; (IV) The name and address of every person known or believed by the petitioner to be legally responsible for the care, support, and maintenance of the respondent, if available; and (V) The name, address, and telephone number of the attorney, if any, who has most recently represented the respondent. (b) Upon receipt of a petition satisfying the requirements of subsection (4)(a) of this section, if the court is not satisfied that probable cause exists to issue an order for an evaluation, the court shall identify a facility designated by the commissioner, an intervening professional, or a certified peace officer to provide screening of the respondent to determine whether probable cause exists to believe the allegations. (c) Following the screening described in subsection (4)(b) of this section, the facility, intervening professional, or certified peace officer designated by the court shall file a report with the court and may initiate an emergency mental health hold at the time of screening. The report must include a recommendation as to whether probable cause exists to believe that the respondent has a mental health disorder and, as a result of the mental health disorder, is a danger to the respondent's self or others or is gravely disabled and whether the respondent will voluntarily receive evaluation or treatment. The screening report submitted to the court pursuant to this subsection (4)(c) is confidential in accordance with section 27-65-123 and must be furnished to the respondent or the respondent's attorney or personal representative. mental health disorder, is a danger to the respondent's self or others or is gravely disabled and whether the respondent will voluntarily receive evaluation or treatment. The screening report submitted to the court pursuant to this subsection (4)(c) is confidential in accordance with section 27-65-123 and must be furnished to the respondent or the respondent's attorney or personal representative. (d) Whenever it appears, by petition and screening pursuant to this section, to the satisfaction of the court that probable cause exists to believe that the respondent has a mental health disorder and, as a result of the mental health disorder, is a danger to the respondent's self or others or is gravely disabled and that efforts have been made to secure the cooperation of the respondent but the respondent has refused or failed to accept evaluation voluntarily, the court shall issue an order for evaluation authorizing a certified peace officer or secure transportation provider to take the respondent into custody and transport the respondent to a facility designated by the commissioner for an emergency mental health hold. At the time the respondent is taken into custody, a copy of the petition and the order for evaluation must be given to the respondent and promptly thereafter to the one lay person designated by the respondent and to the person in charge of the facility named in the order or the respondent's designee. If the respondent refuses to accept a copy of the petition and the order for evaluation, such refusal must be documented in the petition and the order for evaluation. (5) When a person is transported to an emergency medical services facility or a facility designated by the commissioner, the facility may detain the person under an emergency mental health hold for evaluation for a period not to exceed seventy-two hours from the time the emergency mental health hold was placed or ordered. Nothing in this section prohibits an emergency medical services facility from involuntarily holding the person in order to stabilize the person as required pursuant to the federal "Emergency Medical Treatment and Labor Act", 42 U.S.C. sec. 1395dd, or if the treating professional determines that the individual's physical or mental health disorder impairs the person's ability to make an informed decision to refuse care and the provider determines that further care is indicated. If, in the opinion of the person in charge of the evaluation, the person can be properly cared for without being detained, the person shall be provided services on a voluntary basis. If the person in charge of the evaluation determines the person should be released, the person in charge of the evaluation may terminate the emergency mental health hold. (6) (a) Each person detained for an emergency mental health hold pursuant to this section shall receive an evaluation as soon as possible after the person is presented to the facility and shall receive such treatment and care as the person's condition requires for the full period that the person is held. The evaluation may include an assessment to determine if the person continues to meet the criteria for an emergency mental health hold and requires further mental health care in a facility designated by the commissioner. The evaluation must state whether the person should be released, referred for further care and treatment on a voluntary basis, or certified for short-term treatment pursuant to section 27-65-109. (b) Each evaluation must be completed using a standardized form approved by the commissioner and may be completed by a professional person; a licensed advanced practice registered nurse with training in psychiatric nursing; or a licensed physician assistant, a licensed clinical social worker, a licensed professional counselor, or a licensed marriage and family therapist who has two years of experience in behavioral health safety and risk assessment working in a health-care setting. sioner and may be completed by a professional person; a licensed advanced practice registered nurse with training in psychiatric nursing; or a licensed physician assistant, a licensed clinical social worker, a licensed professional counselor, or a licensed marriage and family therapist who has two years of experience in behavioral health safety and risk assessment working in a health-care setting. (c) If the person conducting an evaluation pursuant to subsection (6)(a) of this section is not a professional person and the evaluating person recommends the detained person be certified for short-term treatment pursuant to section 27-65-109, the evaluating person shall notify the facility of the recommendation. A certification may only be initiated by a professional person. (7) (a) If a person is evaluated at an emergency medical services facility and the evaluating professional determines that the person continues to meet the criteria for an emergency mental health hold pursuant to subsection (1) of this section, the emergency medical services facility shall immediately notify the BHA if the facility cannot locate appropriate placement. Once notified, the BHA shall support the emergency medical services facility in locating an appropriate placement option on an inpatient or outpatient basis, whichever is clinically appropriate. (b) If an appropriate placement option cannot be located pursuant to subsection (7)(a) of this section and the person continues to meet the criteria for an emergency mental health hold pursuant to subsection (1) of this section and the person has been medically stabilized, the emergency medical services facility may place the person under a subsequent emergency mental health hold. If the facility places the person under a subsequent emergency mental health hold, the facility shall immediately notify the BHA, the person's lay person, and the court, and the court shall immediately appoint an attorney to represent the person. The facility may notify the court where the person resides by mail. Once the court is notified, the emergency medical services facility is not required to take any further action to provide the person with an attorney unless specified in subsection (10) of this section. The emergency medical services facility shall notify the BHA after each emergency mental health hold is placed. The BHA is responsible for actively assisting the facility in locating appropriate placement for the person. If the person has been recently transferred from an emergency medical services facility to a facility designated by the commissioner and the designated facility is able to demonstrate that the facility is unable to complete the evaluation before the initial emergency mental health hold is set to expire, the designated facility may place the person under a subsequent emergency mental health hold and shall immediately notify the BHA and lay person. n emergency medical services facility to a facility designated by the commissioner and the designated facility is able to demonstrate that the facility is unable to complete the evaluation before the initial emergency mental health hold is set to expire, the designated facility may place the person under a subsequent emergency mental health hold and shall immediately notify the BHA and lay person. (c) The BHA shall maintain data on the characteristics of each person placed on a subsequent emergency mental health hold pursuant to subsection (7)(b) of this section. The BHA may contract with entities coordinating care or with providers serving within the safety net system developed pursuant to section 27-63-105 to meet the requirements of this subsection (7). (8) (a) The facility shall provide each person detained for an emergency mental health hold discharge instructions. The discharge instructions must be completed for every person, regardless of the person's discharge status, before the person is released. If the detained person refuses to accept the discharge instructions, the refusal must be documented in the person's medical record. At a minimum, the discharge instructions must include: (I) A summary of why the person was detained or evaluated for an emergency mental health hold; detailed information as to why the evaluating professional determined the person no longer meets the criteria for an emergency mental health hold or certification pursuant to section 27-65-109; and whether the person may receive services on a voluntary basis pursuant to subsection (6) of this section; (II) If the person's medications were changed or the person was newly prescribed medications during the emergency mental health hold, a clinically appropriate supply of medications, as determined by the judgment of a licensed health-care provider, for the person until the person can access another provider or follow-up appointment; (III) A safety plan for the person and, if applicable, the person's lay person where indicated by the person's mental health disorder or mental or emotional state; (IV) Notification to the person's primary care provider, if applicable; (V) A referral to appropriate services, if such services exist in the community, if the person is discharged without food, housing, or economic security. Any referrals and linkages must be documented in the person's medical record. (VI) The phone number to call or text the Colorado crisis services hotline and information on the availability of peer support services; (VII) Information on how to establish a psychiatric advance directive if one is not presented; (VIII) Medications that were changed during the emergency mental health hold, including any medications that the person was taking or that were previously prescribed upon admission, and which medications, if any, were changed or discontinued at the time of discharge; (IX) A list of any screening or diagnostic tests conducted during the emergency mental health hold, if requested; (X) A summary of therapeutic treatments provided during the emergency mental health hold, if requested; (XI) Any laboratory work, including blood samples or imaging that was completed or attempted, if requested; (XII) The person's vital signs upon discharge from the emergency mental health hold, if requested; (XIII) A copy of any psychiatric advance directive presented to the facility, if applicable; and (XIV) How to contact the discharging facility if needed. (b) The facility shall document in the person's medical record whether the person accepted the discharge instructions. The facility shall provide the discharge instructions to the person's parent or legal guardian if the person is under eighteen years of age, and to the person's lay person, when possible. o the facility, if applicable; and (XIV) How to contact the discharging facility if needed. (b) The facility shall document in the person's medical record whether the person accepted the discharge instructions. The facility shall provide the discharge instructions to the person's parent or legal guardian if the person is under eighteen years of age, and to the person's lay person, when possible. (c) Upon discharge, the facility shall discuss with the person, the person's parent or legal guardian, or the person's lay person the statewide care coordination infrastructure established in section 27-60-204 to facilitate a follow-up appointment for the person within seven calendar days after the discharge. Facilities shall comply with this subsection (8)(c) when the statewide care coordination infrastructure created in section 27-60-204 is fully operational, as determined by the BHA. The BHA shall immediately notify facilities when the statewide care coordination infrastructure is available to assist persons with discharge. (d) (I) The facility shall, at a minimum, attempt to follow up with the person, the person's parent or legal guardian, or the person's lay person at least forty-eight hours after discharge. The facility is encouraged to utilize peer support professionals, as defined in section 27-60-108 (2)(b), when performing follow-up care with individuals and in developing a continuing care plan pursuant to subsection (8)(a)(I) of this section. The facility may facilitate follow-up care through contracts with community-based behavioral health providers or the Colorado behavioral health crisis hotline. If the facility facilitates follow-up care through a third-party contract, the facility shall obtain authorization from the person to provide follow-up care. (II) If the person is enrolled in medicaid, the facility is not required to meet the requirements of this subsection (8)(d) and instead, the facility shall notify the person's relevant managed care entity, as defined in section 25.5-5-403, of the person's discharge and need for ongoing follow-up care prior to the person's discharge. (III) If the facility contracts with a safety net provider, as defined in section 27-50-101, to provide behavioral health services to a person on or following an emergency mental health hold, the facility shall work with the safety net provider in order to meet the requirements of this subsection (8)(d). (e) The facility shall encourage the person to designate a family member, friend, or other person as a lay person to participate in the person's discharge planning and shall notify the person that the person is able to rescind the authorization of a lay person at any time. If the person designates a lay person and has provided necessary authorization, the facility shall attempt to involve the lay person in the person's discharge planning. The facility shall notify the lay person that the person is being discharged or transferred. (9) (a) On or before July 1, 2024, and each July 1 thereafter, each emergency medical services facility that has evaluated a person pursuant to this section shall provide an annual report to the BHA that includes only disaggregated and nonidentifying information concerning persons who were treated at an emergency medical services facility pursuant to this section. The report must comply with section 24-1-136 (9) and is exempt from section 24-1-136 (11)(a)(I). The report must contain the following: (I) The names and counties of the facilities; (II) The total number of persons treated pursuant to this section, including a summary of demographic information; (III) A summary regarding the different reasons for which persons were treated pursuant to this section; and (IV) A summary of the disposition of persons transferred to a designated facility. (I). The report must contain the following: (I) The names and counties of the facilities; (II) The total number of persons treated pursuant to this section, including a summary of demographic information; (III) A summary regarding the different reasons for which persons were treated pursuant to this section; and (IV) A summary of the disposition of persons transferred to a designated facility. (b) (I) Any information disaggregated and provided to the BHA pursuant to this subsection (9) is privileged and confidential. Such information must not be made available to the public except in an aggregate format that cannot be used to identify an individual facility. The information is not subject to civil subpoena and is not discoverable or admissible in any civil, criminal, or administrative proceeding against an emergency medical services facility or health-care professional. The information must be used only to assess statewide behavioral health services needs and to plan for sufficient levels of statewide behavioral health services. In collecting the data pursuant to the requirements of this subsection (9), the BHA shall protect the confidentiality of patient records, in accordance with state and federal laws, and shall not disclose any public identifying or proprietary information of any hospital, hospital administrator, health-care professional, or employee of a health-care facility. (II) Subsection (9)(b)(I) of this section does not apply to information that is otherwise available from a source outside of the data collection activities required pursuant to subsection (9)(a) of this section. (10) (a) A person detained for an emergency mental health hold pursuant to this section has the following rights: (I) To be told the reason for the person's detainment and the limitations of the person's detainment, including a description of the person's right to refuse medication, unless the person requires emergency medications, and that the detainment does not mean all treatment during detainment is mandatory; (II) To request a change to voluntary status; (III) To be treated fairly, with respect and recognition of the person's dignity and individuality, by all employees of the facility with whom the person comes in contact; (IV) To not be discriminated against on the basis of age, race, ethnicity, religion, culture, spoken language, physical or mental disability, socioeconomic status, sex, sexual orientation, gender identity, or gender expression; (V) To retain and consult with an attorney at any time; except that, unless specified in subsection (7)(b) of this section, the facility is not required to retain an attorney on behalf of the person but must allow the person to contact an attorney; (VI) To continue the practice of religion; (VII) Within twenty-four hours after the person's request, to see and receive the services of a patient representative who has no direct or indirect clinical, administrative, or financial responsibility for the person; (VIII) To have reasonable access to telephones or other communication devices and to make and to receive calls or communications in private. Facility staff shall not open, delay, intercept, read, or censor mail or other communications or use mail or other communications as a method to enforce compliance with facility staff. ect clinical, administrative, or financial responsibility for the person; (VIII) To have reasonable access to telephones or other communication devices and to make and to receive calls or communications in private. Facility staff shall not open, delay, intercept, read, or censor mail or other communications or use mail or other communications as a method to enforce compliance with facility staff. (IX) To wear the person's own clothes, keep and use the person's own personal possessions, and keep and be allowed to spend a reasonable sum of the person's own money. A facility may temporarily restrict a person's access to personal clothing or personal possessions, until a safety assessment is completed. If the facility restricts a person's access to personal clothing or personal possessions, the facility shall have a discussion with the person about why the person's personal clothing or personal possessions are being restricted. A licensed medical professional or a licensed behavioral health professional shall conduct a safety assessment as soon as possible. The licensed professional shall document in the person's medical record the specific reasons why it is not safe for the person to possess the person's personal clothing or personal possessions. The facility shall periodically conduct additional safety assessments to determine whether the person may possess the person's personal clothing or personal possessions, with the goal of restoring the person's rights established pursuant to this section. (X) To keep and use the person's cell phone, unless access to the cell phone causes the person to destabilize or creates a danger to the person's self or others, as determined by a provider, facility staff member, or security personnel involved in the person's care; (XI) To have the person's information and records disclosed to family members and a lay person pursuant to section 27-65-123; (XII) To have the person's treatment records remain confidential, except as required by law; (XIII) To not be fingerprinted, unless required by law; (XIV) To not be photographed, except upon admission for identification and administrative purposes. Any photographs must be confidential and must not be released by the facility except pursuant to a court order. Nonmedical photographs must not be taken or used without appropriate consent or authorization. (XV) To have appropriate access to adequate water, hygiene products, and food and to have the person's nutritional needs met in a manner that is consistent with recognized dietary practices; (XVI) To have personal privacy to the extent possible during the course of treatment; and (XVII) To have the ability to meet with visitors in accordance with the facility's current visitor guidelines. (b) A person's rights under this subsection (10) may only be denied if access to the item, program, or service causes the person to destabilize or creates a danger to the person's self or others, as determined by a licenced provider involved in the person's care. Denial of any right must be entered into the person's treatment record and must be made available, upon request, to the person, the person's legal guardian, or the person's attorney. (c) A facility shall not intentionally retaliate or discriminate against a detained person or employee for contacting or providing information to any official or to an employee of any state protection and advocacy agency or for initiating, participating in, or testifying in a grievance procedure or in an action for any remedy authorized pursuant to this section. Any facility that violates this subsection (10) commits an unclassified misdemeanor and shall be fined not more than one thousand dollars. (d) Any person whose rights are denied or violated pursuant to this section has the right to file a complaint against the facility with the behavioral health administration and the department of public health and environment.

