DEPARTMENT OF HUMAN SERVICES
ARTICLE 1 DEPARTMENT OF HUMAN SERVICES
27-1-101 to 27-1-306. (Repealed)
Source: L. 2010: Entire article repealed, (SB 10-175), ch. 188, p. 675, § 1, effective April 29.
Editor's note: This article was numbered as article 11 of chapter 3, C.R.S. 1963. For amendments to this article prior to its repeal in 2010, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume. The provisions of this article were relocated to articles 66, 68, and 90 of this title. For the location of specific provisions, see the editor's notes following each section in said articles that were relocated and the comparative tables located in the back of the index.
ARTICLE 2 GENERAL ADMINISTRATIVE PROVISIONS
27-2-101 to 27-2-110. (Repealed)
Source: L. 2010: Entire article repealed, (SB 10-175), ch. 188, p. 675, § 1, effective April 29.
Editor's note: This article was numbered as article 3 of chapter 130, C.R.S. 1963. For amendments to this article prior to its repeal in 2010, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume. The provisions of this article were relocated to article 91 of this title. For the location of specific provisions, see the editor's notes following each section in said article and the comparative tables located in the back of the index.
MENTAL HEALTH
General Provisions
ARTICLE 9 COMMITMENT AND GENERAL PROVISIONS
27-9-101 to 27-9-133. (Repealed)
Editor's note:
- This article was numbered as article 1 of chapter 71, C.R.S. 1963. This article was repealed on revision as obsolete, effective July 1, 1975. For pertinent information concerning this article, see (2) of this note.
- The article was repealed and reenacted in 1973 with an effective date of July 1, 1974. (See L. 73, p. 819 .) Section 3 of chapter 67, Session Laws of Colorado 1974, changed the effective date of the repeal and reenactment from July 1, 1974, to July 1, 1975. (See L. 74, p. 287 .) In compiling C.R.S. 1973, which was not available until 1974, two versions were printed. Article 1 of chapter 71, C.R.S. 1963, was reorganized and renumbered as article 9 of title 27 in the compilation of C.R.S. 1973 and contained the original version of article 1 of chapter 71 found in C.R.S. 1963 in effect until July 1, 1975. The repealed and reenacted version of article 1 of chapter 71, C.R.S. 1963, effective July 1, 1975, was renumbered as article 10 in the compilation of C.R.S. 1973 and replaced article 9. (For the version of article 1 of chapter 71 in effect until July 1, 1975, see article 9 of title 27 in the original volume of C.R.S. 1973, pages 381 through 398.) For a detailed comparison of the former article 9 prior to its repeal by revision in 1975, see the comparative tables located in the back of the index.
Cross references: For current provisions concerning care and treatment of persons with mental illness, see article 65 of this title.
ARTICLE 10 CARE AND TREATMENT OF PERSONS WITH MENTAL ILLNESS
27-10-101 to 27-10-129. (Repealed)
Source: L. 2010: Entire article repealed, (SB 10-175), ch. 188, p. 675, § 1, effective April 29.
Editor's note: This article was numbered as article 1 of chapter 71, C.R.S. 1963. This article replaced article 9 of this title, effective July 1, 1975. For amendments to this article prior to its repeal in 2010, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume and the editor's note following the repeal of article 9 of this title. (For the version of article 1 of chapter 71 in effect July 1, 1975, see article 10 of title 27 in the original volume of C.R.S. 1973, pages 399 through 414.) The provisions of this article were relocated to article 65 of this title. For the location of specific provisions, see the editor's notes following each section in said article and the comparative tables located in the back of the index.
ARTICLE 10.3 CHILD MENTAL HEALTH TREATMENT ACT
27-10.3-101 to 27-10.3-108. (Repealed)
Source: L. 2010: Entire article repealed, (SB 10-175), ch. 188, p. 675, § 1, effective April 29.
Editor's note: This article was added in 1999. For amendments to this article prior to its repeal in 2010, consult the Colorado statutory research explanatory note beginning on page vii in the front of this volume. The provisions of this article were relocated to article 67 of this title. For the location of specific provisions, see the editor's notes following each section in said article and the comparative tables located in the back of the index.
ARTICLE 10.5 CARE AND TREATMENT OF PERSONS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES
Cross references: For provisions concerning home- and community-based services for persons with developmental disabilities, see part 3 of article 6 of title 25.5.
Section
PART 1 RIGHTS OF PERSONS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES
27-10.5-101. Legislative declaration - repeal. (Repealed)
Source: L. 75: Entire article added, p. 906, § 1, effective July 1. L. 85: Entire section amended, p. 983, § 1, effective July 1. L. 92: Entire section amended, p. 1350, § 1, effective July 1. L. 2013: (2) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-201 in 2014.
- Subsection (2) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-102. Definitions - repeal.
[ Editor's note: This version of the introductory portion of this section is effective until July 1, 2024. ] As used in this article, unless the context otherwise requires:
[ Editor's note: This version of the introductory portion of this section is effective July 1, 2024. ] As used in this article 10.5, unless the context otherwise requires:
-
"Authorized representative" has the same meaning as set forth in section 25.5-10-202, C.R.S.
(1.5) [ Editor's note: Subsection (1.5) is effective July 1, 2024. ] "Case management agency" has the same meaning as set forth in section 25.5-6-1702 (2).
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"Case management services" has the same meaning as set forth in section 25.5-10-202, C.R.S. (2.3) "Case manager" has the same meaning as set forth in section 25.5-10-202, C.R.S.
(2.5) (Deleted by amendment, L. 2008, p. 1442 , 1, effective August 5, 2008.)
-
- "Community-centered board" has the same meaning as set forth in section 25.5-10-202, C.R.S.
- This subsection (3) is repealed, effective July 1, 2024.
- (Deleted by amendment, L. 2013.)
- "Consent" has the same meaning as set forth in section 25.5-10-202, C.R.S.
- "Contribution" has the same meaning as set forth in section 25.5-10-202, C.R.S.
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"Court" has the same meaning as set forth in section 25.5-10-202, C.R.S.
(7.5) [ Editor's note: Subsection (7.5) is effective July 1, 2024. ] "Defined service area" has the same meaning as set forth in section 25.5-6-1702 (7).
- "Department" means the department of human services.
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- "Designated service area" has the same meaning as set forth in section 25.5-10-202, C.R.S.
- This subsection (9) is repealed, effective July 1, 2024.
- "Developmental disabilities professional" has the same meaning as "intellectual and developmental disabilities professional" as set forth in subsection (21.5) of this section.
-
- "Developmental disability" has the same meaning as "intellectual and developmental disability" as set forth in section 25.5-10-202, C.R.S.
- "Person with a developmental disability" has the same meaning as "person with an intellectual and developmental disability" as set forth in section 25.5-10-202, C.R.S.
-
"Child with a developmental delay" means:
- A person less than five years of age with delayed development as defined by the department; or
- A person less than five years of age who is at risk of having a developmental disability as defined by the department.
- The projected date for initiation of services and supports; and
- The anticipated outcomes to be achieved by receiving the services and supports.
- "Early intervention services and supports" means services described in and provided pursuant to part 7 of this article, including education, training, and assistance in child development, parent education, therapies, and other activities for infants and toddlers and their families that are designed to meet the developmental needs of infants and toddlers including, but not limited to, cognition, speech, communication, physical, motor, vision, hearing, social-emotional, and self-help skills.
-
[ Editor's note: This version of subsection (13) is effective until July 1, 2024.] "Eligible for supports and services" refers to any person with an intellectual and developmental disability or delay as determined eligible by the community-centered boards,
pursuant to section
27-10.5-106
. (13) [
Editor's note: This version of subsection (13) is effective July 1, 2024.
] "Eligible for supports and services" refers to any person with an intellectual and developmental disability or delay as determined eligible by the case management agency, pursuant to section
27-10.5-106
. (13.5) (Deleted by amendment,
L. 2008, p. 1442
, 1, effective August 5, 2008.)
(13.7) "Enrolled" means that a person with an intellectual and developmental disability who is eligible for supports and services has been authorized, as defined by rules promulgated by the department, to participate in a program funded pursuant to this article.
- "Executive director" means the executive director of the department of human services.
-
"Family" has the same meaning as set forth in section 25.5-10-202, C.R.S.
(15.5) (Deleted by amendment, L. 2013.)
- "Gastrostomy tube" has the same meaning as set forth in section 25.5-10-202, C.R.S.
-
"Human rights committee" has the same meaning as set forth in section 25.5-10-202, C.R.S.
(17.5) "IDEA" means the federal "Individuals with Disabilities Education Improvement Act of 2004", 20 U.S.C. sec. 1400 et seq., as amended, and its implementing regulations, 34 CFR part 303.
- "Inclusion" has the same meaning as set forth in section 25.5-10-202, C.R.S.
-
(Deleted by amendment, L. 2012.)
(19.5) "Individualized family service plan" or "IFSP" means a written plan developed pursuant to 20 U.S.C. sec. 1436 and 34 CFR 303.340 that authorizes the provision of early intervention services to an eligible child and the child's family. An IFSP shall serve as the individualized plan, pursuant to paragraph (c) of subsection (20) of this section, for a child from birth through two years of age.
-
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"Individualized plan" means a written plan designed by an interdisciplinary team for the purpose of identifying:
(I) The needs and preferences of the person or family receiving services;
(II) The specific services and supports appropriate to meet those needs and preferences;
-
[ Editor's note: This version of subsection (20)(b) is effective until July 1, 2024.] Every individualized plan will include a statement of agreement with the plan, signed by the person receiving services or other such person legally authorized to sign
on behalf of the person and a representative of the community-centered board.
(b) [ Editor's note: This version of subsection (20)(b) is effective July 1, 2024. ] Every individualized plan must include a statement of agreement with the plan, signed by the person receiving services or other such person legally authorized to sign on behalf of the person and a representative of the case management agency.
- Any other service or support plan, designated by the department, that meets all of the requirements of an individualized plan will be considered to be an individualized plan pursuant to this article.
- (Deleted by amendment, L. 2013.)
-
"Individualized plan" means a written plan designed by an interdisciplinary team for the purpose of identifying:
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"Infants and toddlers" means a child with a developmental delay from birth through two years of age.
(21.5) "Intellectual and developmental disabilities professional" means a person who has professional training and experience in the intellectual and developmental disabilities field, as defined by the department.
- "Interdependence" has the same meaning as set forth in section 25.5-10-202, C.R.S.
- "Interdisciplinary team" has the same meaning as set forth in section 25.5-10-202, C.R.S.
- "Least restrictive environment" has the same meaning as set forth in section 25.5-10-202, C.R.S.
-
"Person receiving services" means a person with an intellectual and developmental disability who is enrolled in a program funded pursuant to this article.
(25.5) "Program" means a specific group of services or supports as defined by rules promulgated by the department and for which funding is available pursuant to this article to a person with an intellectual and developmental disability who is eligible for supports and services.
- Repealed.
- "Regional center" means a facility or program operated directly by the department that provides services and supports to persons with intellectual and developmental disabilities.
- "Service agency" has the same meaning as set forth in section 25.5-10-202, C.R.S.
- "Service and support coordination" means planning, locating, facilitating access to, coordinating, and reviewing all aspects of needed and preferred services, supports, and resources that are provided in cooperation with the person receiving services, the person's family, as appropriate, the family of a child with a developmental delay, and the involved public or private agencies. Planning includes the development or review of an existing individualized plan. "Service and support coordination" also includes the reassessment of the needs and preferences of the person receiving services or the needs and preferences of the family of the person, with maximum participation of the person receiving services and the person's parents, guardian, or authorized representative, as appropriate.
-
"Services and supports" means one or more of the following: Education, training, therapies, identification of natural supports, and other activities provided to:
- Enable persons with intellectual and developmental disabilities to make responsible choices, exert greater control over their lives, experience presence and inclusion in their communities, develop their competencies and talents, maintain relationships, foster a sense of belonging, and experience personal security and self-respect;
- Enhance child development and healthy parent-child and family interaction for eligible infants and toddlers and their families pursuant to part 7 of this article; and
- Enable families, who choose or desire to maintain a family member with an intellectual and developmental disability at home, to obtain support and to enjoy a typical lifestyle.
- "Sterilization" has the same meaning as set forth in section 25.5-10-202, C.R.S.
- (Deleted by amendment, L. 2013.)
Source: L. 75: Entire article added, p. 906, § 1, effective July 1. L. 76: (4)(a) amended, p. 671, § 1, effective May 20. L. 85: Entire section R&RE, p. 984, § 2, effective July 1. L. 88: (6)(b) amended, p. 1082, § 1, effective April 9. L. 91: (13.5) added, p. 1163, § 4, effective March 29. L. 92: Entire section R&RE, p. 1351, § 2, effective July 1. L. 93: (11)(a) amended, p. 1668, § 81, effective July 1; (8) and (14) amended, p. 1162, § 132, effective July 1, 1994. L. 2001: (4) amended, p. 106, § 4, effective March 21. L. 2002: (11)(a) amended, p. 1024, § 47, effective June 1. L. 2004: (20)(d) added, p. 480, § 1, effective August 4. L. 2007: (2.5), (13.5), and (17.5) added, p. 1559, § 5, effective May 31. L. 2008: (15.5) added and (24) amended, p. 2179, § 1, effective June 5; entire section amended, p. 1442, § 1, effective August 5; (2.3) and (32) added, p. 2206, § 1, effective August 5. L. 2009: (15.5) amended, (SB 09-044), ch. 57, p. 208, § 9, effective March 25. L. 2010: (13.7) and (25.5) added and (25) and (32) amended, (HB 10- 1213), ch. 220, p. 960, § 1, effective May 10; (26) repealed, (SB 10-208), ch. 314, p. 1472, § 1, effective May 27. L. 2013: Entire section amended, (HB 13-1314), ch. 323, p. 1786, § 2, effective March 1, 2014. L. 2021: IP, (13), and (20)(b) amended and (1.5) and (7.5) added, (HB 21-1187), ch. 83, p. 348, § 56, effective July 1, 2024; (3)(b) and (9)(b) added by revision, (HB 21-1187), ch. 83, pp. 348, 354, §§ 56, 70.
Editor's note:
- Amendments to this section by House Bill 08-1031, Senate Bill 08-002, and House Bill 08-1366 were harmonized.
- Subsection (19.5) was originally numbered as (20.5) in House Bill 08-1366 but has been renumbered on revision for ease of location.
Cross references: For the legislative declaration contained in the 1993 act amending subsections (8) and (14), see section 1 of chapter 230, Session Laws of Colorado 1993.