C.R.S. § 27-65-107 Emergency transportation - application - screening - respondent's rights

27-65-107. Emergency transportation - application - screening - respondent's rights. (1) (a) When a certified peace officer or emergency medical services provider has probable cause to believe a person is experiencing a behavioral health crisis or is gravely disabled and, as a result, without professional intervention the person may be a danger to the person's self or others, then the certified peace officer or emergency medical services provider may take the person into protective custody and transport the person to an outpatient mental health facility or a facility designated by the commissioner or other clinically appropriate facility designated by the commissioner. If such a service is not available, the person may be taken to an emergency medical services facility. (b) An individual may not be transported pursuant to this subsection (1) if an intervening professional has assessed the person during the same emergency event and determined the individual does not meet the criteria for an emergency mental health hold pursuant to section 27-65-106. (c) If a behavioral heath crisis response team is known to be available in a timely manner, the certified peace officer or emergency medical services provider shall access the behavioral health crisis response team prior to transporting an individual involuntarily pursuant to this subsection (1). (2) When a person is transported against the person's will pursuant to subsection (1) of this section, the facility shall require an application, in writing, stating the circumstances under which the person's condition was called to the attention of the certified peace officer or emergency medical services provider and further stating sufficient facts, obtained from personal observations or obtained from others whom the certified peace officer or emergency medical services provider reasonably believes to be reliable, to establish that the person is experiencing a behavioral health crisis or is gravely disabled and, as a result, it is believed that without professional intervention the person may be a danger to the person's self or others. The application must indicate the name of the person and the time the person was transported. A copy of the application must be furnished to the person being transported. (3) (a) Once the person is presented to an outpatient mental health facility or facility designated by the commissioner, an intervening professional shall screen the person immediately. If an intervening professional is not immediately available, the person must be screened within eight hours after the person's arrival at the facility to determine if the person meets criteria for an emergency mental health hold pursuant to section 27-65-106. Once the screening is complete and if the person meets the criteria, the intervening professional shall first pursue voluntary treatment and evaluation. If the person refuses or the intervening professional has reasonable grounds to believe the person will not remain voluntarily, the intervening professional may place the person under an emergency mental health hold pursuant to section 27-65-106. Once the screening is complete and if the person meets the criteria, the intervening professional shall first pursue voluntary treatment and evaluation. If the person refuses or the intervening professional has reasonable grounds to believe the person will not remain voluntarily, the intervening professional may place the person under an emergency mental health hold pursuant to section 27-65-106. (b) If a person detained pursuant to this section is transported to an emergency medical services facility, the involuntary transportation hold expires upon the facility receiving the person for screening by an intervening professional. (4) (a) A person detained pursuant to this section has the following rights while being detained, which must be explained to the person before being transported to a receiving facility: (I) To not be detained under an emergency transportation hold pursuant to this section for longer than fourteen hours, to not be transported for longer than six hours, and to receive a screening within eight hours after being presented to the receiving facility. This subsection (4)(a)(I) does not prohibit a facility from holding the person as authorized by state and federal law, including the federal "Emergency Medical Treatment and Labor Act", 42 U.S.C. sec. 1395dd, or if the treating professional determines that the individual's physical or mental health disorder impairs the person's ability to make an informed decision to refuse care and the provider determines that further care is indicated. (II) To request a phone call to an interested party prior to being transported. If the certified peace officer or emergency medical services provider believes access to a phone poses a physical danger to the person or someone else, the receiving facility shall make the call on the person's behalf immediately upon arrival at the receiving facility. (III) To wear the person's own clothes and keep and use personal possessions that the person had in the person's possession at the time of detainment. A facility may temporarily restrict a person's access to personal clothing or personal possessions until a safety assessment is completed. If the facility restricts a person's access to personal clothing or personal possessions, the facility shall have a discussion with the person about why the person's personal clothing or personal possessions are being restricted. A licensed medical professional or a licensed behavioral health professional shall conduct a safety assessment as soon as possible. The licensed professional shall document in the person's medical record the specific reasons why it is not safe for the person to possess the person's personal clothing or personal possessions. (IV) To keep and use the person's cell phone, unless access to the cell phone causes the person to destabilize or creates a danger to the person's self or others, as determined by a provider, facility staff member, or security personnel involved in the person's care; (V) To have appropriate access to adequate water and food, and to have the person's nutritional needs met in a manner that is consistent with recognized dietary practices, to the extent reasonably possible at the receiving facility; (VI) To be treated fairly, with respect and recognition of the person's dignity and individuality; and (VII) To file a grievance with the BHA, the department of public health and environment, or the office of the ombudsman for behavioral health access to care established pursuant to part 3 of article 80 of this title 27. ary practices, to the extent reasonably possible at the receiving facility; (VI) To be treated fairly, with respect and recognition of the person's dignity and individuality; and (VII) To file a grievance with the BHA, the department of public health and environment, or the office of the ombudsman for behavioral health access to care established pursuant to part 3 of article 80 of this title 27. (b) A person's rights pursuant to subsection (4)(a) of this section may only be denied if access to the item, program, or service causes the person to destabilize or creates a danger to the person's self or others, as determined by a licensed provider involved in the person's care or transportation. Denial of any right must be entered into the person's treatment record or BHA-approved form. Information pertaining to a denial of rights contained in the person's treatment record must be made available, upon request, to the person, the person's attorney, or the person's lay person.