ANNOTATION
Law reviews. For article, "Group Home Regulations Under State and Federal Law", see 35 Colo. Law. 37 (Feb. 2006).
Adoption of section permitting developmentally disabled persons to live in group homes reflects legislative intent to assist such persons to live in normal residential surroundings. Double D Manor v. Evergreen Meadows, 773 P.2d 1046 (Colo. 1989).
27-10.5-103. Duties of the executive director - rules - definition.
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[ Editor's note: This version of the introductory portion to subsection (1) is effective until July 1, 2022.] In order to implement the provisions of this article, the executive director shall carry out the following duties, subject to available appropriations:
(1) [ Editor's note: This version of the introductory portion to subsection (1) is effective July 1, 2022. ] In order to implement the provisions of this article 10.5, the executive director shall carry out the following duties, subject to available appropriations:
- Promote effective coordination with agencies serving persons with intellectual and developmental disabilities in order to improve continuity of services and supports for persons facing life transitions from toddler to preschool, school to adult life, and work to retirement;
-
[ Editor's note: This version of subsection (1)(b) is effective until July 1, 2022.] Conduct appropriate part C child find activities as described in section 27-10.5-704. Part C child find activities conducted by the department shall include, but need
not be limited to, case management, referral, transitions, and public education outreach and awareness of early intervention services.
(b) [ Editor's note: This version of subsection (1)(b) is effective July 1, 2022. ] Conduct appropriate part C child find activities as described in section 27-10.5-704. Part C child find activities conducted by the department include, but need not be limited to, early intervention evaluations, case management, referrals to public education systems or other community resources, implementation of state-level interagency operating agreements, and public outreach and awareness of early intervention evaluations and services.
- Operate regional centers pursuant to part 3 of this article; and
-
Facilitate employment first policies and practices by:
- Providing department input and assistance to the employment first advisory partnership established in part 3 of article 84 of title 8, C.R.S., in carrying out its duties; and
- Presenting the reports and recommendations of the employment first advisory partnership to the department's legislative committee of reference pursuant to section 8-84-303 (7), C.R.S.
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In accordance with section 24-4-103, and in coordination with the requirements of article 10 of title 25.5, the department shall adopt such rules as are necessary to carry out the provisions and purposes of this article 10.5, including but not limited
to the following:
- Standards for services and supports, including preparation of individualized plans;
- Purchase of services and supports and financial administration;
- Procedures for resolving disputes over eligibility determination and the modification, denial, or termination of services;
- Procedures for admission to programs contained in this article;
- Systems of quality assurance and data collection;
- The rights of a person receiving services;
- Confidentiality of records of a person receiving services;
- Designation of authorized representatives and delineation of their rights and duties pursuant to this article;
-
- The establishment of guidelines and procedures for authorization of persons for administration of nutrition and fluids through gastrostomy tubes.
- The department shall require that a service agency providing residential or day program services or supports have a staff member qualified pursuant to subparagraph (III) of this paragraph (i) on duty at any time the facility administers said nutrition and fluids through gastrostomy tubes, and that the facility maintain a written record of each nutrient or fluid administered to each person receiving services, including the time and the amount of the nutrient or fluid.
- A person who is not otherwise authorized by law to administer nutrition and fluids through gastrostomy tubes is allowed to perform the duties only under the supervision of a licensed nurse or physician. A person who administers nutrition and fluids in compliance with the provisions of this subsection (2)(i) is exempt from the licensing requirements of the "Colorado Medical Practice Act", article 240 of title 12, and the "Nurse and Nurse Aide Practice Act", article 255 of title 12. Nothing in this subsection (2)(i) shall be deemed to authorize the administration of medications through gastrostomy tubes. A person administering medications through gastrostomy tubes is subject to the requirements of part 3 of article 1.5 of title 25.
- For purposes of this paragraph (i), "administration" means assisting a person in the ingestion of nutrition or fluids according to the direction and supervision of a licensed nurse or physician.
- Child find activities, as described in section 27-10.5-704.
Source: L. 75: Entire article added, p. 908, § 1, effective July 1. L. 79: (4)(b) amended, p. 1640, § 47, effective July 19. L. 85: Entire section R&RE, p. 987, § 3, effective July 1. L. 88: (2)(j) repealed and (3) amended, pp. 1083, 1082, §§ 9, 2, effective April 9. L. 91: (2)(k) added, p. 1164, § 6, effective March 29; (1)(f) amended, p. 1859, § 22, effective April 11. L. 92: (2)(k)(V) repealed, p. 2011, § 5, effective June 2; entire section amended, p. 1357, § 3, effective July 1. L. 93: (1)(f) amended, p. 1162, § 133, effective July 1, 1994; (1)(f) repealed, p. 1121, § 32, effective July 1, 1994. L. 94: (1)(f) RC&RE, p. 2613, § 18, effective July 1. L. 2003: IP(2) and (2)(k)(III) amended, p. 714, § 54, effective July 1. L. 2006: (1)(f) amended, p. 2021, § 112, effective July 1. L. 2007: Entire section amended, p. 1559, § 6, effective May 31. L. 2008: (1)(h) and (2)(l) amended, p. 1448, § 2, effective August 5. L. 2009: IP(2) amended, (SB 09-044), ch. 57, p. 208, § 10, effective March 25. L. 2010: (2)(e) amended, (SB 10-208), ch. 314, p. 1472, § 2, effective May 27. L. 2013: Entire section R&RE, (HB 13-1314), ch. 323, p. 1792, § 3, effective March 1, 2014. L. 2016: (1)(b) and (1)(c) amended and (1)(d) added, (SB 16-077), ch. 360, p. 1507, § 8, effective July 1. L. 2019: IP(2) and (2)(i)(III) amended, (HB 19-1172), ch. 136, p. 1712, § 197, effective October 1. L. 2020: (2)(i)(III) amended, (HB 20-1183), ch. 157, p. 704, § 65, effective July 1. L. 2021: IP(1) and (1)(b) amended, (SB 21-275), ch. 393, p. 2613, § 6, effective July 1, 2022.
Editor's note: Amendments to this section by Senate Bill 92-096 and Senate Bill 92-133 were harmonized.
Cross references: For the legislative declaration contained in the 1993 act repealing subsection (1)(f), see section 1 of chapter 230, Session Laws of Colorado 1993. For the legislative declaration contained in the 1994 act recreating and reenacting subsection (1)(f), see section 1 of chapter 345, Session Laws of Colorado 1994. For the legislative declaration in SB 16-077, see section 1 of chapter 360, Session Laws of Colorado 2016.
27-10.5-103.5. Community centered boards and service agencies - local public procurement units - repeal. (Repealed)
Source: L. 92: Entire section added, p. 1077, § 3, effective July 1. L. 96: Entire section amended, p. 1476, § 37, effective June 1. L. 2013: (2) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-205 in 2014.
- Subsection (2) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-104. Authorized services and supports - conditions of funding - purchase of services and supports - boards of county commissioners - appropriation - repeal.
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[ Editor's note: This version of the introductory portion to subsection (1) is effective until July 1, 2024.] Subject to annual appropriations by the general assembly, the department shall provide or purchase, pursuant to subsection (4) of this section,
authorized services and supports from community-centered boards or service agencies for persons who have been determined to be eligible for such services and supports pursuant to section 27-10.5-106, and as specified in the eligible
person's individualized plan. Those services and supports may include, but need not be limited to, the following:
(1) [ Editor's note: This version of the introductory portion to subsection (1) is effective July 1, 2024. ] Subject to annual appropriations by the general assembly, the department shall provide or purchase, pursuant to subsection (4) of this section, authorized long-term services and supports from case management agencies or service agencies for persons who have been determined to be eligible for such long-term services and supports pursuant to section 27-10.5-106, and as specified in the eligible person's individualized plan. Those long-term services and supports may include, but need not be limited to, the following:
- Early intervention services and supports that offer infants and toddlers and their families services and supports to enhance child development in the areas of cognition, speech, communication, physical, motor, vision, hearing, social-emotional development, and self-help skills; parent-child or family interaction; and early identification, screening, and assessment services that are provided pursuant to part 7 of this article;
- Case management services;
- Day services and supports that offer opportunities for persons with intellectual and developmental disabilities to experience and actively participate in valued adult roles in the community. These services and supports will enable persons receiving services to access and participate in community activities, such as work, recreation, higher education, and senior citizen activities. Day services and supports, including early intervention services, may also include the administration of nutrition or fluids through gastrostomy tubes, if administered by a person authorized pursuant to section 27-10.5-103 (2)(i) and supervised by a licensed nurse or physician.
- Residential services and supports, including an array of training, learning, experiential, and support activities provided in living alternatives designed to meet the individual needs of persons receiving services and may include the administration of nutrition or fluids through gastrostomy tubes, if administered by a person authorized pursuant to section 27-10.5-103 (2)(i) and supervised by a licensed nurse or physician; and
- Ancillary services, including activities that are secondary but integral to the provision of the services and supports specified in this subsection (1).
- Service agencies receiving funds pursuant to subsection (1) of this section shall comply with all of the provisions of this article and the rules promulgated thereunder.
- Service and support coordination shall be purchased pursuant to part 7 of this article.
-
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The department may purchase services and supports, including service and support coordination, directly from service agencies if:
- Required by the federal requirements for the state to qualify for federal funds under Title XIX of the federal "Social Security Act", as amended, including programs authorized pursuant to part 4 of article 6 of title 25.5, C.R.S.; or
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- The executive director has determined that a service or support provided or purchased by a designated community-centered board does not meet established standards and the continuation of purchase of the service or support through the community-centered board is not in the best interests of the persons receiving services.
- This subsection (4)(a)(II) is repealed, effective July 1, 2024.
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[ Editor's note: This version of subsection (4)(b) is effective until July 1, 2024.] The department shall only purchase services and supports directly from those community-centered boards or service agencies that meet established standards.
(b) [ Editor's note: This version of subsection (4)(b) is effective July 1, 2024. ] The department shall only purchase long-term services and supports directly from those service agencies that meet established standards.
- Nothing in this section shall be construed to prohibit the provision of services and supports, including case management services, directly by the department through regional centers, for persons receiving services in regional centers.
- Nothing in this section shall be construed to require the provision of services and supports, including case management services, directly by the department.
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The department may purchase services and supports, including service and support coordination, directly from service agencies if:
-
- Each year the general assembly shall appropriate moneys to the department to provide or purchase services and supports for persons with intellectual and developmental disabilities pursuant to this section. Unless specifically provided otherwise, services and supports shall be purchased on the basis of state funding less any federal or cash funds received for general operating expenses from any other state or federal source, less funds available to a person receiving residential services or supports after such person receives an allowance for personal needs or for meeting other obligations imposed by federal or state law. The yearly appropriation, when combined with all other sources of funds, shall in no case exceed one hundred percent of the approved program costs as determined by the general assembly. Funds received for capital construction shall not be considered in the calculation for the distribution of funds under the provisions of this section.
- The department is authorized to use up to three percent of the appropriation allocated for early intervention services and supports for training and technical assistance to ensure that the latest developments for early intervention services and supports are rapidly integrated into service provision throughout the state.
Source: L. 75: Entire article added, p. 909, § 1, effective July 1. L. 79: (6)(b) amended, p. 1640, § 48, effective July 19. L. 85: Entire section R&RE, p. 988, § 4, effective July 1. L. 88: (2) and (8) amended, p. 1082, § 3, effective April 9; (7)(b) amended, p. 812, § 13, effective May 24. L. 91: (1)(d) amended, p. 1163, § 5, effective March 29. L. 92: Entire section R&RE, p. 1359, § 4, effective July 1. L. 93: (1)(a) amended, p. 1789, § 75, effective June 6; IP(1), IP(4)(a), and (7)(a) amended, p. 1162, § 134, effective July 1, 1994. L. 94: (7)(b) amended, p. 823, § 51, effective April 27. L. 96: (5) amended, p. 472, § 6, effective July 1. L. 2008: Entire section amended, p. 2216, § 1, effective June 5; (4)(a.7) added, p. 2180, § 2, effective June 5; (1) and (3) amended, p. 1448, § 3, effective August 5. L. 2010: (7)(b) amended, (HB 10-1013), ch. 399, p. 1916, § 48, effective June 10. L. 2013: Entire section R&RE, (HB 13-1314), ch. 323, p. 1794, § 4, effective March 1, 2014. L. 2021: IP(1) and (4)(b) amended, (HB 21-1187), ch. 83, p. 348, § 57, effective July 1, 2024; (4)(a)(II)(B) added by revision, (HB 21-1187), ch. 83, pp. 348, 354, §§ 57, 70.
Editor's note: Amendments to this section by House Bill 08-1366, Senate Bill 08-002, and House Bill 08-1220 were harmonized.
Cross references: For the legislative declaration contained in the 1993 act amending the introductory portions to subsections (1) and (4)(a) and subsection (7)(a), see section 1 of chapter 230, Session Laws of Colorado 1993.
ANNOTATION
Annotator's note. Since provisions similar to those in repealed § 27-11-103 were included in this section as amended in 1985, relevant cases construing those provisions in the repealed section have been included in the annotations to this section.
School board lacks standing to challenge the constitutionality of this section because, as a political subdivision of the state whose duty it is to carry out the educational policies of the state, the school district and officers thereof cannot question the constitutionality of a statute fixing their duties. Denver Ass'n for Retarded Children v. Sch. Dist. No. 1, 188 Colo. 310 , 535 P.2d 200 (1975).
Kindergarten included in school district's "regular school program". Where the defendant school board conceded that they maintain a free kindergarten for children who are five years of age and, but for the mental retardation or serious handicap of the children being educated through the board, they would attend the district's free kindergarten, such kindergarten is included in the school district's "regular school program" as that phrase is used in this section. Denver Ass'n for Retarded Children v. Sch. Dist. No. 1, 188 Colo. 310 , 535 P.2d 200 (1975).
Mandamus proper remedy. Subsection (7)(b) clearly requires that the "school district shall provide to the community incorporated board" a sum of money determined by a stated formula; therefore, the clear right of a school board to demand performance, and the clear legal duty on a school district to act, makes this a proper case for disposition by mandamus. Denver Ass'n for Retarded Children v. Sch. Dist. No. 1, 188 Colo. 310 , 535 P.2d 200 (1975).
Superintendent not proper party defendant in mandamus action. Since under § 22-32-107 the official duty of paying over the amounts in question as required by this section was that of the treasurer, as authorized by the board of education, and not that of the superintendent, the superintendent was not a proper party defendant in a mandamus action to require such payment. Denver Ass'n for Retarded Children v. Sch. Dist. No. 1, 188 Colo. 310 , 535 P.2d 200 (1975).
Amounts payable under section not subject to prejudgment interest. Since the amounts to be paid under this section arise neither out of contract nor out of a fiduciary relationship, the plaintiffs were not entitled to prejudgment interest. Denver Ass'n for Retarded Children v. Sch. Dist. No. 1, 188 Colo. 310 , 535 P.2d 200 (1975).
Applied in Adams County Cmty. Center for Retarded & Seriously Handicapped, Inc. v. State Dept. of Insts., 197 Colo. 448 , 594 P.2d 1046 (1979).
27-10.5-104.2. Services and supports - waiting list reduction - cash fund - repeal. (Repealed)
Source: L. 2008: Entire section added, p. 2209, § 2, effective August 5. L. 2009: (2) amended, (SB 09-228), ch. 410, p. 2264, § 17, effective July 1. L. 2013: (1), (2), and (3)(a) amended and (1.5) added, (HB 13-1314), ch. 323, p. 1796, § 5, effective May 28; (6) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-207 in 2014.
- Subsection (6) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-104.5. Case management agencies when acting as a service agency - money - rules - repeal.
-
- A service agency, including a community centered board when acting as a service agency, shall comply with the requirements set forth in this article and the rules promulgated thereunder.
- This subsection (1) is repealed, efffective July 1, 2024.
- (Deleted by amendment, L. 92, p. 1363 , § 5, effective July 1, 1992.)
-
[ Editor's note: This version of the introductory portion to subsection (3) is effective until July 1, 2024.] The department shall promulgate rules to implement the purchase of services and supports from a community-centered board or a service agency.
The rules shall include, but need not be limited to: (3) [
Editor's note: This version of the introductory portion to subsection (3) is effective July 1, 2024.
] The department shall promulgate rules to implement the purchase of long-term services and supports from a case management agency or a service agency. The rules must include, but need not be limited to:
- Terms and conditions necessary to promote the effective delivery of services and supports;
- [ Editor's note: This version of subsection (3)(b) is effective until July 1, 2024.] Procedures for obtaining an annual audit of designated community-centered boards and service agencies not affiliated with a designated community-centered board to provide financial information deemed necessary by the department to establish costs of services and supports and to ensure proper management of moneys received pursuant to section 27-10.5-104 ; (b) [ Editor's note: This version of subsection (3)(b) is effective July 1, 2024. ] Procedures for obtaining an annual audit of case management agencies and service agencies not affiliated with a case management agency to provide financial information deemed necessary by the department to establish costs of long-term services and supports and to ensure proper management of money received pursuant to section 27-10.5-104 ;
-
- Delineation of a system to resolve contractual disputes between the department and designated community-centered boards or service agencies and between designated community-centered boards and service agencies, including the contesting of any rates that the designated community-centered boards charge to service agencies based upon a percentage of the rates that service agencies charge for services and supports;
- This subsection (3)(c) is repealed, effective July 1, 2024.
- [ Editor's note: This version of subsection (3)(d) is effective until July 1, 2024.] Specification of what services and supports are to be reimbursed by the department and secondarily by the community-centered board, the source of reimbursement, actual service or support costs, incentives, and program service objectives which affect reimbursement; (d) [ Editor's note: This version of subsection (3)(d) is effective July 1, 2024. ] Specification of what long-term services and supports are to be reimbursed by the department and secondarily by the case management agencies, the source of reimbursement, actual long-term service or support costs, incentives, and program service objectives which affect reimbursement;
- The methods of coordinating the purchase of services and supports, including, but not limited to, service and support coordination, with other federal, state, and local programs which provide funding for authorized services and supports;
- (Deleted by amendment, L. 92, p. 1363 , § 5, effective July 1, 1992.)
- (Deleted by amendment, L. 2008, p. 2219 , § 2, effective June 5, 2008.)
-
[ Editor's note: This version of subsection (3)(i) is effective until July 1, 2024.] Criteria for and limitations on any rates that designated community-centered boards charge to service agencies based upon a percentage of the rates that service agencies
charge for services and supports.
- [ Editor's note: This version of subsection (3)(i) is effective July 1, 2024.] Criteria for and limitations on any rates that case management agencies charge to service agencies based upon a percentage of the rates that service agencies charge for long-term services and supports.
(3.5) [ Editor's note: This version of subsection (3.5) is effective July 1, 2024. ] Any incorporated service agency which is registered in Colorado as a foreign corporation shall organize a local advisory board consisting of individuals who reside within the defined service area. The advisory board must be representative of the community at large and persons receiving services and their families.
-
[ Editor's note: This version of subsection (4) is effective until July 1, 2024.] Upon a determination by the executive director that services or supports have not been provided in accordance with the program or financial administration standards specified
in this article and the rules and regulations promulgated thereunder, the executive director may reduce, suspend, or withhold payment to a designated community centered board, service agency under contract with a designated community
centered board, or service agency from which the department of human services purchased services or supports directly. When the executive director decides to reduce, suspend, or withhold payment, the executive director shall specify
the reasons therefor and the actions which are necessary to bring the service agency into compliance.
(4) [ Editor's note: This version of subsection (4) is effective July 1, 2024. ] Upon a determination by the executive director that long-term services or supports have not been provided in accordance with the program or financial administration standards specified in this article 10.5 and the rules and regulations promulgated thereunder, the executive director may reduce, suspend, or withhold payment to a case management agency, service agency under contract with a case management agency, or service agency from which the department of human services purchased long-term services or supports directly. When the executive director decides to reduce, suspend, or withhold payment, the executive director shall specify the reasons therefor and the actions which are necessary to bring the service agency into compliance.
- Nothing in this article or in any rules or regulations promulgated pursuant thereto and no actions taken by the executive director pursuant to this article shall be construed to affect the obtaining of funds from local authorities, including those funds obtained from a mill levy assessed by a county or municipality for the purpose of purchasing services or supports for persons with developmental disabilities, or to require that such funds from local authorities be used to supplant state or federal funds available for purchasing services and supports for persons with developmental disabilities.
- (Deleted by amendment, L. 92, p. 1363 , § 5, effective July 1, 1992.)
Source: L. 85: Entire section added, p. 991, § 5, effective July 1. L. 88: (6) amended, p. 1083, § 4, effective April 9. L. 92: Entire section amended, p. 1363, § 5, effective July 1. L. 93: (3)(d) and (4) amended, p. 1163, § 135, effective July 1, 1994. L. 2008: (3) amended, p. 2219, § 2, effective June 5; IP(3) and (3)(a) amended, p. 2180, § 3, effective June 5. L. 2009: (1), IP(3), and (3)(b) amended, (SB 09-044), ch. 57, p. 208, § 11, effective March 25. L. 2013: (3) amended, (HB 13-1314), ch. 323, p. 1797, § 6, effective March 1, 2014. L. 2021: IP(3), (3)(b), (3)(d), (3)(i), (3.5), and (4) amended, (HB 21-1187), ch. 83, p. 349, § 58, effective July 1, 2024; (1)(b) and (3)(c)(II) added by revision, (HB 21-1187), ch. 83, pp. 349, 354, §§ 58, 70.
Editor's note: Amendments to subsection (3) by House Bill 08-1220 and Senate Bill 08-002 were harmonized.
Cross references: For the legislative declaration contained in the 1993 act amending this section, see section 1 of chapter 230, Session Laws of Colorado 1993.
27-10.5-105. Case management agencies - purchase of services and supports.
-
[ Editor's note: This version of the introductory portion to subsection (1) is effective until July 1, 2024.] Once a community-centered board has been designated pursuant to section 25.5-10-209, C.R.S., it shall, subject to available appropriations:
(1) [ Editor's note: This version of the introductory portion to subsection (1) is effective July 1, 2024. ] Once a case management agency has been designated pursuant to section 25.5-6-1703, it shall, subject to available appropriations:
-
[ Editor's note: This version of subsection (1)(a) is effective until July 1, 2024.] Determine eligibility and develop an individualized plan for each person who receives services or supports pursuant to section 25.5-10-211, C.R.S.; except that, for a
child from birth through two years of age, eligibility determination and development of an individualized family service plan shall be made pursuant to part 7 of this article;
(a) [ Editor's note: This version of subsection (1)(a) is effective July 1, 2024. ] Determine eligibility and develop an individualized plan for each person who receives long-term services or supports pursuant to section 25.5-6-1704; except that, for a child from birth through two years of age, eligibility determination and development of an individualized family service plan must be made pursuant to part 7 of this article 10.5;
- Provide case management services, including service and support coordination and periodic reviews, for persons receiving services and families with children with intellectual and developmental disabilities;
- Obtain or provide early intervention services and supports pursuant to part 7 of this article;
- Take steps to notify eligible persons, and their families as appropriate, regarding the availability of services and supports;
- Pursuant to section 27-10.5-704, collaborate with the department as it develops and implements a statewide plan for public education outreach and awareness efforts related to part C child find and the availability of early intervention services.
-
[ Editor's note: This version of subsection (1)(a) is effective until July 1, 2024.] Determine eligibility and develop an individualized plan for each person who receives services or supports pursuant to section 25.5-10-211, C.R.S.; except that, for a
child from birth through two years of age, eligibility determination and development of an individualized family service plan shall be made pursuant to part 7 of this article;
Source: L. 75: Entire article added, p. 910, § 1, effective July 1. L. 85: Entire section R&RE, p. 992, § 6, effective July 1. L. 88: (2)(f) repealed and (4) amended, p. 1083, §§ 9, 5, effective April 9. L. 90: (2)(a) amended, p. 412, § 42, effective June 7. L. 92: Entire section R&RE, p. 1365, § 6, effective July 1. L. 93: IP(1) amended, p. 1163, § 136, effective July 1, 1994. L. 2007: (2) amended, p. 1562, § 7, effective May 31. L. 2008: (2) amended, p. 2220, § 3, effective June 5; entire section amended, p. 1450, § 4, effective August 5. L. 2010: (2)(d) amended, (HB 10-1213), ch. 220, p. 961, § 2, effective May 10; (2)(f) repealed, (SB 10-208), ch. 314, p. 1472, § 3, effective May 27. L. 2013: Entire section R&RE, (HB 13-1314), ch. 323, p. 1797, § 7, effective March 1, 2014. L. 2014: IP(1) and (1)(a) amended, (HB 14-1363), ch. 302, p. 1270, § 33, effective May 31. L. 2021: IP(1) and (1)(a) amended, (HB 21-1187), ch. 83, p. 350, § 59, effective July 1, 2024.
Cross references: For the legislative declaration contained in the 1993 act amending this section, see section 1 of chapter 230, Session Laws of Colorado 1993.
ANNOTATION
Nonprofit corporation offering services to the developmentally disabled pursuant to this section is not a political subdivision for purposes of the federal National Labor Relations Act. The corporation functions not as a state-created department or administrative arm of government, but essentially as a private contractor. Jefferson County Cmty. Center v. N.L.R.B., 732 F.2d 122 (10th Cir.), cert. denied, 496 U.S. 1086, 105 S. Ct. 591, 83 L. Ed. 2d 701 (1984) (decided under former § 27-11-103).
27-10.5-105.5. Revocation of designation - repeal. (Repealed)
Source: L. 85: Entire section added, p. 995, § 7, effective July 1. L. 88: (3) amended, p. 1083, § 6, effective April 9. L. 92: Entire section amended, p. 1368, § 7, effective July 1. L. 2013: (4) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-210 in 2014.
- Subsection (4) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-106. Eligibility determination.
[ Editor's note: This version of this section is effective until July 1, 2024. ] Any person may request an evaluation pursuant to section 25.5-10-211, C.R.S., to determine whether he or she has an intellectual and developmental disability and is eligible to receive services and supports pursuant to this article. Application for eligibility determination shall be made to the designated community-centered board in the designated service area where the person resides.
27-10.5-106. Eligibility determination.
[ Editor's note: This version of this section is effective July 1, 2024. ] Any person may request an evaluation pursuant to section 25.5-6-1704 to determine whether the person has an intellectual and developmental disability and is eligible to receive long-term services and supports pursuant to this article 10.5. Application for eligibility determination must be made to the case management agency in the defined service area where the person resides.
Source: L. 75: Entire article added, p. 910, § 1, effective July 1. L. 85: Entire section R&RE, p. 995, § 8, effective July 1. L. 88: (4) amended, p. 1083, § 7, effective April 9. L. 92: Entire section amended, p. 1368, § 8, effective July 1. L. 93: (1)(b) amended, p. 1163, § 137, effective July 1, 1994. L. 2007: (2) and (3) amended, p. 1564, § 8, effective May 31. L. 2008: Entire section amended, p. 1453, § 5, effective August 5. L. 2009: (1)(b) amended, (SB 09-044), ch. 57, p. 208, § 12, effective March 25. L. 2010: (1)(b) and (2) amended and (5) added, (HB 10-1213), ch. 220, p. 961, § 3, effective May 10. L. 2013: Entire section R&RE, (HB 13-1314), ch. 323, p. 1798, § 8, effective March 1, 2014. L. 2014: Entire section amended, (HB 14-1363), ch. 302, p. 1270, § 34, effective May 31. L. 2021: Entire section amended, (HB 21-1187), ch. 83, p. 350, § 60, effective July 1, 2024.
Cross references: For the legislative declaration contained in the 1993 act amending this section, see section 1 of chapter 230, Session Laws of Colorado 1993.
27-10.5-107. Procedure for resolving disputes over eligibility, modification of services or supports, and termination of services or supports.
-
Every state or local service agency receiving state moneys pursuant to section 27-10.5-104 or section 25.5-10-105, C.R.S., shall adopt a procedure for the resolution of disputes arising between the service agency and any recipient of, or applicant for,
services or supports authorized under section 27-10.5-104 or section 25.5-10-105, C.R.S. Procedures for the resolution of disputes regarding early intervention services shall be in compliance with IDEA. The procedures shall be
consistent with rules promulgated by the department pursuant to article 4 of title 24, C.R.S., and shall be applicable to the following disputes:
- A contested decision that the applicant is not eligible for services or supports;
- A contested decision to provide, modify, reduce, or deny services or supports set forth in the individualized plan or individualized family service plan of the person receiving services;
- A contested decision to terminate services or supports;
- A contested decision that the person receiving services is no longer eligible for services or supports.
- (Deleted by amendment, L. 92, p. 1369 , § 9, effective July 1, 1992.)