C.R.S. § 27-65-108 Care coordination for persons certified or in need of ongoing treatment

27-65-108. Care coordination for persons certified or in need of ongoing treatment. (1) A facility designated by the commissioner shall notify and engage the BHA prior to terminating or transferring a person certified pursuant to section 27-65-108.5, 27-65-109, 27-65-110, or 27-65-111. The BHA may provide care coordination services to support a person whose certification is terminated but who is in need of ongoing treatment and services. (2) The BHA shall, directly or through a contract, provide care coordination services to a person certified pursuant to section 27-65-108.5, 27-65-109, 27-65-110, or 27-65-111 and determined by the designated facility and the BHA to need care coordination services.

C.R.S. § 27-65-108.5 Court-ordered certification for short-term treatment for incompetent defendants in a criminal matter - contents of petition - procedure to contest petition - commitment to behavioral health administration - definition

27-65-108.5. Court-ordered certification for short-term treatment for incompetent defendants in a criminal matter - contents of petition - procedure to contest petition - commitment to behavioral health administration - definition. (1) Upon petition of the district attorney, a professional person, a representative of the BHA, or a representative of the office of civil and forensic mental health, a court may certify a person for short-term treatment for not more than three months under the following conditions: (a) The person is a respondent in a criminal matter in which the person has been found incompetent to proceed; (b) The court hearing the criminal matter referred the matter for filing of a petition pursuant to section 16-8.5-111 or 16-8.5-116.5; (c) The person has been advised of the availability of, but has not accepted, voluntary treatment, or, if reasonable grounds exist to believe that the person will not remain in a voluntary treatment program, the person's acceptance of voluntary treatment does not preclude certification; (d) The facility or community provider that will provide short-term treatment has been designated or approved by the commissioner to provide such treatment; and (e) The person, the person's legal guardian, and the person's lay person, if applicable, have been advised of the person's right to an attorney and to contest the certification for short-term treatment. (2) The petition filed pursuant to subsection (1) of this section must: (a) State sufficient facts to establish reasonable grounds that the respondent has a mental health disorder and, as a result of the mental health disorder, is a danger to the respondent's self or others or is gravely disabled; (b) Be accompanied by a report of the competency evaluator or professional person who has evaluated the respondent within fifty-six days before submission of the petition, unless the respondent whose certification is sought has refused to submit to an evaluation or the respondent cannot be evaluated due to the respondent's condition; (c) Be filed within fourteen days after the initiating party received the court order from the criminal court initiating the process; (d) Be filed with the court in the county where the respondent resided or was physically present immediately prior to the filing of the petition; except that if the person was arrested for the prior case and held in custody, the petition may be filed in the county where the respondent resided or was physically present immediately prior to the respondent's arrest; and (e) Provide recommendations if any certification should occur on an inpatient or outpatient basis. (3) Within twenty-four hours after certification, copies of the certification must be personally delivered to the respondent, the BHA, or the office of civil and forensic mental health. The department shall retain a copy as part of the respondent's record. If the criminal case is pending, or not yet dismissed, notice of the filing of the petition should be given by the petitioning party to the criminal court, which shall provide such notice to the prosecuting and defense attorneys in the criminal case and any attorney appointed pursuant to section 27-65-113. The court shall ask the respondent to designate one other person whom the respondent wants to be informed regarding the petition. If the respondent is incapable of making such a designation at the time the petition is delivered, the court may ask the respondent to designate such person as soon as the respondent is capable. the criminal case and any attorney appointed pursuant to section 27-65-113. The court shall ask the respondent to designate one other person whom the respondent wants to be informed regarding the petition. If the respondent is incapable of making such a designation at the time the petition is delivered, the court may ask the respondent to designate such person as soon as the respondent is capable. (4) Whenever a petition is filed pursuant to this section, the court shall immediately appoint an attorney to represent the respondent. The court shall provide the respondent with a written notice that the respondent has a right to a hearing on the petition and may make a written request for a jury trial. The respondent has the right to an attorney for all proceedings conducted pursuant to this section, including any appeals. The attorney representing the respondent must be provided with a copy of the petition and any supporting materials immediately upon the attorney's appointment. The respondent may only waive counsel when the respondent makes a knowing and voluntary waiver in front of the court. (5) Upon the filing of the petition pursuant to this section and affording the respondent a chance to contest the petition, the court may grant or deny certification based on the facts established in the petition, subject to the court's further review or a jury trial. (6) Within fourteen days after receipt of the petition filed pursuant to this section, the respondent, or the respondent's attorney, may request a jury trial by filing a written motion with the court. (7) The respondent may knowingly and voluntarily consent in writing to the petition. (8) The respondent or the respondent's attorney may, at any time, file a written request for the court to review short-term certification or request that inpatient certification be changed to outpatient treatment. If the review is requested, the court shall hear the matter within fourteen days after the request, and the court shall give notice to the respondent, the respondent's attorney, the department, and the community or facility provider who is or will provide treatment. The hearing must be held in accordance with section 27-65-113. At the conclusion of the hearing, the court may enter or confirm the certification for short-term treatment, discharge the respondent, or enter any other appropriate order. (9) Section 27-65-109 (7) to (10) applies to proceedings held pursuant to this section. (10) In assessing whether the respondent with a pending criminal charge is a danger to self or others or is gravely disabled, if the person is incarcerated, the professional person and court shall not rely upon the fact that the person is incarcerated to establish that the respondent is not a danger to self or others or is not gravely disabled. (11) An emergency mental health hold pursuant to section 27-65-106 is not a prerequisite to a proceeding pursuant to this section. (12) For the purposes of this section only, "respondent" means the defendant in the referring criminal matter.