-
The department shall promulgate rules pursuant to article 4 of title 24, C.R.S., setting forth procedures for the resolution of disputes specified in subsection (1) of this section that shall:
- Require that all applicants for services and supports and the parents or guardian of a minor, the guardian, or an authorized representative be informed orally and in writing, in their native language, of the dispute resolution procedures at the time of application, at the time the individualized plan is developed, and any time changes in the plan are contemplated;
- Require that a service agency keep a written record of all proceedings specified pursuant to this section;
- Require that no person receiving services be terminated from such services or supports during the resolution process;
- Require that utilizing the dispute resolution procedure shall not prejudice the future provision of appropriate services or supports to individuals; and
- Require that the intended action not occur until after reasonable notice has been provided to the person, the parents or guardian of a minor, the guardian, or an authorized representative, along with an opportunity to utilize the resolution process, except in emergency situations, as determined by the department.
(3.5) The resolution process need not conform to the requirements of section 24-4-105, C.R.S., as long as the rules adopted by the department include provisions specifically setting forth procedures, time frames, notice, an opportunity to be heard and to present evidence, and the opportunity for impartial review of the decision in dispute by the executive director or designee, if the resolution process has failed.
- and (5) (Deleted by amendment, L. 92, p. 1369 , § 9, effective July 1, 1992.)
Source: L. 75: Entire article added, p. 911, § 1, effective July 1. L. 85: Entire section R&RE, p. 996, § 9, effective July 1. L. 88: (5) amended, p. 1083, § 8, effective April 9. L. 92: Entire section amended, p. 1369, § 9, effective July 1. L. 2008: (1) amended, p. 1454, § 6, effective August 5. L. 2009: IP(1), IP(3), and (3.5) amended, (SB 09-044), ch. 57, p. 209, § 13, effective March 25. L. 2013: IP(1) amended, (HB 13-1314), ch. 323, p. 1798, § 9, effective March 1, 2014.
27-10.5-108. Discharge.
- A person receiving services shall be discharged from services or supports upon a determination, made pursuant to the individualized planning process, that the services or supports are no longer appropriate. At least ten days prior to effectuation of the discharge, notification of discharge shall be given to the person receiving services, the parents or guardian of such a person who is a minor, and such person's legal guardian and authorized representative when applicable.
- When a person receiving services notifies a service agency that such person no longer wishes to receive a service or support, the person shall be discharged from such service or support unless the person is subject to a petition to impose a legal disability or to remove a legal right, filed pursuant to section 27-10.5-110 or section 25.5-10-216, C.R.S., or for whom a legal guardian has been appointed, affecting the person's ability to voluntarily terminate services or supports. The parents of the person receiving services who is a minor and such person's guardian shall be notified of the person's wish to terminate services or supports, but no minor will be discharged without the consent of the parent or legal guardian.
Source: L. 75: Entire article added, p. 911, § 1, effective July 1. L. 85: Entire section R&RE, p. 997, § 10, effective July 1. L. 92: Entire section amended, p. 1371, § 10, effective July 1. L. 2013: (2) amended, (HB 13-1314), ch. 323, p. 1799, § 10, effective March 1, 2014.
27-10.5-109. Community residential home - licenses - rules - repeal. (Repealed)
Source: L. 75: Entire article added, p. 911, § 1, effective July 1. L. 85: Entire section R&RE, p. 997, § 11, effective January 1, 1986. L. 92: Entire section amended, p. 1371, § 11, effective July 1. L. 94: Entire section amended, p. 2712, § 287, effective July 1. L. 2008: IP(6) amended, p. 1454, § 7, effective August 5. L. 2009: (3), (5), and IP(6) amended, (SB 09-044), ch. 57, p. 209, § 14, effective March 25. L. 2012: (2) and (3) amended, (HB 12-1294), ch. 252, p. 1260, § 12, effective June 4. L. 2013: (6)(d) added, (SB 13-283), ch. 332, p. 1896, § 16, effective May 28; (7) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-214 in 2014.
- Subsection (7) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-109.5. Compliance with local government zoning regulations - notice to local governments - provisional licensure - repeal. (Repealed)
Source: L. 2000: Entire section added, p. 1517, § 5, effective June 1. L. 2013: (4) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-215 in 2014.
- Subsection (4) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-110. Imposition of legal disability - removal of legal right.
- Any interested person may petition the court pursuant to section 25.5-10-216, C.R.S., to impose a legal disability on or to remove a legal right from a person with an intellectual and developmental disability as defined in section 25.5-10-202, C.R.S. The petition shall set forth the disability to be imposed or the legal right to be removed and the reasons therefor. The petition may affect the right to contract, the right to determine place of abode or provisions of services and supports, the right to operate a motor vehicle, and other similar rights.
- A person shall not be admitted to a regional center without a court order issued pursuant to section 25.5-10-216, C.R.S., except in an emergency or for the purpose of temporary respite care.
Source: L. 75: Entire article added, p. 912, § 1, effective July 1. L. 85: Entire section R&RE, p. 998, § 12, effective July 1. L. 92: Entire section amended, p. 1372, § 12, effective July 1. L. 2010: (2)(a)(II) amended, (HB 10-1213), ch. 220, p. 961, § 4, effective May 10. L. 2013: Entire section R&RE, (HB 13-1314), ch. 323, p. 1799, § 11, effective March 1, 2014.
27-10.5-110.5. Rights of persons with intellectual and developmental disabilities.
Each person receiving services pursuant to this article and article 10 of title 25.5, C.R.S., shall have the rights set forth in sections 25.5-10-223 to 25.5-10-230, C.R.S.
Source: L. 2013: Entire section added, (HB 13-1314), ch. 323, p. 1799, § 12, effective March 1, 2014.
27-10.5-111. Conduct of court proceedings - repeal. (Repealed)
Source: L. 75: Entire article added, p. 912, § 1, effective July 1. L. 85: Entire section R&RE, p. 1000, § 13, effective July 1. L. 2013: (2) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-217 in 2014.
- Subsection (2) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-112. Individuals' rights - repeal. (Repealed)
Source: L. 75: Entire article added, p. 912, § 1, effective July 1. L. 85: Entire section R&RE, p. 1000, § 14, effective July 1. L. 92: Entire section amended, p. 1374, § 13, effective July 1. L. 2013: (5) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-218 in 2014.
- Subsection (5) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-113. Right to individualized plan or individualized family service plan - repeal. (Repealed)
Source: L. 75: Entire article added, p. 913, § 1, effective July 1. L. 85: (1) and (2) amended and (3) repealed, pp. 1001, 1016, §§ 15, 46, effective July 1. L. 92: Entire section R&RE, p. 1375, § 14, effective July 1. L. 2007: Entire section amended, p. 1565, § 9, effective May 31. L. 2008: Entire section amended, p. 1455, § 8, effective August 5. L. 2010: (2) amended, (HB 10-1213), ch. 220, p. 962, § 5, effective May 10. L. 2013: (3) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-219 in 2014.
- Subsection (3) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-114. Right to medical care and treatment - repeal. (Repealed)
Source: L. 75: Entire article added, p. 913, § 1, effective July 1. L. 85: (1), (3) to (5), (7), and (8) amended, p. 1001, § 16, effective July 1. L. 92: Entire section amended and (6.5) added, pp. 1375, 1157, §§ 15, 13, effective July 1. L. 97: (6.5) amended, p. 1024, § 47, effective August 6. L. 2003: (3) and (6.5) amended, p. 714, § 55, effective July 1. L. 2013: (11) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-220 in 2014.
- Subsection (11) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-115. Right to humane care and treatment - repeal. (Repealed)
Source: L. 75: Entire article added, p. 914, § 1, effective July 1. L. 85: (2) and (8) amended, p. 1002, § 17, effective July 1. L. 92: Entire section R&RE, p. 1377, § 16, effective July 1. L. 2013: (12) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-221 in 2014.
- Subsection (12) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-116. Right to religious belief, practice, and worship - repeal. (Repealed)
Source: L. 75: Entire article added, p. 915, § 1, effective July 1. L. 85: Entire section amended, p. 1004, § 18, effective July 1. L. 92: Entire section amended, p. 1379, § 17, effective July 1. L. 2013: (2) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-222 in 2014.
- Subsection (2) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-117. Rights to communications and visits - repeal. (Repealed)
Source: L. 75: Entire article added, p. 915, § 1, effective July 1. L. 85: (1) to (3), (5), and (6) amended and (4) and (7) repealed, pp. 1004, 1016, §§ 19, 46, effective July 1. L. 92: Entire section amended, p. 1379, § 18, effective July 1. L. 2013: (8) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-223 in 2014.
- Subsection (8) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-118. Right to fair employment practices - repeal. (Repealed)
Source: L. 75: Entire article added, p. 916, § 1, effective July 1. L. 85: Entire section amended, p. 1004, § 20, effective July 1. L. 92: Entire section amended, p. 1379, § 19, effective July 1. L. 2013: (7) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-224 in 2014.
- Subsection (7) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-119. Right to vote - repeal. (Repealed)
Source: L. 75: Entire article added, p. 916, § 1, effective July 1. L. 85: Entire section amended, p. 1005, § 21, effective July 1. L. 92: Entire section amended, p. 1380, § 20, effective July 1. L. 2007: Entire section amended, p. 1798, § 71, effective June 1. L. 2013: Entire section amended, (HB 13-1303), ch. 185, p. 750, § 130, effective May 10; (2) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- Amendments to this section by House Bill 13-1303 and House Bill 13-1314 were harmonized, and this section was relocated to § 25.5-10-225 in 2014.
- Subsection (2) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-120. Records and confidentiality of information pertaining to eligible persons or their families - repeal. (Repealed)
Source: L. 75: Entire article added, p. 916, § 1, effective July 1. L. 85: Entire section amended, p. 1005, § 22, effective July 1. L. 92: Entire section amended, p. 1380, § 21, effective July 1. L. 2008: (4) added, p. 1455, § 9, effective August 5. L. 2013: (5) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-226 in 2014.
- Subsection (5) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-121. Right to personal property - repeal. (Repealed)
Source: L. 75: Entire article added, p. 917, § 1, effective July 1. L. 85: Entire section amended, p. 1006, § 23, effective July 1. L. 92: Entire section amended, p. 1381, § 22, effective July 1. L. 2013: (4) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-227 in 2014.
- Subsection (4) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-122. Right to influence policy - repeal. (Repealed)
Source: L. 75: Entire article added, p. 917, § 1, effective July 1. L. 85: Entire section amended, p. 1007, § 24, effective July 1. L. 92: Entire section amended, p. 1382, § 23, effective July 1. L. 2013: (2) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-228 in 2014.
- Subsection (2) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-123. Right to notification - repeal. (Repealed)
Source: L. 75: Entire article added, p. 917, § 1, effective July 1. L. 85: Entire section amended, p. 1007, § 25, effective July 1. L. 92: Entire section amended, p. 1382, § 24, effective July 1. L. 2013: (2) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-229 in 2014.
- Subsection (2) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-124. Discrimination - repeal. (Repealed)
Source: L. 75: Entire article added, p. 917, § 1, effective July 1. L. 85: Entire section amended, p. 1007, § 26, effective July 1. L. 92: Entire section amended, p. 1382, § 25, effective July 1. L. 2013: (2) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-230 in 2014.
- Subsection (2) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-125. Transfer of residents. (Repealed)
Source: L. 75: Entire article added, p. 917, § 1, effective July 1. L. 85: Entire section repealed, p. 1016, § 46, effective July 1.
27-10.5-126. Return of residents. (Repealed)
Source: L. 75: Entire article added, p. 917, § 1, effective July 1. L. 85: Entire section repealed, p. 1016, § 46, effective July 1.
27-10.5-127. Restoration of rights. (Repealed)
Source: L. 75: Entire article added, p. 917, § 1, effective July 1. L. 85: Entire section repealed, p. 1016, § 46, effective July 1.
27-10.5-128. Sterilization rights - repeal. (Repealed)
Source: L. 75: Entire article added, p. 918, § 1, effective July 1. L. 85: IP(1), (1)(b), and (2) amended, p. 1007, § 27, effective July 1. L. 92: Entire section R&RE, p. 1382, § 26, effective July 1. L. 2013: (6) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-231 in 2014.
- Subsection (6) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-129. Competency to give consent to sterilization - repeal. (Repealed)
Source: L. 75: Entire article added, p. 918, § 1, effective July 1. L. 85: IP(1) and (2) to (4) amended, p. 1008, § 28, effective July 1. L. 92: Entire section R&RE, p. 1383, § 27, effective July 1. L. 2013: (4) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-232 in 2014.
- Subsection (4) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-130. Court-ordered sterilization - repeal. (Repealed)
Source: L. 75: Entire article added, p. 919, § 1, effective July 1. L. 85: (1) amended, p. 1009, § 29, effective July 1. L. 92: Entire section R&RE, p. 1384, § 28, effective July 1. L. 2013: (7) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-233 in 2014.
- Subsection (7) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-131. Confidentiality of sterilization proceedings - repeal. (Repealed)
Source: L. 75: Entire article added, p. 919, § 1, effective July 1. L. 85: Entire section amended, p. 1009, § 30, effective July 1. L. 92: Entire section amended, p. 1386, § 29, effective July 1. L. 2013: (2) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-234 in 2014.
- Subsection (2) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-132. Limitations on sterilization - repeal. (Repealed)
Source: L. 75: Entire article added, p. 919, § 1, effective July 1. L. 2013: (3) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-235 in 2014.
- Subsection (3) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-133. Group homes for the developmentally disabled. (Repealed)
Source: L. 75: Entire article added, p. 919, § 1, effective July 1. L. 76: (1)(a), (1)(b), and (2) amended and (2.5) added, p. 671, § 2, effective May 20. L. 85: Entire section repealed, p. 1016, § 46, effective July 1.
27-10.5-134. Civil action and attorney fees - repeal. (Repealed)
Source: L. 75: Entire article added, p. 920, § 1, effective July 1. L. 2013: (2) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-236 in 2014.
- Subsection (2) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-135. Terminology - repeal. (Repealed)
Source: L. 75: Entire article added, p. 920, § 1, effective July 1. L. 85: Entire section amended, p. 1009, § 31, effective July 1. L. 92: Entire section amended, p. 1386, § 30, effective July 1. L. 2005: (2) amended, p. 773, § 54, effective June 1. L. 2006: (1) amended, p. 1406, § 72, effective August 7. L. 2013: (3) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-237 in 2014.
- Subsection (3) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-136. Adjudication of competency. (Repealed)
Source: L. 75: Entire article added, p. 920, § 1, effective July 1.
Editor's note: Subsection (2) provided for the repeal of this section, effective July 1, 1976. (See L. 75, p. 920 .)
27-10.5-137. Federal funds - repeal. (Repealed)
Source: L. 85: Entire section added, p. 1009, § 32, effective July 1. L. 2013: (2) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-238 in 2014.
- Subsection (2) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-138. Service provision system evaluation. (Repealed)
Source: L. 85: Entire section added, p. 1009, § 32, effective July 1.
Editor's note: Subsection (2) provided for the repeal of this section, effective July 1, 1988. (See L. 85, p. 1009 .)
27-10.5-139. Evaluations to determine whether a defendant is mentally retarded for purposes of class 1 felony trials - repeal. (Repealed)
Source: L. 95: Entire section added, p. 1258, § 24, effective July 1. L. 2002: Entire section amended, p. 1541, § 281, effective October 1. L. 2013: (2) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note:
- This section was relocated to § 25.5-10-239 in 2014.
- Subsection (2) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-140. Child find - responsibilities - interagency operating agreements - rules. (Repealed)
Source: L. 2007: Entire section added, p. 1565, § 10, effective May 31. L. 2008: Entire section repealed, p. 1455, § 10, effective August 5.
27-10.5-141. Retaliation prohibited - repeal. (Repealed)
Source: L. 2008: Entire section added, p. 1235, § 5, effective May 27. L. 2013: (2) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 13, 56.
Editor's note: Subsection (2) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-142. Caregiver abuse - duties of the department - working group - issues - report - funding - repeal. (Repealed)
Source: L. 2008: Entire section added, p. 2212, § 1, effective June 5. L. 2013: (7) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 14, 56.
Editor's note: Subsection (7) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
27-10.5-143. Caregiver abuse - task force - repeal. (Repealed)
Source: L. 2009: Entire section added, (HB 09-1178), ch. 84, p. 308, § 1, effective April 2. L. 2013: (3) added by revision, (HB 13-1314), ch. 323, pp. 1799, 1813, §§ 14, 56.
Editor's note: Subsection (3) provided for the repeal of this section, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
PART 2 STATE COUNCIL ON DEVELOPMENTAL DISABILITIES
27-10.5-201. Legislative declaration.
The general assembly finds that state and local agencies provide a variety of services and supports to persons with developmental disabilities including institutional care, residential, social, and income maintenance services, diagnostic and health-related services, and educational and other programs. Because these services and supports are supported by many diverse agencies and organizations and because congress, through the federal "Developmental Disabilities Services and Facilities Construction Act", and amendments thereto, has called for the establishment of state councils to provide coordination and planning in the field of developmental disabilities, the general assembly declares that there is need to establish a state council on developmental disabilities to be responsible for the coordination of services and supports to the persons with developmental disabilities and to serve as an advocate for such persons. The general assembly further finds that there is need to carefully define the duties and responsibilities of a state council on developmental disabilities.
Source: L. 79: Entire part added, p. 1117, § 1, effective July 1. L. 85: Entire section amended, p. 1010, § 33, effective July 1. L. 92: Entire section amended, p. 1386, § 31, effective July 1. L. 2002: Entire section amended, p. 1024, § 48, effective June 1.
27-10.5-202. Definitions.
As used in this part 2, unless the context otherwise requires:
-
"Developmental disability" means a severe, chronic disability of a person nine years of age or older which:
- Is attributable to a mental or physical impairment or combination of mental and physical impairments;
- Is manifested before the person attains age twenty-two;
-
Results in substantial functional limitations in three or more of the following areas of major life activity:
- Self-care;
- Receptive and expressive language;
- Learning;
- Mobility;
- Self-direction;
- Capacity for independent living; and
- Economic self-sufficiency; and
- Reflects the person's need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services and supports which are of lifelong or extended duration and are individually planned and coordinated; except that such term when applied to infants and young children means individuals from birth to age nine years, inclusive, who have substantial developmental delay or specific congenital or acquired conditions with a high probability of resulting in developmental disabilities if services or supports are not provided.
- "State plan" means the state plan for developmental disabilities established pursuant to the provisions of section 27-10.5-204 and as required by the federal "Developmental Disabilities Services and Facilities Construction Act", and amendments thereto, including the "Rehabilitation, Comprehensive Services, and Developmental Disabilities Amendments of 1978", Pub.L. 95-602.
- "State council" means the Colorado developmental disabilities council established pursuant to section 27-10.5-203.
Source: L. 79: Entire part added, p. 1117, § 1, effective July 1. L. 92: Entire section amended, p. 1386, § 32, effective July 1. L. 2002: IP(1), (1)(d), and (3) amended, p. 1025, § 49, effective June 1.
Editor's note: Pub.L. 95-602 is contained in 29 U.S.C. sec. 720.
27-10.5-203. Establishment of state council.
- There is hereby created, within the office of the executive director of the department of human services, the Colorado developmental disabilities council. The powers, duties, and functions of the state council are transferred by a type 1 transfer, as such transfer is defined by the "Administrative Organization Act of 1968", article 1 of title 24, C.R.S., to the department of human services. The state council shall operate in accordance with the federal "Developmental Disabilities Assistance and Bill of Rights Act of 2000", 42 U.S.C. sec. 15001 et seq.
- The state council shall consist of twenty-four members appointed by the governor for three-year terms; except that of the members first appointed, one-third shall be appointed for one-year terms, one-third shall be appointed for two-year terms, and one-third shall be appointed for three-year terms. Vacancies shall be filled by appointment for the unexpired term.
- The state council shall at all times include in its membership representatives of the principal state agencies, including the state agency that administers funds provided under the federal "Rehabilitation Act of 1973", the state agency that administers funds provided under the federal "Individuals with Disabilities Education Act", the state agency that administers funds provided under the federal "Older Americans Act of 1965", and the state agency that administers funds provided under Titles V and XIX of the federal "Social Security Act" for persons with developmental disabilities; university centers for excellence in developmental disabilities education, research, and service; nongovernmental agencies; and private nonprofit groups concerned with services and supports for persons with developmental disabilities.
-
At least one-half of the membership of the state council shall consist of persons who:
- Are persons with developmental disabilities;
- Are parents or guardians of such persons; or
- Are family members or guardians of persons with mentally impairing developmental disabilities, and who are not employees of a state agency which receives funds or provides services and supports under this part 2, and who are not employees implementing programs under the federal "Social Security Act" or of any other entity which receives funds or provides services and supports under this part 2.
-
Of the members of the state council described in subsection (4) of this section:
- At least one-third shall be persons with developmental disabilities;
- At least one-third shall be individuals described in paragraph (c) of subsection (4) of this section, and at least one of such individuals shall be an immediate relative or guardian of an institutionalized or previously institutionalized person with a developmental disability.
- Members of the state council shall serve without compensation but shall be entitled to reimbursement for their expenses while attending regular and special meetings of the state council.
- The state council shall operate in accordance with bylaws adopted by a quorum of its membership.
- For the purposes of holding meetings of the council, a quorum shall be a simple majority of the council membership in attendance.
Source: L. 79: Entire part added, p. 1118, § 1, effective July 1. L. 85: (2) and (6) amended, p. 1010, § 34, effective July 1. L. 92: Entire section R&RE, p. 1387, § 33, effective July 1. L. 93: (1) amended, p. 1164, § 138, effective July 1, 1994. L. 2002: (1), (2), (3), IP(4), IP(5), (6), and (7) amended, p. 1025, § 50, effective June 1.
Cross references: (1) For the legislative declaration contained in the 1993 act amending this section, see section 1 of chapter 230, Session Laws of Colorado 1993.
(2) For the "Individuals with Disabilities Education Act", see Pub.L. 91-230, codified at 20 U.S.C. sec. 1400 et seq. For the "Older Americans Act of 1965", see Pub.L. 89-73, codified at 42 U.S.C. sec. 3001 et seq.
27-10.5-204. Development of the state plan.
The state council shall develop a five-year state plan for developmental disabilities in accordance with the federal "Developmental Disabilities Assistance and Bill of Rights Act of 2000", 42 U.S.C. sec. 15024. The state plan shall include establishment of goals and priorities for meeting the needs of persons with developmental disabilities, including recommendations concerning state program operations and funding for a comprehensive system of services and supports to persons with developmental disabilities. The state plan shall be prepared in compliance with federal requirements and shall designate the state agency responsible for administration of the state plan. The state council shall submit the state plan to the governor for approval.
Source: L. 79: Entire part added, p. 1118, § 1, effective July 1. L. 92: Entire section amended, p. 1389, § 34, effective July 1. L. 2002: Entire section amended, p. 1026, § 51, effective June 1.
27-10.5-205. Powers and duties.
-
The state council shall:
- Monitor the plans and programs of state agencies established and administered pursuant to the state plan;
- Review budgets and other programs and proposals for funding services and supports to persons with developmental disabilities;
-
[ Editor's note: This version of subsection (1)(c) is effective until July 1, 2024.] Review programs that provide services and supports to persons with developmental disabilities under contracts with state agencies and community centered boards as authorized
by the state plan;
(c) [ Editor's note: This version of subsection (1)(c) is effective July 1, 2024. ] Review programs that provide long-term services and supports to persons with intellectual and developmental disabilities under contracts with state agencies and case management agencies as authorized by the state plan;
- Encourage cooperation and coordination of services and supports of public and private agencies including home care services and assist in the elimination of unnecessary and duplicative programs and procedures;
- Identify gaps in services and supports to persons with developmental disabilities and monitor programs for deinstitutionalization of such persons;
- Serve in an advisory capacity to the governor and the general assembly on matters affecting persons with developmental disabilities;
- Meet at least quarterly and as often as necessary to fulfill its duties and responsibilities;
- Have all powers necessary to carry out the provisions of this part 2.
Source: L. 79: Entire part added, p. 1118, § 1, effective July 1. L. 85: (1)(b), (1)(c), (1)(e), and (1)(f) amended, p. 1011, § 35, effective July 1. L. 92: Entire section amended, p. 1389, § 35, effective July 1. L. 2002: IP(1) amended, p. 1026, § 52, effective June 1. L. 2021: (1)(c) amended, (HB 21-1187), ch. 83, p. 350, § 61, effective July 1, 2024.
27-10.5-206. State council employees.
Subject to available appropriations, the executive director of the department of human services may employ such personnel as are required by the state council, pursuant to the provisions of section 13 of article XII of the state constitution. The executive director of the department of human services will appoint the staff director to the state council, accepting the recommendations of the council.
Source: L. 79: Entire part added, p. 1119, § 1, effective July 1. L. 93: Entire section amended, p. 1164, § 139, effective July 1, 1994. L. 2002: Entire section amended, p. 1026, § 53, effective June 1.
Cross references: For the legislative declaration contained in the 1993 act amending this section, see section 1 of chapter 230, Session Laws of Colorado 1993.
27-10.5-207. Cooperation of departments.
The departments of human services, public health and environment, and education shall cooperate with the state council in the development of and implementation of the recommendations made within the state plan. Said departments shall provide documents and other assistance requested by the state council or its representatives which are essential for the state council to meet its federal and state statutory requirements.
Source: L. 79: Entire part added, p. 1119, § 1, effective July 1. L. 92: Entire section amended, p. 1390, § 36, effective July 1. L. 93: Entire section amended, p. 1164, § 140, effective July 1, 1994. L. 2002: Entire section amended, p. 1027, § 54, effective June 1.
Cross references: For the legislative declaration contained in the 1993 act amending this section, see section 1 of chapter 230, Session Laws of Colorado 1993.
27-10.5-208. Service provision system evaluation. (Repealed)
Source: L. 85: Entire section added, p. 1011, § 36, effective July 1.
Editor's note: Subsection (2) provided for the repeal of this section, effective July 1, 1988. (See L. 85, p. 1011 .)
PART 3 REGIONAL CENTERS
Editor's note: Provisions similar to the provisions of this part 3 were found in article 14 of this title prior to its repeal in 1985.
27-10.5-301. Regional centers for persons with developmental disabilities.
There are hereby established state regional centers in Wheat Ridge, Pueblo, and Grand Junction. The essential object of such regional centers shall be to provide state operated services and supports to persons with developmental disabilities. A regional center may not permit the cultivation, use, or consumption of retail marijuana on its premises.
Source: L. 85: Entire part added, p. 1011, § 37, effective July 1. L. 92: Entire section amended, p. 1390, § 37, effective July 1. L. 2013: Entire section amended, (SB 13-283), ch. 332, p. 1896, § 17, effective May 28.
ANNOTATION
Law reviews. For article, "Liability of Counties for Support of Inmates in State Institutions", see 29 Dicta 27 (1952).
For the object and purpose of the institution, see People ex rel. Dunbar v. County Court, 128 Colo. 374 , 262 P.2d 550 (1953) (decided under former § 27-14-102).
27-10.5-302. Directors.
The executive director shall appoint, pursuant to section 13 of article XII of the state constitution, a director for each regional center. Persons appointed must be skilled and trained administrators with experience related to the needs of persons with developmental disabilities. The director of each regional center shall appoint such other employees in accordance with section 13 of article XII of the state constitution as are necessary to carry out the functions of the regional center.
Source: L. 85: Entire part added, p. 1012, § 37, effective July 1. L. 92: Entire section amended, p. 1390, § 38, effective July 1.
27-10.5-303. Annual reports - publications.
The director of each regional center shall report to the executive director at such times and on such matters as the executive director may require. Publications of each regional center circulated in quantity outside the department shall be subject to the approval and control of the executive director.
Source: L. 85: Entire part 3 added, p. 1012, § 37, effective July 1. L. 92: Entire section amended, p. 1391, § 39, effective July 1.
27-10.5-304. Admissions.
- There may be admitted to any regional center persons with developmental disabilities who have been ordered placed in a regional center pursuant to section 27-10.5-110, if the applicant or legal guardian is a bona fide resident of Colorado.
- (Deleted by amendment, L. 92, p. 1391 , § 40, effective July 1, 1992.)
Source: L. 85: Entire part added, p. 1012, § 37, effective July 1. L. 92: Entire section amended, p. 1391, § 40, effective July 1.
Cross references: For the interstate compact on mental health, see part 10 of article 60 of title 24.
ANNOTATION
Not all who are committed can be admitted, nor is it desirable that they should be under all circumstances. If it were so, the purpose of the institution might be defeated by over-crowding, resulting in part from the admission of those who are not fit subjects, and thus making training less effective, if not impossible. People ex rel. Dunbar v. County Court, 128 Colo. 374 , 262 P.2d 550 (1953) (decided under former § 27-14-106).
27-10.5-305. Endowment fund.