C.R.S. § 27-65-109 Certification for short-term treatment - procedure

27-65-109. Certification for short-term treatment - procedure. (1) A person may be certified for not more than three months for short-term treatment under the following conditions: (a) The professional staff of the facility detaining the person on an emergency mental health hold has evaluated the person and has found the person has a mental health disorder and, as a result of the mental health disorder, is a danger to the person's self or others or is gravely disabled; (b) The person has been advised of the availability of, but has not accepted, voluntary treatment; but, if reasonable grounds exist to believe that the person will not remain in a voluntary treatment program, the person's acceptance of voluntary treatment does not preclude certification; (c) The facility or community provider that will provide short-term treatment has been designated by the commissioner to provide such treatment; and (d) The person, the person's legal guardian, and the person's lay person, if applicable, have been advised of the person's right to an attorney and to contest the certification for short-term treatment. (2) The notice of certification must be signed by a professional person who participated in the evaluation. The notice of certification must: (a) State facts sufficient to establish reasonable grounds to believe that the respondent has a mental health disorder and, as a result of the mental health disorder, is a danger to the respondent's self or others or is gravely disabled; (b) Be filed with the court within forty-eight hours, excluding Saturdays, Sundays, and court holidays, after the date of certification; (c) Be filed with the court in the county in which the respondent resided or was physically present immediately prior to being taken into custody; and (d) Provide recommendations if the certification should take place on an inpatient or outpatient basis. (3) Within twenty-four hours after certification, copies of the certification must be personally delivered to the respondent, the BHA, and a copy must be kept by the evaluating facility as part of the respondent's record, if applicable. The facility or court shall ask the respondent to designate a lay person whom the respondent wishes to be informed regarding certification. If the respondent is incapable of making such a designation at the time the certification is delivered, the respondent must be asked to designate a lay person as soon as the respondent is capable. In addition to the copy of the certification, the respondent must be given a written notice that a hearing upon the respondent's certification for short-term treatment may be had before the court or a jury upon written request directed to the court pursuant to subsection (6) of this section. (4) Upon certification of the respondent, the facility designated for short-term treatment has custody of the respondent. (5) Whenever a certification is filed with the court by a professional person, the court shall immediately appoint an attorney to represent the respondent. The respondent has the right to an attorney for all proceedings conducted pursuant to this section, including any appeals. The attorney representing the respondent must be provided with a copy of the certification immediately upon the attorney's appointment. The respondent may only waive counsel when the respondent makes a knowing and intelligent waiver in front of the court. esent the respondent. The respondent has the right to an attorney for all proceedings conducted pursuant to this section, including any appeals. The attorney representing the respondent must be provided with a copy of the certification immediately upon the attorney's appointment. The respondent may only waive counsel when the respondent makes a knowing and intelligent waiver in front of the court. (6) The respondent or the respondent's attorney may at any time file a written request that the certification for short-term treatment or the treatment be reviewed by the court or that the treatment be on an outpatient basis. If review is requested, the court shall hear the matter within ten days after the request, and the court shall give notice to the respondent and the respondent's attorney and the certifying and treating professional person of the time and place of the hearing. The hearing must be held in accordance with section 27-65-113. At the conclusion of the hearing, the court may enter or confirm the certification for short-term treatment, discharge the respondent, or enter any other appropriate order. (7) Records and papers in proceedings pursuant to this section must be maintained separately by the clerks of the several courts. Upon the release of any respondent in accordance with section 27-65-112, the facility shall notify the clerk of the court within five days after the release, and the clerk shall immediately seal the record in the case and omit the name of the respondent from the index of cases in the court until and unless the respondent becomes subject to an order of certification for long-term care and treatment pursuant to section 27-65-110 or until and unless the court orders the records opened for good cause shown. In the event a petition is filed pursuant to section 27-65-110, the certification record may be opened and become a part of the record in the long-term care and treatment case and the name of the respondent indexed. (8) Whenever it appears to the court, by reason of a report by the treating professional person or the BHA or any other report satisfactory to the court, that a respondent detained for evaluation and treatment or certified for short-term treatment should be transferred to another facility for treatment and the safety of the respondent or the public requires that the respondent be transported by a secure transportation provider or a law enforcement agency, the court may issue an order directing the law enforcement agency where the respondent resides or secure transportation provider to deliver the respondent to the designated facility. (9) A respondent certified for short-term treatment may be discharged upon the signature of the treating medical professional and the medical director of the facility. A respondent certified for short-term treatment on an outpatient basis may be discharged upon the signature of the approved professional person overseeing the respondent's treatment, and the professional person shall notify the BHA prior to the discharge. A facility or program shall make the respondent's discharge instructions available to the respondent, the respondent's attorney, and the respondent's legal guardian, if applicable, within seven days after discharge, if requested. A facility or program that is transferring a respondent to a different treatment facility or to an outpatient provider shall provide all treatment records to the facility or provider accepting the respondent at least twenty-four hours prior to the transfer. he respondent, the respondent's attorney, and the respondent's legal guardian, if applicable, within seven days after discharge, if requested. A facility or program that is transferring a respondent to a different treatment facility or to an outpatient provider shall provide all treatment records to the facility or provider accepting the respondent at least twenty-four hours prior to the transfer. (10) If the professional person in charge of the evaluation and treatment believes that a period longer than three months is necessary to treat the respondent, the professional person shall file with the court an extended certification at least thirty days prior to the expiration date of the original certification. An extended certification for treatment must not be for a period of more than three months. The respondent is entitled to a hearing on the extended certification under the same conditions as an original certification. The attorney initially representing the respondent shall continue to represent the respondent, unless the court appoints another attorney.

C.R.S. § 27-65-110 Long-term care and treatment of persons with mental health disorders - procedure

27-65-110. Long-term care and treatment of persons with mental health disorders - procedure. (1) Whenever a respondent has received an extended certification for treatment pursuant section 27-65-109 (10), the professional person in charge of the certification for short-term treatment or the BHA may file a petition with the court at least thirty days prior to the expiration date of the extended certification for long-term care and treatment of the respondent under the following conditions: (a) The professional staff of the agency or facility providing short-term treatment has analyzed the respondent's condition and has found that the respondent has a mental health disorder and, as a result of the mental health disorder, is a danger to the respondent's self or others or is gravely disabled; (b) The respondent has been advised of the availability of, but has not accepted, voluntary treatment; but, if reasonable grounds exist to believe that the respondent will not remain in a voluntary treatment program, the respondent's acceptance of voluntary treatment does not preclude an order pursuant to this section; and (c) The facility that will provide long-term care and treatment has been designated by the commissioner to provide the care and treatment. (2) Every petition for long-term care and treatment must include a request for a hearing before the court prior to the expiration of six months after the date of original certification and provide a recommendation as to whether the certification for long-term care and treatment should take place on an inpatient or outpatient basis. A copy of the petition must be delivered personally to the respondent for whom long-term care and treatment is sought and electronically delivered to the respondent's attorney of record simultaneously with the filing. (3) Within ten days after receipt of the petition, the respondent or the respondent's attorney may request a hearing before the court or a jury trial by filing a written request with the court. (4) The court or jury shall determine whether the conditions of subsection (1) of this section are met and whether the respondent has a mental health disorder and, as a result of the mental health disorder, is a danger to the respondent's self or others or is gravely disabled. The court shall issue an order of long-term care and treatment for a term not to exceed six months, discharge the respondent for whom long-term care and treatment was sought, or enter any other appropriate order. An order for long-term care and treatment must grant custody of the respondent to the BHA for placement with an agency or facility designated by the commissioner to provide long-term care and treatment. The BHA may delegate the physical custody of the respondent to a facility designated by the commissioner and the requirement for the provision of services and care coordination. When a petition contains a request that a specific legal disability be imposed or that a specific legal right be deprived, the court may order the disability imposed or the right deprived if the court or a jury has determined that the respondent has a mental health disorder or is gravely disabled and that, as a result, the respondent is unable to competently exercise the specific legal right or perform the function for which the disability is sought to be imposed. Any interested person may ask leave of the court to intervene as a copetitioner for the purpose of seeking the imposition of a legal disability or the deprivation of a legal right. a mental health disorder or is gravely disabled and that, as a result, the respondent is unable to competently exercise the specific legal right or perform the function for which the disability is sought to be imposed. Any interested person may ask leave of the court to intervene as a copetitioner for the purpose of seeking the imposition of a legal disability or the deprivation of a legal right. (5) An original order of long-term care and treatment or any extension of such order expires on the date specified, unless further extended as provided in this subsection (5). If an extension is being sought, the professional person in charge of the evaluation and treatment shall certify to the court at least thirty days prior to the expiration date of the order in force that an extension of the order is necessary for the care and treatment of the respondent subject to the order in force, and a copy of the certification must be simultaneously delivered to the respondent and electronically delivered to the respondent's attorney of record. At least twenty days before the expiration of the order, the court shall give written notice to the respondent and the respondent's attorney of record that a hearing upon the extension may be had before the court or a jury upon written request to the court within ten days after receipt of the notice. If a hearing is not requested by the respondent within such time, the court may proceed ex parte. If a hearing is timely requested, the hearing must be held before the expiration date of the order in force. If the court or jury finds that the conditions of subsection (1) of this section continue to be met and that the respondent has a mental health disorder and, as a result of the mental health disorder, is a danger to others or to the respondent's self or is gravely disabled, the court shall issue an extension of the order. Any extension must not exceed six months, but there may be as many extensions as the court orders pursuant to this section. (6) A respondent certified for long-term care and treatment may be discharged from the facility upon the signature of the treating professional person and medical director of the facility, and the facility shall notify the BHA prior to the respondent's discharge. The facility shall make the respondent's discharge instructions available to the respondent, the respondent's attorney, the respondent's lay person, and the respondent's legal guardian, if applicable, within one week after discharge, if requested. A facility that is transferring a respondent to a different facility or to an outpatient program shall provide all treatment records to the facility or provider accepting the respondent at least twenty-four hours prior to the transfer.