There is hereby authorized the regional center endowment fund. Any parent, person, corporation, or institution may contribute to said endowment fund. The bylaws to be provided by the department of human services shall prescribe the different endowments; but the investments from said endowment fund shall be in state, county, or city bonds or in first mortgages on improved realty for not more than forty percent of the actual value of such realty.
Source: L. 85: Entire part added, p. 1012, § 37, effective July 1. L. 92: Entire section amended, p. 1391, § 41, effective July 1. L. 94: Entire section amended, p. 2712, § 288, effective July 1.
Cross references: For the legislative declaration contained in the 1994 act amending this section, see section 1 of chapter 345, Session Laws of Colorado 1994.
27-10.5-306. Gifts - receipt and disposition.
Each regional center is hereby authorized to receive gifts, legacies, devises, and conveyances of property, real or personal, that may be made, given, or granted to or for such regional center. If the gifts are not prescribed, the director, with approval of the executive director, shall exercise such authority and make such disposition of the gift property as may be for the best interest of said regional center.
Source: L. 85: Entire part added, p. 1012, § 37, effective July 1. L. 92: Entire section amended, p. 1391, § 42, effective July 1.
27-10.5-307. Expenditures.
No moneys shall be paid by the state treasurer out of any other appropriation for, or moneys belonging to, a regional center, except upon warrants of the controller upon vouchers in favor of the persons to whom the state is indebted on account of said regional center and certified by the director of said regional center.
Source: L. 85: Entire part added, p. 1013, § 37, effective July 1. L. 92: Entire section amended, p. 1392, § 43, effective July 1.
27-10.5-308. Buildings - Pueblo. (Repealed)
Source: L. 85: Entire part added, p. 1013, § 37, effective July 1. L. 91: Entire section amended, p. 1146, § 17, effective May 18. L. 92: Entire section repealed, p. 1392, § 44, effective July 1.
27-10.5-309. Lease of property at regional center - regional center enterprise fund - creation. (Repealed)
Source: L. 85: Entire part added, p. 1013, § 37, effective July 1. L. 92: Entire section amended, p. 1392, § 45, effective July 1. L. 2008: Entire section repealed, p. 1345, § 3, effective May 27.
27-10.5-310. Regional centers task force - creation - members - recommendations - utilization study - reporting - repeal. (Repealed)
Source: L. 2014: Entire section added, (HB 14-1338), ch. 298, p. 1247, § 1, effective May 31.
Editor's note: Subsection (12) provided for the repeal of this section, effective December 31, 2015. (See L. 2014, p. 1247 .)
27-10.5-311. Regional centers - waiver beds - prohibition on closure or sale - repeal. (Repealed)
Source: L. 2015: Entire section added, (SB 15-243), ch. 131, p. 405, § 1, effective August 5. L. 2016: Entire section amended, (SB 16-178), ch. 274, p. 1135, § 2, effective June 10.
Editor's note: Subsection (2) provided for the repeal of this section, effective July 1, 2017. (See L. 2016, p. 1135 .)
27-10.5-312. Grand Junction regional center campus - vacating and sale or transfer - legislative declaration - definition - repeal. (Repealed)
Source: L. 2016: Entire section added, (SB 16-178), ch. 274, p. 1133, § 1, effective June 10. L. 2018: (3)(b) amended, (HB 18-1049), ch. 134, p. 887, § 1, effective April 12. L. 2019: (3)(a) and (3)(b)(I) amended, (HB 19-1062), ch. 20, p. 74, § 1, effective August 2.
Editor's note: Subsection (5) provided for the repeal of this secion, effective June 30, 2021. (See L. 2016, p. 1133 .)
27-10.5-313. Regional center - employees - adult protective services data system check.
On and after January 1, 2019, prior to employment, a regional center shall submit the name of a person who will be providing direct care, as defined in section 26-3.1-101 (3.5), to an at-risk adult, as defined in section 26-3.1-101 (1.5), as well as any other required identifying information, to the department of human services for a check of the Colorado adult protective services data system pursuant to section 26-3.1-111, to determine if the person is substantiated in a case of mistreatment of an at-risk adult.
Source: L. 2017: Entire section added, (HB 17-1284), ch. 272, p. 1505, § 14, effective May 31.
PART 4 FAMILY SUPPORT SERVICES
27-10.5-401 to 27-10.5-408. (Repealed)
Editor's note:
- This part 4 was added in 1991. For amendments to this part 4 prior to its repeal in 2014, consult the 2013 Colorado Revised Statutes and the Colorado statutory research explanatory note beginning on page vii in the front of this volume. This part 4 was relocated to part 3 of article 10 of title 25.5, effective March 1, 2014. Former C.R.S. section numbers are shown in editor's notes following those sections that were relocated. For a detailed comparison of this part 4, see the comparative tables located in the back of the index.
- Section 27-10.5-408 provided for the repeal of this part 4, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
PART 5 COLORADO FAMILY SUPPORT LOAN FUND
27-10.5-501 to 27-10.5-504. (Repealed)
Editor's note:
- This part 5 was added in 1991. For amendments to this part 5 prior to its repeal in 2014, consult the 2013 Colorado Revised Statutes and the Colorado statutory research explanatory note beginning on page vii in the front of this volume. This part 5 was relocated to part 4 of article 10 of title 25.5, effective March 1, 2014. Former C.R.S. section numbers are shown in editor's notes following those sections that were relocated. For a detailed comparison of this part 5, see the comparative tables located in the back of the index.
- Section 27-10.5-504 provided for the repeal of this part 5, effective March 1, 2014. (See L. 2013, pp. 1799, 1813.)
PART 6 STUDY OF SELF-SUFFICIENCY TRUSTS
27-10.5-601. (Repealed)
Source: L. 96: Entire part repealed, p. 563, § 24, effective April 24.
Editor's note: This part 6 was added in 1991. For amendments to this part 6 prior to its repeal in 1996, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
PART 7 COORDINATED SYSTEM OF PAYMENT FOR EARLY INTERVENTION SERVICES FOR INFANTS AND TODDLERS
Editor's note: This part 7 was added in 2007 and was not amended prior to 2008. The substantive provisions of this part 7 were repealed and reenacted in 2008, resulting in the addition, relocation, and elimination of sections as well as subject matter. For the text of this part 7 prior to 2008, consult the 2007 Colorado Revised Statutes. Former C.R.S. section numbers are shown in editor's notes following those sections that were relocated.
27-10.5-701. Legislative declaration.
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The general assembly hereby finds that:
- There is an urgent and substantial need to enhance the development of infants and toddlers with disabilities, to minimize their potential for developmental delay, and to recognize the significant brain development that occurs during a child's first three years of life;
- The longer a child's developmental delays are not addressed, the more developmental difficulties the child will experience in the future, the less prepared the child will be for school, the more special education needs the child is likely to have, and the more costly those problems will be to address;
- The capacity of families to meet the special needs of their infants and toddlers with disabilities needs to be supported and enhanced;
- Colorado's system for providing early intervention services to eligible infants and toddlers from birth through two years of age with significant developmental delays and disabilities relies on multiple sources of funding;
- The early childhood and school readiness commission, which was the successor of the child care commission, was created in the 2004 legislative session to study, review, and evaluate the development of plans for creating a comprehensive early childhood system;
- The early childhood and school readiness commission extensively studied and evaluated issues regarding early intervention services for infants and toddlers who have delays in development and learned that there is no coordinated system of payment for early intervention services, resulting in the provision of disjunctive or interrupted services to eligible children and inadequate reimbursement of early intervention service providers;
- The early childhood and school readiness commission was also informed that many eligible children are covered as dependents by their parents' health-care plans, but some of the plans may deny benefits for early intervention services, thereby eliminating a source of private funds for the payment of early intervention services;
- Pursuant to part C of the federal "Individuals with Disabilities Education Act", 20 U.S.C. sec. 1400 et seq., there is an urgent and substantial need to facilitate the coordination of payment for early intervention services from federal, state, local, and private sources, including public medical assistance and private insurance coverage;
- Existing levels of local, state, federal, and private funding may be more efficiently used, more children may be served, and a higher quality of services may be provided if the existing early intervention system is modified to create a more coherent and coordinated system of payment for early intervention services;
- The involvement of a child's primary health-care provider and other health- care providers is an essential component of effective planning for the provision of early intervention services; and
- The provision of early intervention services is intended only to meet the developmental needs of an infant or toddler and not to replace other needed medical services that are recommended by the child's primary health-care provider.
Source: L. 2008: Entire part R&RE, p. 1456, § 11, effective August 5. L. 2009: (1)(j) and (1)(k) added, (HB 09-1237), ch. 216, p. 979, § 2, effective May 2.
Editor's note: This section is similar to former § 27-10.5-701 as it existed prior to 2008.
27-10.5-702. Definitions.
As used in this part 7, unless the context otherwise requires:
- "Administrative unit" means a school district, a board of cooperative services, or the state charter school institute that is providing educational services to exceptional children and that is responsible for the local administration of the education of exceptional children pursuant to article 20 of title 22, C.R.S.
- "Carrier" has the same meaning as set forth in section 10-16-102 (8), C.R.S.
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[ Editor's note: This version of subsection (3) is effective until July 1, 2024.] "Certified early intervention service broker" or "broker" means a community-centered board or other entity designated by the department of health care policy and financing
pursuant to section 25.5-10-209, C.R.S., to perform the duties and functions specified in section 27-10.5-708 in a particular designated service area. Notwithstanding the provisions of section 27-10.5-104 (4), if the department
of health care policy and financing is unable to designate a community-centered board or other entity to serve as the broker for a particular designated service area, the department shall serve as the broker for the designated
service area and may contract directly with early intervention service providers to provide early intervention services to eligible children in the designated service area.
(3) [ Editor's note: This version of subsection (3) is effective July 1, 2024. ] "Certified early intervention service broker" or "broker" means a case management agency or an entity, as those terms are defined in section 25.5-6-1702, that has entered into a contract with the department to perform the duties and functions specified in section 27-10.5-708 in a particular defined service area. Notwithstanding the provisions of section 27-10.5-104 (4), if there is not a case management agency or an entity and the department is unable to designate an organization to serve as the broker for a particular defined service area, the department shall serve as the broker for the defined service area and may contract directly with early intervention service providers to provide early intervention services to eligible children in the defined service area.
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"Child find" means the program component of IDEA that requires states to find, identify, locate, evaluate, and serve all children with disabilities, from birth to twenty-one years of age. Child find includes:
- Part C child find, which is the program component of IDEA that requires states to find, identify, locate, evaluate, and serve children from birth through two years of age; and
- Part B child find, which is the program component of IDEA that requires states to find, identify, locate, evaluate, and serve children from three to twenty-one years of age.
- "Coordinated system of payment" means the policies and procedures developed by the department, in cooperation with the departments of education, health care policy and financing, and public health and environment, the division of insurance in the department of regulatory agencies, private health insurance carriers, and certified early intervention service brokers, to ensure that available public and private sources of funds to pay for early intervention services for eligible children are accessed and utilized in an efficient manner.
-
"Department" means the department of human services.
(6.5) "Early intervention evaluations" means evaluations conducted pursuant to the early intervention program for infants and toddlers under part C of the federal "Individuals with Disabilities Education Act", 20 U.S.C. sec. 1400 et seq.
- "Early intervention services" means services as defined by the department in accordance with part C that are authorized through an eligible child's IFSP and are provided to families at no cost or through the application of a sliding fee schedule. Early intervention services, as specified in an eligible child's IFSP, shall qualify as meeting the standard for medically necessary services as used by private health insurance and as used by public medical assistance, to the extent allowed pursuant to section 25.5-1-124, C.R.S.
- "Early intervention state plan" means the state plan for a comprehensive and coordinated system of early intervention services required pursuant to part C.
- "Eligible child" means an infant or toddler, from birth through two years of age, who, as defined by the department in accordance with part C, has significant delays in development or has a diagnosed physical or mental condition that has a high probability of resulting in significant delays in development or who is eligible for services pursuant to section 27-10.5-102 (11)(c).
-
"Evaluation" means:
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For the purposes of part C child find, the procedures used to determine a child's initial and continuing eligibility for part C child find, including but not limited to:
- Determining the status of the child in each of the developmental areas;
- Identifying the child's unique strengths and needs;
- Identifying any early intervention services that might serve the child's needs; and
- Identifying priorities and concerns of the family and any resources to which the family has access.
- For the purposes of part B child find, the procedures used under IDEA for children with disabilities to determine whether a child has a disability and the nature and extent of special education and related services that the child will need.
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For the purposes of part C child find, the procedures used to determine a child's initial and continuing eligibility for part C child find, including but not limited to:
- "Individualized family service plan" or "IFSP" means a written plan developed pursuant to 20 U.S.C. sec. 1436 and 34 CFR 303.340 that authorizes the provision of early intervention services to an eligible child and the child's family. An IFSP shall serve as the individualized plan, pursuant to section 27-10.5-102 (20)(c), for a child from birth through two years of age.
- "Multidisciplinary team" means the involvement of two or more disciplines or professions in the provision of integrated and coordinated services, including evaluation and assessment activities defined in 34 CFR 303.322 and development of the child's IFSP.
- "Part B" means the program component of IDEA that requires states to find, identify, locate, evaluate, and serve children with disabilities from three to twenty-one years of age.
- "Part C" means the early intervention program for infants and toddlers who are eligible for services under part C of the federal "Individuals with Disabilities Education Act", 20 U.S.C. sec. 1400 et seq.
- "Private health insurance" means a health coverage plan, as defined in section 10-16-102 (34), C.R.S., that is purchased by individuals or groups to provide, deliver, arrange for, pay for, or reimburse any of the costs of health-care services, as defined in section 10-16-102 (33), C.R.S., provided to a person entitled to receive benefits or services under the health coverage plan.
- "Public medical assistance" means medical services that are provided by the state through the "Colorado Medical Assistance Act", articles 4 to 6 of title 25.5, C.R.S., or the "Children's Basic Health Plan Act", article 8 of title 25.5, C.R.S., or other public medical assistance funding sources to qualifying individuals.
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[ Editor's note: This version of subsection (17) is effective until July 1, 2022.] "Qualified early intervention service provider" or "qualified provider" means a person or agency, as defined by the department by rule in accordance with part C, who provides
early intervention services and is listed on the registry of early intervention service providers pursuant to section 27-10.5-708 (1)(a).
(17) [ Editor's note: This version of subsection (17) is effective July 1, 2022. ] "Qualified early intervention service provider" or "qualified provider" means a person or agency, as defined by the department by rule in accordance with part C, who provides early intervention services or early intervention evaluations and is listed on the registry of early intervention service providers pursuant to section 27-10.5-708 (1)(a). In the event of a shortage of qualified early intervention evaluators, the department may contract with an administrative unit to conduct early intervention evaluations if a contract is entered between the department and the administrative unit, including written consent of the director of special education, with conditions for conducting and completing the evaluations, including identification of staff, costs for services, timelines for contract completion, and any other contract elements.
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[ Editor's note: This version of subsection (18) is effective until July 1, 2022.] "Service coordination" means the activities carried out by a service coordinator to assist and enable an eligible child and the eligible child's family to receive the rights,
procedural safeguards, and services that are authorized to be provided under the early intervention program.
(18) [ Editor's note: This version of subsection (18) is effective July 1, 2022. ] "Service coordination" means the activities carried out by a service coordinator to coordinate evaluation and intake activities, assist, and enable an eligible child and the eligible child's family to receive the rights, procedural safeguards, and services that are authorized to be provided under the early intervention program.
- "State interagency coordinating council" means the council that is established pursuant to part C and appointed by the governor to advise and assist the lead agency designated or established under part C.
Source: L. 2008: Entire part R&RE, p. 1457, § 11, effective August 5. L. 2013: (2) and (15) amended, (HB 13-1266), ch. 217, p. 993, § 67, effective May 13; (3) amended, (HB 13-1314), ch. 323, p. 1812, § 51, effective March 1, 2014. L. 2014: (3) amended, (HB 14-1363), ch. 302, p. 1270, § 35, effective May 31. L. 2018: (6.5) added, (HB 18-1333), ch. 176, p. 1210, § 1, effective April 30. L. 2021: (17) and (18) amended, (SB 21-275), ch. 393, p. 2614, § 7, effective July 1, 2022; (3) amended, (HB 21-1187), ch. 83, p. 350, § 62, effective July 1, 2024.
Editor's note: This section is similar to former § 27-10.5-702 as it existed prior to 2008.
27-10.5-703. Early intervention services - administration - duties of department - rules.
- Subject to annual appropriation from the general assembly, the department shall administer early intervention services and shall coordinate early intervention services with existing services provided to eligible infants and toddlers from birth through two years of age and their families.
- The department shall promulgate rules, pursuant to section 27-10.5-103, as necessary for the implementation of this section and to ensure that all IDEA timelines and requirements are met, including but not limited to administrative remedies if the timelines and requirements are not met.
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[ Editor's note: This version of introductory portion to subsection (3) is effective until July 1, 2022.] In administering early intervention services, the department shall have and perform the following duties:
(3) [ Editor's note: This version of introductory portion to subsection (3) is effective July 1, 2022. ] In administering early intervention services, the department shall perform the following duties:
- To design early intervention services in a manner consistent with part C;
- To develop and promulgate rules after consultation with the state interagency coordinating council;
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[ Editor's note: This version of subsection (3)(c) is effective until July 1, 2022.] To ensure eligibility determination for a child with disabilities from birth through two years of age, based in part on information received concerning the screening
and evaluation performed by an entity that conducts early intervention evaluations;
(c) [ Editor's note: This version of subsection (3)(c) is effective July 1, 2022. ] To ensure eligibility determination for a child with disabilities from birth through two years of age, based in part on information received concerning the screening and evaluation;
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[ Editor's note: This version of subsection (3)(d) is effective until July 1, 2022.] To ensure that an individualized family service plan is developed for infants and toddlers from birth through two years of age who are eligible for early intervention
services. The IFSP shall be developed in compliance with part C requirements and in coordination with part C child find evaluations or early intervention evaluations where applicable, including the mandatory IFSP meeting
at which the family receives information concerning the results of the evaluation. The initial IFSP shall be developed in collaboration with a representative from the entity that participated in the child's evaluation.
The representative shall participate in the initial meeting for the development of the child's IFSP.
(d) [ Editor's note: This version of subsection (3)(d) is effective July 1, 2022. ] To ensure that an individualized family service plan is developed for infants and toddlers from birth through two years of age who are eligible for early intervention services. The IFSP must be developed in compliance with part C requirements, including the mandatory IFSP meeting at which the family receives information concerning the results of the initial early intervention evaluation. The initial IFSP must be developed in collaboration with a representative from an evaluation provider that participated in the child's evaluation. The representative shall participate in the initial meeting for the development of the child's IFSP.
- To allocate moneys;
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[ Editor's note: This version of subsection (3)(f) is effective until July 1, 2024.] To coordinate training and provide technical assistance to community centered boards, service providers, and other constituents who are involved in the delivery of early
intervention services to infants and toddlers from birth through two years of age;
(f) [ Editor's note: This version of subsection (3)(f) is effective July 1, 2024. ] To coordinate training and provide technical assistance to certified early intervention service brokers, service providers, and other constituents who are involved in the delivery of early intervention services to infants and toddlers from birth through two years of age;
-
[ Editor's note: This version of subsection (3)(g) is effective until July 1, 2024.] To monitor and evaluate early intervention services provided through this part 7; and
(g) [ Editor's note: This version of subsection (3)(g) is effective July 1, 2024. ] To monitor and evaluate early intervention services provided through this part 7;
-
[ Editor's note: This version of subsection (3)(h) is effective until July 1, 2024.] To coordinate contracts, expenditures, and billing for early intervention services provided through this part 7.
(h) [ Editor's note: This version of subsection (3)(h) is effective July 1, 2024. ] To coordinate contracts, expenditures, and billing for early intervention services provided through this part 7; and
- [ Editor's note: Subsection (3)(i) is effective July 1, 2024.] To certify early intervention service brokers within a defined service area.
Source: L. 2008: Entire part R&RE, p. 1460, § 11, effective August 5. L. 2009: (2) amended, (SB 09-044), ch. 57, p. 210, § 15, effective March 25. L. 2018: (3)(c) and (3)(d) amended, (HB 18-1333), ch. 176, p. 1212, § 3, effective April 30. L. 2021: IP(3), (3)(c), and (3)(d) amended, (SB 21-275), ch. 393, p. 2614, § 8, effective July 1, 2022; (3)(f), (3)(g), and (3)(h) amended and (3)(i) added, (HB 21-1187), ch. 83, p. 351, § 63, effective July 1, 2024.
27-10.5-703.5. Child find from birth through two years of age - responsibilities - rules - interagency operating agreements - funding - report - repeal.
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- On or before October 1, 2018, the department shall enter into an interagency agreement, referred to in this section as the "agreement", with the department of education to study the administration of early intervention evaluations.
-
The agreement must include a process for studying the following, in relation to conducting early intervention evaluations:
- Establishing clear lines of responsibility and accountability using contracts and interagency agreements;
- Necessary reporting requirements and report-sharing requirements, including deadlines for report-sharing;
- A description of how funding should be allocated between the parties to the agreement;
- Monitoring of program compliance and agreement compliance;
- Evaluation timeline requirements;
- Evaluation tools;
- The location of evaluations, including a pilot program for in-home evaluations;
- A pilot program for integrated services that allows for wraparound services;
- Practices to ensure minimal disruption to families;
- Data collection from local education agencies and entities that conduct early intervention evaluations regarding actual costs associated with part C evaluations and early intervention evaluations; and
- Transition for part C services in the department to part B services in the department of education, including timelines for this transition.
- The executive director, in consultation with the commissioner of education, shall hire an independent third party to facilitate and assist the departments entering into the agreement.
-
- Except as provided in subsection (1)(d)(II) of this section, on or before November 1, 2018, the department and the department of education shall report to the joint budget committee on the agreement.
- In the event that the department and the department of education do not enter into the agreement by October 1, 2018, the department and the department of education shall each submit alternative interagency agreements to the joint budget committee by November 1, 2018, from which the joint budget committee shall select an interagency agreement before the beginning of the succeeding calendar year.
- On or before June 30, 2019, the department and the department of education shall report to the joint budget committee concerning the agreement, including recommendations for the administration of early intervention evaluations.
- This section is repealed, effective July 1, 2022.
Source: L. 2018: Entire section added, (HB 18-1333), ch. 176, p. 1210, § 2, effective April 30. L. 2021: (3) added by revision, (SB 21-275), ch. 393, p. 2618, §§ 13, 15.
27-10.5-704. Child find - responsibilities - interagency operating agreements - rules.
[ Editor's note: This version of this section is effective until July 1, 2022.]
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The department shall have the following responsibilities and duties for children from birth through two years of age who are referred for early intervention services:
- To develop and implement, in coordination with community centered boards, service agencies, governmental units, and the departments of education, public health and environment, and health care policy and financing, a statewide plan for public education, outreach, and awareness efforts related to child find and the availability of early intervention services;
- To ensure that referrals from the community are accepted and families are assisted in connecting with the appropriate agency for intake and case management services;
- To ensure that intake and case management services are provided after a referral has been made by working with community centered boards as the single entry point for a family into the developmental disabilities system, as described in section 27-10.5-102 (3); and
- To work with community centered boards, administrative units, and the department of education to assist a child with disabilities as he or she transitions from the developmental disabilities system into the public education system at no later than three years of age as required by IDEA.
- To facilitate the implementation of early intervention evaluations that are the responsibility of the department pursuant to this part 7 and to implement an effective and collaborative system of early intervention services, the department shall enter into any necessary interagency operating agreements at the state level and the local level.
- To facilitate the implementation of part C child find and early intervention evaluations, and the use of medicaid funds, the department and entities that conduct early intervention evaluations may, when appropriate, share information with the department of education, the department of health care policy and financing, or other entities that conduct early intervention evaluations or that offer child find services pursuant to section 22-20-118, so long as each department or local agency acts in compliance with the federal "Health Insurance Portability and Accountability Act of 1996", 42 U.S.C. sec. 1320d.
- As of July 1, 2022, the department of human services shall administer part C child find pursuant to this part 7; except that, on and after May 1, 2022, the department of human services shall administer the referral intake process for part C child find evaluations.
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On or before July 1, 2022, the department shall establish a state-level interagency operating agreement, referred to in this section as the "agreement", with the department of human services concerning the coordination of transitions of children from
part C child find to part B child find. In developing the agreement, the department and the department of human services shall involve stakeholder participation, including representatives from administrative units and part C entities.
The agreement must also include:
- The definition of a child who is potentially eligible for part B;
- The processes for a parent of a child to opt out of required notifications;
- The required notification concerning a child who is potentially eligible for part B;
- A process for resolving disputes between an administrative unit and a part C entity concerning the satisfaction of agreement requirements, including remedies and sanctions;
- A process for resolving disputes between the department and the department of human services concerning systemic and statewide issues related to agreement requirements;
- The development and delivery of standardized communication materials for a parent of a child who is potentially eligible for part B, including information concerning eligibility, referral, evaluation, and service delivery;
- The development and delivery of standardized training for part C and part B providers, including information concerning eligibility, referral, evaluation, and service delivery for the programs;
- The process for transferring a child's assessment, IFSP, and other necessary information to an administrative unit for consideration of a part B evaluation and eligibility determination, if a parent has provided written consent;
-
- Processes to ensure timely notification to the administrative unit if a child is potentially eligible for part B. At a minimum, timely notification must occur not later than when a child is two years and six months of age; except that timely notification must occur not later than when a child is two years and three months of age if a child has a low incidence diagnosis including, but not limited to, visual impairment, including blindness; hearing impairment, including deafness; or deaf-blind.
- If a child is determined to be eligible for part C when the child is older than the ages described in subsection (5)(i)(I) of this section, timely notification must occur not later than ten business days after the eligibility determination.
- A process for including an administrative unit representative in a transition conference for a child who transitions from part C to part B;
- A process for including an early intervention services provider in the development of an IEP, if requested by the parent of the child; and
- A process for timely transferring data that is required by law between the department and the department of human services.
- The department and the department of human services shall review and revise the agreement to account for any changes to state or federal law, as necessary. At a minimum, the agreement must be reviewed once every five years. In the review and revision of the agreement, the department and the department of human services shall involve stakeholder participation, including representatives from administrative units and part C entities.
27-10.5-704. Child find - responsibilities - interagency operating agreements - rules.
[ Editor's note: This version of this section is effective July 1, 2022.]
-
The department has the following responsibilities and duties for children from birth through two years of age who are referred for early intervention services:
- To develop and implement, in coordination with certified early intervention service brokers, service agencies, governmental units, and the departments of education, public health and environment, and health care policy and financing, a statewide plan for public education, outreach, and awareness efforts related to child find and the availability of early intervention services;
- To ensure that referrals from the community are accepted and families are assisted in connecting with the appropriate agency for intake and case management services;
- To facilitate the implementation of early intervention evaluations that are the responsibility of the department pursuant to this part 7 and to implement an effective and collaborative system of early intervention services, the department shall enter into any necessary interagency operating agreements at the state level and the local level; and
- To facilitate the implementation of part C child find and early intervention evaluations, and the use of medicaid funds, the department and entities that conduct early intervention evaluations may, when appropriate, share information with the department of education, the department of health care policy and financing, or other entities that conduct early intervention evaluations, so long as each department or local agency acts in compliance with the federal "Health Insurance Portability and Accountability Act of 1996", 42 U.S.C. sec. 1320d, as amended, and the federal "Family Educational Rights and Privacy Act of 1974", 20 U.S.C. sec. 1232g, as amended, and all federal regulations and applicable guidelines adopted thereto.
- As of July 1, 2022, the department of human services shall administer part C child find pursuant to this part 7; except that, on and after May 1, 2022, the department of human services shall administer the referral intake process for part C child find evaluations.
-
On or before July 1, 2022, the department shall establish a state-level interagency operating agreement, referred to in this section as the "agreement", with the department of human services concerning the coordination of transitions of children from
part C child find to part B child find. In developing the agreement, the department and the department of human services shall involve stakeholder participation, including representatives from administrative units and part C entities.
The agreement must also include:
- The definition of a child who is potentially eligible for part B;
- The processes for a parent of a child to opt out of required notifications;
- The required notification concerning a child who is potentially eligible for part B;
- A process for resolving disputes between an administrative unit and a part C entity concerning the satisfaction of agreement requirements, including remedies and sanctions;
- A process for resolving disputes between the department and the department of human services concerning systemic and statewide issues related to agreement requirements;
- The development and delivery of standardized communication materials for a parent of a child who is potentially eligible for part B, including information concerning eligibility, referral, evaluation, and service delivery;
- The development and delivery of standardized training for part C and part B providers, including information concerning eligibility, referral, evaluation, and service delivery for the programs;
- The process for transferring a child's assessment, IFSP, and other necessary information to an administrative unit for consideration of a part B evaluation and eligibility determination, if a parent has provided written consent;
-
- Processes to ensure timely notification to the administrative unit if a child is potentially eligible for part B. At a minimum, timely notification must occur not later than when a child is two years and six months of age; except that timely notification must occur not later than when a child is two years and three months of age if a child has a low incidence diagnosis including, but not limited to, visual impairment, including blindness; hearing impairment, including deafness; or deaf-blind.