C.R.S. § 27-65-111 Certification on an outpatient basis - short-term and long-term care

27-65-111. Certification on an outpatient basis - short-term and long-term care. (1) Any respondent certified pursuant to section 27-65-108.5, 27-65-109, or 27-65-110 may be provided treatment on an outpatient basis. The outpatient treatment provider shall develop a treatment plan for the respondent receiving treatment on an outpatient basis with the goal of the respondent finding and sustaining recovery. The treatment plan must include measures to keep the respondent or others safe, as informed by the respondent's need for certification. The treatment plan may include, but is not limited to: (a) Intensive case management; (b) Assertive community treatment; (c) Peer recovery services; (d) Individual or group therapy; (e) Day or partial-day programming activities; (f) Intensive outpatient programs; (g) Educational and vocational training or activities; and (h) Housing and transportation assistance. (2) The respondent, the respondent's legal guardian, the respondent's patient representative or the respondent's lay person, or any party at any court hearing may contest a respondent's treatment regimen, including court-ordered medications, at any court hearing related to the respondent's certification for treatment. (3) The facility responsible for providing services to a respondent on a certification on an outpatient basis shall proactively reach out to the respondent to engage the respondent in treatment. If the respondent refuses treatment or court-ordered medication and is decompensating psychiatrically, the court may order a certified peace officer or secure transportation provider to transport the respondent to an appropriate, least restrictive designated facility in collaboration with the BHA and the provider holding the certification. The respondent does not need to be imminently dangerous to the respondent's self or others for the provider to request, and the court to order, transportation to a facility for the respondent to receive treatment and court-ordered medications. The facility responsible for providing services to a respondent on a certification on an outpatient basis shall provide the court information on the facility's proactive outreach to the respondent and the professional person's and psychiatric advanced practice registered nurse's basis for medical opinion. (4) If a respondent is placed in a more restrictive setting, the respondent has the right to judicial review within ten days after filing a written request. (5) (a) In addition to any other limitation on liability, a person providing care to a respondent placed on short-term or long-term certification on an outpatient basis is only liable for harm subsequently caused by or to a respondent who: (I) Has been terminated from certification despite meeting statutory criteria for certification pursuant to section 27-65-108.5, 27-65-109, or 27-65-110; or (II) Provided services to the respondent not within the scope of the person's professional license, or was reckless or grossly negligent in providing services. (b) A provider is not liable if a respondent's certification is terminated, despite meeting criteria for certification, if the provider is unable to locate the respondent despite proactive and reasonable outreach. (6) A respondent subject to a short-term or long-term certification on an outpatient basis has the following rights, in addition to those enumerated in section 27-65-119: (a) To request a change to voluntary status. A change to voluntary status may be denied by the supervising professional person or advanced practice registered nurse with training in psychiatric nursing responsible for the respondent's treatment if the professional person or advanced practice registered nurse with training in psychiatric nursing determines reasonable grounds exist to believe that the respondent will not remain in a voluntary treatment program. ary status may be denied by the supervising professional person or advanced practice registered nurse with training in psychiatric nursing responsible for the respondent's treatment if the professional person or advanced practice registered nurse with training in psychiatric nursing determines reasonable grounds exist to believe that the respondent will not remain in a voluntary treatment program. (b) To be treated fairly, with respect and recognition of the respondent's dignity and individuality, by all employees of the treatment facility with whom the respondent comes in contact; (c) To appropriate treatment, which must be administered skillfully, safely, and humanely. A respondent shall receive treatment suited to the respondent's needs that must be determined in collaboration with the respondent. (d) To not be discriminated against on the basis of age, race, ethnicity, religion, culture, spoken language, physical or mental disability, socioeconomic status, sex, sexual orientation, gender identity, or gender expression; (e) To retain and consult with an attorney at any time; (f) Within forty-eight hours after the respondent's request, to see and receive the services of a patient representative, including a peer specialist, who has no direct or indirect clinical, administrative, or financial responsibility for the respondent; (g) To have the respondent's behavioral health orders for scope of treatment or psychiatric advance directive reviewed and considered by the court as the preferred treatment option for involuntary administration of medications unless, by clear and convincing evidence, the respondent's directive does not qualify as effective participation in behavioral health decision-making; (h) To have the respondent's information and records disclosed to adult family members and a lay person pursuant to section 27-65-123; (i) To have access to a representative within the facility who provides assistance to file a grievance; and (j) To have the right to file a motion with the court at any time to contest the certification.

C.R.S. § 27-65-112 Termination of certification for short-term and long-term treatment

27-65-112. Termination of certification for short-term and long-term treatment. (1) An original or extended certification for short-term treatment issued pursuant to section 27-65-108.5 or 27-65-109, or an order or extension for certification for long-term care and treatment pursuant to section 27-65-110, terminates as soon as the professional person in charge of treatment of the respondent and the BHA determine the respondent has received sufficient benefit from the treatment for the respondent to end involuntary treatment. Whenever a certification or extended certification is terminated pursuant to this section, the professional person in charge of providing treatment shall notify the court in writing within five days after the termination. (2) Before termination, a respondent who leaves a facility may be returned to the facility by order of the court without a hearing or by the superintendent or director of the facility without a court order. After termination, a respondent may be returned to the facility only in accordance with this article 65.

C.R.S. § 27-65-113 Hearing procedures - jurisdiction

27-65-113. Hearing procedures - jurisdiction. (1) Hearings before the court pursuant to section 27-65-108.5, 27-65-109, or 27-65-110 are conducted in the same manner as other civil proceedings before the court. The burden of proof is on the person or facility seeking to detain the respondent. The court or jury shall determine that the respondent is in need of care and treatment only if the court or jury finds by clear and convincing evidence that the respondent has a mental health disorder and, as a result of the mental health disorder, is a danger to the respondent's self or others or is gravely disabled. (2) The court, after consultation with respondent's counsel to obtain counsel's recommendations, may appoint a professional person to examine the respondent for whom short-term treatment or long-term care and treatment is sought and to testify at the hearing before the court as to the results of the professional person's examination. The court-appointed professional person shall act solely in an advisory capacity, and no presumption is attached to the professional person's findings. (3) Every respondent subject to an order for short-term treatment or long-term care and treatment must be advised of the respondent's right to appeal the order by the court at the conclusion of any hearing and, as a result, the order may be entered. (4) The court in which the petition is filed under section 27-65-106 or the certification is filed pursuant to section 27-65-109 is the court of original jurisdiction and of continuing jurisdiction for any further proceedings pursuant to this article 65. When the convenience of the parties and the ends of justice would be promoted by a change in the court having jurisdiction, the court may order a transfer of the proceeding to another county. Until further order of the transferee court, if any, it is the court of continuing jurisdiction. (5) (a) In the event that a respondent or a person found not guilty by reason of impaired mental condition pursuant to section 16-8-103.5 (5), or by reason of insanity pursuant to section 16-8-105 (4) or 16-8-105.5, refuses to accept medication, the court having jurisdiction of the action pursuant to subsection (4) of this section; the court committing the person or defendant to the custody of the department pursuant to section 16-8-103.5 (5), 16-8-105 (4), or 16-8-105.5; or the court of the jurisdiction in which the designated facility treating the respondent or person is located has jurisdiction and venue to accept a petition by a treating physician and to enter an order requiring that the respondent or person accept such treatment or, in the alternative, that the medication be forcibly administered to the respondent or person. The court of the jurisdiction in which the designated facility is located shall not exercise its jurisdiction without the permission of the court that committed the person to the custody of the department. Upon the filing of such a petition, the court shall appoint an attorney, if one has not been appointed, to represent the respondent or person and hear the matter within ten days. (b) In any case brought pursuant to subsection (5)(a) of this section in a court for the county in which the treating facility is located, the county where the proceeding was initiated pursuant to subsection (4) of this section or the court committing the person to the custody of the department pursuant to section 16-8-103.5 (5), 16-8-105 (4), or 16-8-105.5 shall either reimburse the county in which the proceeding pursuant to this subsection (5) was filed and in which the proceeding was held for the reasonable costs incurred in conducting the proceeding or conduct the proceeding itself using its own personnel and resources, including its own district or county attorney, as the case may be. rsuant to section 16-8-103.5 (5), 16-8-105 (4), or 16-8-105.5 shall either reimburse the county in which the proceeding pursuant to this subsection (5) was filed and in which the proceeding was held for the reasonable costs incurred in conducting the proceeding or conduct the proceeding itself using its own personnel and resources, including its own district or county attorney, as the case may be. (c) In the case of a defendant who is found incompetent to proceed pursuant to section 16-8.5-103 and who refuses to accept medication, the jurisdiction for the petition for involuntary treatment procedures is as set forth in section 16-8.5-112. (6) All adversarial proceedings pursuant to this article 65, including proceedings to impose a legal disability pursuant to section 27-65-127, must be conducted by the district attorney of the county where the proceeding is held or by a qualified attorney acting for the district attorney appointed by the district court for that purpose; except that, in any county or in any city and county having a population exceeding fifty thousand persons, the proceedings must be conducted by the county attorney or by a qualified attorney acting for the county attorney appointed by the district court. In any case in which there has been a change of venue to a county other than the county of residence of the respondent or the county in which the certification proceeding was commenced, the county from which the proceeding was transferred shall either reimburse the county to which the proceeding was transferred and in which the proceeding was held for the reasonable costs incurred in conducting the proceeding or conduct the proceeding itself using its own personnel and resources, including its own district or county attorney, as the case may be. (7) Upon request of a legal guardian appointed pursuant to article 14 of title 15, the legal guardian may intervene in any proceeding brought pursuant to this article 65 concerning the legal guardian's ward and, through counsel, may present evidence and represent to the court the views of the legal guardian concerning the appropriate disposition of the case. (8) A lay person may submit an affidavit to the court concerning the lay person's relationship to the respondent, how long the lay person has known the respondent, the lay person's physical address, and the lay person's views concerning the appropriate disposition of the respondent's case.

C.R.S. § 27-65-114 Appeals

27-65-114. Appeals. Appellate review of any order of short-term treatment or long-term care and treatment may be had as provided in the Colorado appellate rules. An appeal must be advanced upon the calendar of the appellate court and must be decided at the earliest practicable time. Pending disposition by the appellate court, the court may make such order as the court may consider proper in the premises relating to the care and custody of the respondent.

C.R.S. § 27-65-115 Habeas corpus

27-65-115. Habeas corpus. Any person detained pursuant to this article 65 is entitled to an order in the nature of habeas corpus upon proper petition to any court generally empowered to issue orders in the nature of habeas corpus.

C.R.S. § 27-65-116 Restoration of rights

27-65-116. Restoration of rights. Any person who, by reason of a judicial decree entered by a court of this state prior to July 1, 1975, is adjudicated as a person with a mental illness is deemed to have been restored to legal capacity and competency.

C.R.S. § 27-65-117 Discrimination - definition

27-65-117. Discrimination - definition. No person who has received an evaluation or treatment pursuant to this article 65 may be discriminated against for receiving an evaluation or treatment. For purposes of this section, "discrimination" means giving any undue weight to the fact of hospitalization or outpatient care and treatment unrelated to a person's present capacity to meet standards applicable to all persons. Any person who suffers injury by reason of a violation of this section has a civil cause of action.

C.R.S. § 27-65-118 Right to treatment - rules

27-65-118. Right to treatment - rules. (1) (a) Any person receiving an evaluation or treatment pursuant to this article 65 is entitled to medical and psychiatric care and treatment, with regard to services listed in section 27-66-101 and services listed in rules authorized by section 27-66-102, suited to meet the person's individual needs, delivered in such a way as to keep the person in the least restrictive environment, and delivered in such a way as to include the opportunity for participation of family members in the person's program of care and treatment, when appropriate. Nothing in this subsection (1)(a) creates any right with respect to any person other than the person receiving an evaluation, care, or treatment. The professional person and the agency or facility providing an evaluation, care, or treatment shall keep records detailing all care and treatment received by the person, and the records must be made available, upon the person's written authorization, to the person's attorney or the person's personal physician. The records are permanent records and must be retained in accordance with section 27-65-123 (4). (b) Any person receiving an evaluation or treatment pursuant to this article 65 may petition the court pursuant to section 13-45-102, for release to a less restrictive setting within or without a treating facility or release from a treating facility when adequate medical and psychiatric care and treatment are not administered. (2) The BHA shall promulgate rules to assure that each agency or facility providing an evaluation, care, or treatment requires the following: (a) Consent for specific therapies and major medical treatment in the nature of surgery. The nature of the consent, by whom it is given, and under what conditions, is determined by rules of the BHA. (b) The order of a physician for any treatment or specific therapy based on appropriate medical examinations; (c) Notation in the patient's treatment record of periodic examinations, evaluations, orders for treatment, and specific therapies, signed by personnel involved; (d) Conduct according to the guidelines contained in the regulations of the federal government and the rules of the BHA with regard to clinical investigations, research, experimentation, and testing of any kind; and (e) Documentation of the findings, conclusions, and decisions in any administrative review of a decision to release or withhold the information requested by a family member or lay person pursuant to section 27-65-123 (1)(g) or (1)(h) and documentation of any information given to a family member or lay person.

C.R.S. § 27-65-119 Rights of respondents certified for short-term treatment or long-term care and treatment

27-65-119. Rights of respondents certified for short-term treatment or long-term care and treatment. (1) Each respondent certified for short-term treatment or long-term care and treatment on an inpatient basis pursuant to sections 27-65-108.5, 27-65-109, and 27-65-110 has the following rights and shall be advised of such rights by the facility: (a) To be treated fairly, with respect and recognition of the respondent's dignity and individuality, by all employees of the facility with whom the respondent comes in contact; (b) To not be discriminated against on the basis of age, race, ethnicity, religion, culture, spoken language, physical or mental disability, socioeconomic status, sex, sexual orientation, gender identity, or gender expression; (c) To retain and consult with an attorney at any time; (d) To meet with or call a personal clinician, spiritual advisor, counselor, crisis hotline, family member, workplace, child care provider, or school at all reasonable times; (e) To continue the practice of religion; (f) Within twenty-four hours after the respondent's request, to see and receive the services of a patient representative who has no direct or indirect clinical, administrative, or financial responsibility for the person; (g) To receive and send sealed correspondence, as well as to be given the assistance of facility staff if the respondent is unable to write, prepare, or mail correspondence. Facility staff shall not open, delay, intercept, read, or censor mail or other communications or use mail or other communications as a method to enforce compliance with facility staff. (h) To have the respondent's behavioral health orders for scope of treatment or psychiatric advance directive reviewed and considered by the court as the preferred treatment option for involuntary administration of medications unless, by clear and convincing evidence, the respondent's directive does not qualify as effective participation in behavioral health decision-making; (i) To have reasonable access to telephones or other communication devices and to make and receive calls or communications in private; (j) To have frequent and convenient opportunities to meet with visitors; (k) To see the respondent's attorney, clergyperson, or physician at any time; (l) To wear the respondent's own clothes, keep and use the respondent's own personal possessions, including the person's cell phone, and keep and be allowed to spend a reasonable sum of the respondent's own money; (m) To have the respondent's information and records disclosed to family members and a lay person pursuant to section 27-65-123; (n) To have the respondent's treatment records remain confidential, except as required by law; (o) To have appropriate access to adequate water, hygiene products, and food and to have the respondent's nutritional needs met in a manner that is consistent with recognized dietary practices; (p) To have personal privacy to the extent possible during the course of treatment; and o section 27-65-123; (n) To have the respondent's treatment records remain confidential, except as required by law; (o) To have appropriate access to adequate water, hygiene products, and food and to have the respondent's nutritional needs met in a manner that is consistent with recognized dietary practices; (p) To have personal privacy to the extent possible during the course of treatment; and (q) To have access to a representative within the facility who provides assistance to file a grievance. (2) A respondent's rights under subsection (1) of this section may be denied if access to the item, program, or service would endanger the safety of the respondent or another person in close proximity and may only be denied by a person involved in the respondent's care. Denial of any right must be entered into the respondent's treatment record. Information pertaining to a denial of rights contained in the respondent's treatment record must be made available, upon request, to the respondent, the respondent's legal guardian, or the respondent's attorney. (3) A respondent admitted to or in a facility must not be fingerprinted unless required by other provisions of law. (4) A respondent may be photographed upon admission for identification and the administrative purposes of the facility. The photographs are confidential and must not be released by the facility except pursuant to court order. Nonmedical photographs shall not be taken or used without appropriate consent or authorization. (5) Any respondent receiving evaluation or treatment under any of the provisions of this article 65 is entitled to a written copy and verbal description in a language or modality accessible to the person of all the rights enumerated in this section, and a minor child must receive written notice of the minor's rights as provided in section 27-65-104 (6)(g). A list of the rights must be prominently posted in all evaluation and treatment facilities in the predominant languages of the community and explained in a language or modality accessible to the respondent. The facility shall assist the respondent in exercising the rights enumerated in this section. (6) A facility shall not intentionally retaliate or discriminate against a person or employee for contacting or providing information to any official or to an employee of any state protection and advocacy agency, or for initiating, participating in, or testifying in a grievance procedure or in an action for any remedy authorized pursuant to this section. Any facility that violates this subsection (6) commits an unclassified misdemeanor and shall be fined not more than one thousand dollars. (7) Any respondent whose rights are denied or violated pursuant to this section has the right to file a compliant against the facility with the behavioral health administration and the department of public health and environment.

C.R.S. § 27-65-120 Administration or monitoring of medications to persons receiving treatment

27-65-120. Administration or monitoring of medications to persons receiving treatment. The commissioner has the power to direct the administration or monitoring of medications in conformity with part 3 of article 1.5 of title 25 to persons receiving treatment in facilities designated pursuant to this article 65.

C.R.S. § 27-65-121 Employment of persons in a facility - rules

27-65-121. Employment of persons in a facility - rules. The BHA shall adopt rules governing the employment and compensation for the administration of care or treatment to persons receiving care or treatment pursuant to this article 65. The BHA shall establish standards for reasonable compensation for such employment.

C.R.S. § 27-65-122 Voting in public elections

27-65-122. Voting in public elections. Any person receiving evaluation, care, or treatment pursuant to this article 65 must be given the opportunity to exercise the person's right to register and to vote in primary and general elections. The agency or facility providing evaluation, care, or treatment shall assist the person, upon the person's request, to obtain voter registration forms and mail ballots and to comply with any other prerequisite for voting.

C.R.S. § 27-65-123 Records

27-65-123. Records. (1) Except as provided in subsection (2) of this section, all information obtained and records prepared in the course of providing any services to any person pursuant to any provision of this article 65 are confidential and privileged matter. The information and records may be disclosed only: (a) In communications between qualified professionals, facility personnel, or state agencies in the provision of services or appropriate referrals; (b) When the recipient of services designates persons to whom information or records may be released; but, if a recipient of services is a ward or conservatee and the ward's or conservatee's guardian or conservator designates, in writing, persons to whom records or information may be disclosed, the designation is valid in lieu of the designation by the recipient; except that nothing in this section compels a physician, psychologist, social worker, nurse, attorney, or other professional personnel to reveal information that has been given to the person in confidence by members of a patient's family or other informants; (c) To the extent necessary to make claims on behalf of a recipient of aid, insurance, or medical assistance to which the recipient may be entitled; (d) If the BHA has promulgated rules for the conduct of research. Such rules must include, but are not limited to, the requirement that all researchers must sign an oath of confidentiality. All identifying information concerning individual patients, including names, addresses, telephone numbers, and social security numbers, must not be disclosed for research purposes. (e) To the courts, as necessary for the administration of this article 65; (f) To persons authorized by an order of court after notice and opportunity for hearing to the person to whom the record or information pertains and the custodian of the record or information pursuant to the Colorado rules of civil procedure; (g) To family members upon admission of a person with a mental health disorder for inpatient or residential care and treatment. The only information that may be released pursuant to this subsection (1)(g) is the location and fact of admission of the person with a mental health disorder who is receiving care and treatment. The disclosure of location is governed by the procedures in section 27-65-124 and is subject to review pursuant to section 27-65-124. (h) To family members or a lay person actively participating in the care and treatment of a person with a mental health disorder, regardless of the length of the participation. The information released pursuant to this subsection (1)(h) is limited to one or more of the following: The diagnosis, the prognosis, the need for hospitalization and anticipated length of stay, the discharge plan, the medication administered and side effects of the medication, and the short-term and long-term treatment goals. The disclosure is governed by the procedures in section 27-65-124 (2) and is subject to review pursuant to section 27-65-124. (i) In accordance with state and federal law to the agency designated pursuant to the federal "Protection and Advocacy for Individuals with Mental Illness Act", 42 U.S.C. sec. 10801 et seq., as the governor's protection and advocacy system for Colorado. (2) Nothing in subsection (1)(g) or (1)(h) of this section precludes the release of information to a parent concerning the parent's minor child. (3) (a) Nothing in this article 65 renders privileged or confidential any information, except written medical records and information that is privileged pursuant to section 13-90-107, concerning observed behavior that constitutes a criminal offense committed upon the premises of any facility providing services pursuant to this article 65 or any criminal offense committed against any person while performing or receiving services pursuant to this article 65. fidential any information, except written medical records and information that is privileged pursuant to section 13-90-107, concerning observed behavior that constitutes a criminal offense committed upon the premises of any facility providing services pursuant to this article 65 or any criminal offense committed against any person while performing or receiving services pursuant to this article 65. (b) Subsection (1) of this section does not apply to physicians or psychologists eligible to testify concerning a criminal defendant's mental condition pursuant to section 16-8-103.6. (4) (a) All facilities shall maintain and retain permanent records, including all applications as required pursuant to section 27-65-106 (3). (b) Outpatient or ambulatory care facilities shall retain all records for a minimum of seven years after discharge from the facility for persons who were eighteen years of age or older when admitted to the facility, or until twenty-five years of age for persons who were under eighteen years of age when admitted to the facility. (c) Inpatient or hospital care facilities shall retain all records for a minimum of ten years after discharge from the facility for persons who were eighteen years of age or older when admitted to the facility, or until twenty-eight years of age for persons who were under eighteen years of age when admitted to the facility. (5) Nothing in this section prohibits or limits the sharing of information by a state institution of higher education police department to authorized university administrators pursuant to section 23-5-141. (6) Nothing in this section prohibits the limited disclosure of necessary information to the prosecuting attorney and criminal defense counsel if a criminal case is still pending against the person.

C.R.S. § 27-65-124 Request for release of information - procedures - review of a decision concerning release of information

27-65-124. Request for release of information - procedures - review of a decision concerning release of information. (1) When a family member requests the location and fact of admission of a person with a mental health disorder pursuant to section 27-65-123 (1)(g), the treating professional person or the professional person's designee, who must be a professional person, shall decide whether to release or withhold such information. The location must be released unless the treating professional person or the professional person's designee determines, after an interview with the person with a mental health disorder, that release of the information to a particular family member would not be in the best interests of the person with a mental health disorder. Any decision to withhold information requested pursuant to section 27-65-123 (1)(g) is subject to administrative review pursuant to this section upon request of a family member or the person with a mental health disorder. The treating facility shall make a record of the information given to a family member pursuant to this subsection (1). For the purposes of this subsection (1), an adult person having a similar relationship to a person with a mental health disorder as a spouse, lay person, parent, child, or sibling of a person with a mental health disorder may also request the location and fact of admission concerning a person with a mental health disorder. (2) (a) When a family member requests information pursuant to section 27-65-123 (1)(h) concerning a person with a mental health disorder, the treating professional person or the professional person's designee shall determine whether the person with a mental health disorder is capable of making a rational decision in weighing the person's confidentiality interests and the care and treatment interests implicated by the release of information. The treating professional person or the professional person's designee shall then determine whether the person with a mental health disorder consents or objects to the release of information. Information must be released or withheld in the following circumstances: (I) If the treating professional person or the professional person's designee makes a finding that the person with a mental health disorder is capable of making a rational decision concerning the person's interests and the person with a mental health disorder consents to the release of information, the treating professional person or the professional person's designee shall order the release of the information unless the professional person or the professional person's designee determines that the release would not be in the best interests of the person with a mental health disorder. (II) If the treating professional person or the professional person's designee makes a finding that the person with a mental health disorder is capable of making a rational decision concerning the person's interests and the person with a mental health disorder objects to the release of information, the treating professional person or the professional person's designee shall not order the release of the information. (III) If the treating professional person or the professional person's designee makes a finding that the person with a mental health disorder is not capable of making a rational decision concerning the person's interests, the treating professional person or the professional person's designee may order the release of the information if the professional person or the professional person's designee determines that the release would be in the best interests of the person with a mental health disorder. (IV) Any determination as to capacity pursuant to this subsection (2)(a) must be used only for the limited purpose of this subsection (2)(a). al person or the professional person's designee may order the release of the information if the professional person or the professional person's designee determines that the release would be in the best interests of the person with a mental health disorder. (IV) Any determination as to capacity pursuant to this subsection (2)(a) must be used only for the limited purpose of this subsection (2)(a). (b) A decision by a treating professional person or the professional person's designee concerning the capability of a person with a mental health disorder pursuant to subsection (2)(a)(III) of this section is subject to administrative review upon the request of the person with a mental health disorder. A decision by a treating professional person or the professional person's designee to order the release or withholding of information pursuant to subsection (2)(a)(III) of this section is subject to administrative review upon the request of either a family member or the person with a mental health disorder. (c) The director of the treating facility shall make a record of any information given to a family member pursuant to subsection (2)(a) of this section and section 27-65-123 (1)(h). (3) When administrative review is requested pursuant to subsection (1) or (2)(b) of this section, the director of the facility providing care and treatment to the person with a mental health disorder shall cause an objective and impartial review of the decision to withhold or release information. The director of the facility shall conduct the review, if the director is a professional person. If the director is not available or if the director cannot provide an objective and impartial review, the review must be conducted by a professional person designated by the director of the facility. The review must include, but need not be limited to, an interview with the person with a mental health disorder. The facility providing care and treatment shall document the review of the decision. (4) If a person with a mental health disorder objects to the release or withholding of information, the person with a mental health disorder and the person's attorney, if any, must be provided with information concerning the procedures for administrative review of a decision to release or withhold information. The person with a mental health disorder must be informed of any information proposed to be withheld or released and to whom and be given a reasonable opportunity to initiate the administrative review process before information concerning the person's care and treatment is released. (5) A family member whose request for information is denied must be provided with information concerning the procedures for administrative review of a decision to release or withhold information. (6) A person with a mental health disorder may file a written request for review by the court of a decision made upon administrative review to release information to a family member requested pursuant to section 27-65-123 (1)(h) and proposed to be released pursuant to subsection (2) of this section. If judicial review is requested, the court shall hear the matter within ten days after the request, and the court shall give notice to the person with a mental health disorder and the person's attorney, the treating professional person, and the person who made the decision upon administrative review of the time and place of the hearing. The hearing must be conducted in the same manner as other civil proceedings before the court. the court shall hear the matter within ten days after the request, and the court shall give notice to the person with a mental health disorder and the person's attorney, the treating professional person, and the person who made the decision upon administrative review of the time and place of the hearing. The hearing must be conducted in the same manner as other civil proceedings before the court. (7) In order to allow a person with a mental health disorder an opportunity to seek judicial review, the treating facility or the treating professional person or the professional person's designee shall not release information requested pursuant to section 27-65-123 (1)(h) until five days after the determination upon administrative review of the director or the director's designee is received by the person with a mental health disorder, and, once judicial review is requested, the treating facility or the treating professional person or the professional person's designee shall not release information except by court order. However, if the person with a mental health disorder indicates an intention not to appeal a determination upon administrative review that is adverse to the person concerning the release of information, the information may be released less than five days after the determination upon review is received by the person with a mental health disorder. (8) This section provides for the release of information only and is not deemed to authorize the release of the written medical record without authorization by the patient or as otherwise provided by law. (9) For purposes of this section, the treating professional person's designee shall be a professional person.

C.R.S. § 27-65-125 Treatment in federal facilities

27-65-125. Treatment in federal facilities. (1) If a person is certified pursuant to this article 65 and is eligible for hospital care or treatment by an agency of the United States, and if a certificate of notification from the agency showing that facilities are available and that the person is eligible for care or treatment is received, the court may order the person to be placed in the custody of the agency for hospitalization. When any person is admitted pursuant to an order of court to any hospital or institution operated by any agency of the United States within or outside this state, the person is subject to the rules and regulations of the agency. The chief officer of any hospital or institution operated by an agency in which the person is so hospitalized shall, with respect to the person, be vested with the same powers as the chief officer of the Colorado mental health institute at Pueblo with respect to detention, custody, transfer, conditional release, or discharge of patients. Jurisdiction is retained in the appropriate courts of this state to inquire into the mental condition of a person so hospitalized and to determine the necessity for continuance of the person's hospitalization. (2) An order of a court of competent jurisdiction of another state, territory, or the District of Columbia authorizing hospitalization of a person to any agency of the United States has the same effect as to the person while in this state as in the jurisdiction in which the court entering the order is situated; the courts of the state or district issuing the order retain jurisdiction of the person so hospitalized for the purpose of inquiring into the person's mental condition and for determining the necessity for continuance of the person's hospitalization. Consent is given to the application of the law of the state or district in which the court issuing the order for hospitalization is located, with respect to the authority of the chief officer of any hospital or institution operated in this state by any agency of the United States to retain custody, transfer, conditionally release, or discharge the person hospitalized.

C.R.S. § 27-65-126 Transfer of persons into and out of Colorado - reciprocal agreements

27-65-126. Transfer of persons into and out of Colorado - reciprocal agreements. The transfer of a person hospitalized voluntarily pursuant to this article 65 out of Colorado or under the laws of another jurisdiction into Colorado are governed by the provisions of the interstate compact on mental health.

C.R.S. § 27-65-127 Imposition of legal disability - deprivation of legal right - restoration - repeal

27-65-127. Imposition of legal disability - deprivation of legal right - restoration - repeal. (1) (a) When an interested person wishes to obtain a determination as to the imposition of a legal disability or the deprivation of a legal right for a person who has a mental health disorder and who is a danger to the person's self or others, is gravely disabled, or is insane, as defined in section 16-8-101, and who is not then subject to proceedings pursuant to this article 65 or part 3 or part 4 of article 14 of title 15, the interested person may petition the court for a specific finding as to the legal disability or deprivation of a legal right. Actions commenced pursuant to this subsection (1) may include but are not limited to actions to determine contractual rights and rights with regard to the operation of motor vehicles. (b) The petition must set forth the disability to be imposed or the legal right to be deprived and the reasons. (2) The court may impose a legal disability or may deprive a respondent of a legal right only upon finding both of the following: (a) That the respondent is a person with a mental health disorder and is a danger to the respondent's self or others, is gravely disabled, or insane, as defined in section 16-8-101; and (b) That the requested disability or deprivation is both necessary and desirable. (3) (a) Beginning January 1, 2023, the BHA shall provide periodic updates to the advisory board related to the implementation of House Bill 22-1256, including updates regarding whether the BHA will have the capability and capacity to assist emergency medical services facilities that treat a person under an emergency mental health hold find appropriate placement, when indicated, for the person at an inpatient or outpatient mental health facility or facility designated by the commissioner. (b) This subsection (3) is repealed, effective July 1, 2025. (4) To have a legal disability removed or a legal right restored, any interested person may file a petition with the court that made the original finding. No legal disability may be imposed nor a legal right be deprived for a period of more than six months without a review hearing by the court at the end of six months, at which time the findings specified in subsection (2) of this section must be reaffirmed to justify continuance of the disability or deprivation. A copy of the petition must be served on the person who filed the original petition, on the person whose rights are affected if the person is not the petitioner, and upon the facility where the person whose rights are affected resides, if any. (5) Whenever any proceedings are instituted or conducted pursuant to this section, the following procedures apply: (a) Upon the filing of a petition, the court shall appoint an attorney to represent the respondent. The respondent may replace the attorney with an attorney of the respondent's own choosing at any time. Attorney fees for an indigent respondent are paid by the court. (b) The court, upon request of an indigent respondent or the respondent's attorney, shall appoint, at the court's expense, one or more professional persons of the respondent's choosing to assist the respondent in the preparation of the respondent's case. (c) Upon demand made at least five days prior to the date of hearing, the respondent has the right to a trial of all issues by a jury of six. (d) At all times the burden is upon the person seeking imposition of a disability or deprivation of a legal right or opposing removal of a disability or deprivation to prove all essential elements by clear and convincing evidence. of the respondent's case. (c) Upon demand made at least five days prior to the date of hearing, the respondent has the right to a trial of all issues by a jury of six. (d) At all times the burden is upon the person seeking imposition of a disability or deprivation of a legal right or opposing removal of a disability or deprivation to prove all essential elements by clear and convincing evidence. (e) Pending a hearing, the court may issue an order temporarily imposing a disability or depriving the respondent of a legal right for a period of not more than ten days in conformity with the standards for issuance of ex parte temporary restraining orders in civil cases, but no individual habilitation or rehabilitation plan is required prior to the issuance of the order. (f) Except as otherwise provided in this subsection (5), all proceedings must be held in conformance with the Colorado rules of civil procedure, but no costs may be assessed against the respondent.

C.R.S. § 27-65-128 Administration - rules

27-65-128. Administration - rules. The BHA shall promulgate any rules and develop and distribute any applications or forms necessary to consistently enforce the provisions of this article 65, including rules concerning involuntary feeding tubes for individuals with an eating disorder. The BHA shall proactively train providers, facilities, counties, judges, magistrates, intervening professionals, and certified peace officers on the procedures under this article 65, which training must include an understanding of the criteria for invoking an emergency mental health hold pursuant to section 27-65-106, the definition of "gravely disabled" and how a person who is gravely disabled may present physically and psychiatrically, and suggested templates and resources to be used by facilities to meet the requirements of section 27-65-106 (8)(a)(III) and (8)(a)(VII).

C.R.S. § 27-65-129 Payment for counsel

27-65-129. Payment for counsel. In order to provide legal representation to persons eligible for an attorney pursuant to this article 65, the judicial department shall pay, out of money appropriated by the general assembly, sums directly to the appointed attorney on a case-by-case basis or, on behalf of the state, shall pay lump-sum grants to and contract with individual attorneys, legal partnerships, legal professional corporations, public interest law firms, or nonprofit legal services corporations.

C.R.S. § 27-65-130 Advisory board - created - service standards and rules

27-65-130. Advisory board - created - service standards and rules. (1) (a) An advisory board, referred to in this section as the "board", is established for the purpose of assisting and advising the commissioner in accordance with subsection (2) of this section in the development of service standards and rules. The board consists of no fewer than eleven but not more than fifteen members appointed by the governor, as follows: (I) One representative from the department of human services; (II) One representative from the BHA; (III) One representative from the department of public health and environment; (IV) One representative from the university of Colorado health sciences center; (V) One representative from a leading professional association of psychiatrists in this state; (VI) One member representing proprietary skilled health-care facilities; (VII) One member representing nonprofit health-care facilities; (VIII) One member representing the Colorado bar association; (IX) One member representing consumers of services for persons with mental health disorders; (X) One member representing families of persons with mental health disorders; (XI) One member representing children's health-care facilities; and (XII) Other persons from both the private and the public sectors who are recognized or known to be interested and informed in the area of the board's purpose and function. (b) In making appointments to the board, the governor is encouraged to include representation by at least one member who is a person with a disability, as defined in section 24-34-301, a family member of a person with a disability, or a member of an advocacy group for persons with disabilities, provided that the other requirements of this section are met. (2) The advisory board is responsible for recommending standards and rules relevant to the provisions of this article 65 for the programs of mental health services to those patients in any health-care facility that has either separate facilities for the care, treatment, and rehabilitation of persons with mental health disorders or those health-care facilities that have as the health-care facility's only purpose the care and treatment of such persons.

C.R.S. § 27-65-131 Data report

27-65-131. Data report. (1) Beginning January 1, 2025, and each January 1 thereafter, the BHA shall annually submit a report to the general assembly on the outcomes and effectiveness of the involuntary commitment system described in this article 65, disaggregated by region, including any recommendations to improve the system and outcomes for persons involuntarily committed or certified pursuant to this article 65. The report must include aggregated and disaggregated nonidentifying individual-level data. At a minimum, the report must include: (a) The number of seventy-two-hour emergency mental health holds that occurred in the state and the number of people placed on a seventy-two-hour emergency mental health hold, including: (I) A summary of the reason each person was placed on an emergency mental health hold; (II) Demographic information of each person placed on an emergency mental health hold; (III) Disposition of each person placed on an emergency mental health hold; (IV) How often a facility was required to ask for assistance from the BHA to find placement for the person pursuant to section 27-65-106 and if placement was found, the average length of time a person had to wait for the placement and the challenges encountered in finding a placement; (V) How many subsequent emergency mental health holds were placed pursuant to section 27-65-106 due to a lack of appropriate placement options; and (VI) How each emergency mental health hold originated, whether by a certified peace officer; intervening professional, including specific professional type; or a court order; (b) The number and characteristics of each certification for short-term treatment, including an extension of short-term treatment, and long-term care and treatment that occurred in the state, including: (I) The number of inpatient versus outpatient certifications; (II) The reason for initiating each certification; (III) The number of certifications initiated by a court order, professional person, or certified peace officer; (IV) The average length of each certification; (V) The demographics of each individual on a certification for short-term treatment; (VI) The services provided; (VII) The services needed that were not available; and (VIII) Any identified barriers preventing the provision of needed services; (c) The outcome of each certification for short-term treatment and certification for long-term care and treatment; (d) The reason each certification was discontinued, disaggregated by those successfully discharged; voluntarily discharged; transferred; not located; with treatment compliance concerns; unable to transfer to another facility or provider, for lack of payment to treatment providers; and for any other reasons; (e) The person's housing and employment status when certification was discontinued; (f) What services were provided versus what services were most frequently needed by people certified on an outpatient basis; (g) Barriers and opportunities with local providers, the judicial branch, and law enforcement; and (h) How many individuals were placed in the custody of the BHA on a certification for short-term treatment who were concurrently involved in the criminal justice system, including the outcomes of each person and any barriers and opportunities that may exist to better serve the population.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://leg.colorado.gov/sites/default/files/images/olls/crs2024-title-27.docxFetched: 10/6/2026

Starting a business in Colorado? Colorado LLC guide: costs and requirements