- If a child is determined to be eligible for part C when the child is older than the ages described in subsection (3)(i)(I) of this section, timely notification must occur not later than ten business days after the eligibility determination.
- A process for including an administrative unit representative in a transition conference for a child who transitions from part C to part B;
- A process for including an early intervention services provider in the development of an IEP, if requested by the parent of the child; and
- A process for timely transferring data that is required by law between the department and the department of human services.
- The department and the department of human services shall review and revise the agreement to account for any changes to state or federal law, as necessary. At a minimum, the agreement must be reviewed once every five years. In the review and revision of the agreement, the department and the department of human services shall involve stakeholder participation, including representatives from administrative units and part C entities.
Source: L. 2008: Entire part R&RE, p. 1461, § 11, effective August 5. L. 2018: (2) and (3) amended, (HB 18-1333), ch. 176, p. 1212, § 4, effective April 30. L. 2021: (4), (5), and (6) added, (SB 21-275), ch. 393, p. 2616, § 10, effective June 30; entire section amended, (SB 21-275), ch. 393, p. 2615, § 9, effective July 1, 2022; (1)(a), (1)(c), and (1)(d) amended, (HB 21-1187), ch. 83, p. 351, § 64, effective July 1, 2024.
Editor's note:
- Subsections (4), (5), and (6) as added by section 10 of SB 21-275 (see L. 2021, p. 2616 ) will be harmonized with the amendment of this section as it appears in section 9 of SB 21-275 and relocated as subsections (2), (3), and (4), effective July 1, 2022.
- Subsections (1)(c) and (1)(d) were amended in HB 21-1187, effective July 1, 2024. However, those amendments were superseded by the amendment of this section in SB 21-275, effective July 1, 2022.
27-10.5-705. Authorized services - conditions of funding - purchases of services - rules.
-
[ Editor's note: This version of subsection (1) is effective until July 1, 2024.] The department shall promulgate rules as are necessary, in accordance with this part 7 and consistent with section 27-10.5-104.5, to implement the purchase of early intervention
services directly or through community centered boards or certified early intervention service brokers.
(1) [ Editor's note: This version of subsection (1) is effective July 1, 2024. ] The department shall promulgate rules as necessary, in accordance with this part 7 and consistent with section 27-10.5-104.5, to implement the purchase of early intervention services directly or through certified early intervention service brokers.
-
[ Editor's note: This version of subsection (2) is effective until July 1, 2024.] Community centered boards, certified early intervention service brokers, and service agencies receiving moneys pursuant to section 27-10.5-708 shall comply with all of the
provisions of this article and the rules promulgated pursuant to this article.
(2) [ Editor's note: This version of subsection (2) is effective July 1, 2024. ] Certified early intervention service brokers and service agencies receiving money pursuant to section 27-10.5-708 shall comply with all of the provisions of this article 10.5 and the rules promulgated pursuant to this article 10.5.
-
[ Editor's note: This version of the introductory portion to subsection (3) is effective until July 1, 2024.] Community centered boards and certified early intervention service brokers shall obtain or provide early intervention services, subject to available
appropriations, including but not limited to:
(3) [ Editor's note: This version of the introductory portion to subsection (3) is effective July 1, 2024. ] Certified early intervention service brokers shall obtain or provide early intervention services, subject to available appropriations, including but not limited to:
- Service coordination with families of eligible infants and toddlers from birth through two years of age. The purpose of service and support coordination shall be to enable a family to utilize service systems to meet its needs in an effective manner and increase the family's confidence and competence. Service coordination is to be rendered in an interagency context that emphasizes interagency collaboration. A family shall have, to the extent possible, a choice as to who shall perform certain facets of service coordination as established in the family's individualized family service plan.
-
[ Editor's note: This version of the introductory portion to subsection (3)(b) is effective until July 1, 2024.] Coordination of early intervention services with local agencies and other community resources at the local level to avoid duplication and
fragmentation of early intervention services. A community centered board shall:
(b) [ Editor's note: This version of the introductory portion to subsection (3)(b) is effective July 1, 2024. ] Coordination of early intervention services with local agencies and other community resources at the local level to avoid duplication and fragmentation of early intervention services. A certified early intervention service broker shall:
-
[ Editor's note: This version of subsection (3)(b)(I) is effective until July 1, 2024.] Coordinate with the local interagency effort regarding outreach, identification, screening, multidisciplinary assessment, and eligibility determination for families
served by the community centered board who requested the services;
(I) [ Editor's note: This version of subsection (3)(b)(I) is effective July 1, 2024. ] Coordinate with the local interagency effort regarding outreach, identification, screening, multidisciplinary assessment, and eligibility determination for families served by the certified early intervention service broker who requested the services;
- Coordinate with the local family support services program; and
- Coordinate with other appropriate state agencies providing programs for infants and toddlers.
-
[ Editor's note: This version of subsection (3)(b)(I) is effective until July 1, 2024.] Coordinate with the local interagency effort regarding outreach, identification, screening, multidisciplinary assessment, and eligibility determination for families
served by the community centered board who requested the services;
- The department is authorized to use up to three percent of the amount of the appropriation for early intervention services for training and technical assistance to ensure that the latest developments for early intervention services are rapidly integrated into service provision throughout the state.
Source: L. 2008: Entire part R&RE, p. 1462, § 11, effective August 5. L. 2009: (1) amended, (SB 09-044), ch. 57, p. 210, § 16, effective March 25. L. 2021: (1), (2), IP(3), IP(3)(b), and (3)(b)(I) amended, (HB 21-1187), ch. 83, p. 352, § 65, effective July 1, 2024.
27-10.5-706. Coordinated system of payment for early intervention services - duties of departments.
-
In order to implement the provisions of this part 7, the department, as lead agency for part C, shall be responsible for the following, subject to available appropriations:
- Establishing an early intervention state plan for a statewide, comprehensive system of early intervention evaluations and early intervention services in accordance with part C child find;
- Establishing an interagency operating agreement between the department and the departments of education, health care policy and financing, and public health and environment regarding the responsibilities of each department to assist in the development and implementation of a statewide, comprehensive system of early intervention services and a coordinated system of payments for early intervention services;
- Developing, in cooperation with the department of education, the department of health care policy and financing, the department of public health and environment, the division of insurance in the department of regulatory agencies, private health insurance carriers, and certified early intervention service brokers, a coordinated system of payment of early intervention services using public and private moneys;
-
[ Editor's note: This version of subsection (1)(d) is effective until July 1, 2024.] Certifying community centered boards or other entities as determined by the department as early intervention service brokers for early intervention services provided
pursuant to this part 7; and
(d) [ Editor's note: This version of subsection (1)(d) is effective July 1, 2024. ] Certifying early intervention service brokers for early intervention services provided pursuant to this part 7; and
- Ensuring an appropriate allocation of payment responsibilities for early intervention services among federal, state, local, and private sources, including public medical assistance and private insurance coverage.
- Any additional source of moneys that may become available for the payment of early intervention services on or after July 1, 2008, as a result of the development and implementation of a statewide, comprehensive system of early intervention services and a coordinated system of payments for early intervention services shall not replace or reduce any other federal or state moneys available for the payment of early intervention services on or before July 1, 2008.
-
[ Editor's note: This version of subsection (3) is effective until July 1, 2024.] Nothing in this part 7 shall be construed to inhibit, encumber, or control the use of local moneys, including county grants, revenues from local mill levies, and private
grants and contributions, that a community centered board or county government may elect to allocate for the benefit of eligible children.
(3) [ Editor's note: This version of subsection (3) is effective July 1, 2024. ] Nothing in this part 7 inhibits, encumbers, or controls the use of local money, including county grants, revenues from local mill levies, and private grants and contributions, that a certified early intervention service broker or county government may elect to allocate for the benefit of eligible children.
- In developing a coordinated system of payment, the department shall not directly or indirectly create a new entitlement for early intervention services funded from the state general fund. However, this subsection (4) shall not prohibit any adjustments to public medical assistance required by section 25.5-1-124, C.R.S.
Source: L. 2008: Entire part R&RE, p. 1463, § 11, effective August 5. L. 2018: IP(1) and (1)(a) amended, (HB 18-1333), ch. 176, p. 1212, § 5, effective April 30. L. 2021: (1)(d) and (3) amended, (HB 21-1187), ch. 83, p. 352, § 66, effective July 1, 2024.
Editor's note: This section is similar to former § 27-10.5-703 as it existed prior to 2008.
27-10.5-707. Cooperation among state agencies - implementing coordinated payment system - revisions to rules - repeal.
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The departments of education, health care policy and financing, and public health and environment shall cooperate with the department to implement the provisions of this part 7 and each department shall:
-
- Assign a representative in accordance with part C child find to advise and assist the department in the development and implementation of the early intervention services system.
- This subsection (1)(a) is repealed, effective July 1, 2022.
- Participate in the ongoing review of funding practices for early intervention services anbd develop or revise procedures for a coordinated system of payment for early intervention services;
- Use uniform forms and procedures for billing the costs of early intervention services to public medical assistance, as specified in the "Colorado Medical Assistance Act", articles 4 to 6 of title 25.5, C.R.S., or the "Children's Basic Health Plan Act", article 8 of title 25.5, C.R.S., as appropriate, and private health insurance, as specified in part 1 of article 16 of title 10, C.R.S.;
- Coordinate revisions to existing rules that are necessary to implement this part 7; and
- Perform other tasks and functions necessary for the implementation of this part 7.
-
- The division of insurance in the department of regulatory agencies shall provide assistance to the department related to the requirements and implementation of section 10-16-104 (1.3), C.R.S., and insurance laws and rules related to billing and claims handling.
-
- Any appropriation for the 2021-22 budget year to the department of human services for part C responsibilities that is in addition to an appropriation pursuant to House Bill 18-1333, enacted in 2018, must be allocated to the department of education to reimburse administrative units for their proportionate share of unfunded costs of part C evaluations during the 2021-22 state fiscal year.
- This subsection (3) is repealed, effective July 1, 2023.
Source: L. 2008: Entire part R&RE, p. 1464, § 11, effective August 5. L. 2021: (3) added, (SB 21-275), ch. 393, p. 2617, § 12, effective June 30; (1)(a)(II) added by revision, (SB 21-275), ch. 393, pp. 2617, 2618, §§ 11, 15.
Editor's note: This section is similar to former § 27-10.5-704 as it existed prior to 2008.
27-10.5-708. Certified early intervention service brokers - duties - payment for early intervention services - fees.
-
[ Editor's note: This version of the introductory portion to subsection (1) is effective until July 1, 2024.] For each designated service area in the state, the certified early intervention service broker for the area shall:
(1) [ Editor's note: This version of the introductory portion to subsection (1) is effective July 1, 2024. ] For each defined service area in the state, the certified early intervention service broker for the area shall:
-
[ Editor's note: This version of subsection (1)(a) is effective until July 1, 2024.] Establish a registry of qualified early intervention service providers to provide early intervention services to eligible children in the designated service area. The
certified early intervention service broker for a designated service area may provide early intervention services directly or may subcontract the provision of services to other qualified providers on the registry.
(a) [ Editor's note: This version of subsection (1)(a) is effective July 1, 2024. ] Establish a registry of qualified early intervention service providers to provide early intervention services to eligible children in the defined service area. The certified early intervention service broker for a defined service area may provide early intervention services directly or may subcontract the provision of services to other qualified providers on the registry.
- Accept and process claims for reimbursement for early intervention services provided under this part 7 by qualified providers;
-
[ Editor's note: This version of subsection (1)(c) is effective until July 1, 2024.] Negotiate for the payment of early intervention services provided to eligible children in the designated service area by qualified providers, to the extent permissible
under federal law; and
(c) [ Editor's note: This version of subsection (1)(c) is effective July 1, 2024. ] Negotiate for the payment of early intervention services provided to eligible children in the defined service area by qualified providers, to the extent permissible under federal law; and
- Ensure payment to a qualified provider for early intervention services rendered by the qualified provider.
-
[ Editor's note: This version of subsection (1)(a) is effective until July 1, 2024.] Establish a registry of qualified early intervention service providers to provide early intervention services to eligible children in the designated service area. The
certified early intervention service broker for a designated service area may provide early intervention services directly or may subcontract the provision of services to other qualified providers on the registry.
- Certified early intervention service brokers shall use procedures and forms determined by the department to document the provision or purchase of early intervention services on behalf of eligible children. Invoices or insurance claims for early intervention services shall be submitted based on the available funding source for each eligible child and the reimbursement rate for the appropriate federal, state, local, or private funding sources, including public medical assistance and private health insurance.
- The department shall establish a schedule of fees to be charged by certified early intervention service brokers for providing broker services under this part 7. In developing the fee schedule, the department shall obtain input from certified early intervention service brokers and shall consider the duties of brokers under this part 7, the expenses incurred by brokers, and the relevant market conditions.
- Use of a certified early intervention broker is voluntary; except that private health insurance carriers that are included under section 10-16-104 (1.3), C.R.S., are required to make payment in trust under section 27-10.5-709. Nothing in this part 7 prohibits a qualified provider of early intervention services from directly billing the appropriate program of public medical assistance or a participating provider, as defined in section 10-16-102 (46), C.R.S., or from directly billing a private health insurance carrier for services rendered under this part 7 for insurance plans that are not included under section 10-16-104 (1.3), C.R.S.
- To the extent requested by the department, certified early intervention service brokers shall participate in ongoing reviews of funding practices for early intervention services and the development or revision of procedures for a coordinated system of payment for early intervention services.
Source: L. 2008: Entire part R&RE, p. 1465, § 11, effective August 5. L. 2009: (4) amended, (HB 09-1237), ch. 216, p. 979, § 3, effective May 2. L. 2013: (4) amended, (HB 13-1266), ch. 217, p. 994, § 68, effective May 13. L. 2021: IP(1), (1)(a), and (1)(c) amended, (HB 21-1187), ch. 83, p. 353, § 67, effective July 1, 2024.
Editor's note: This section is similar to former § 27-10.5-705 as it existed prior to 2008.
27-10.5-709. Payment from private health insurance for early intervention services - trust fund.
- Private health insurance carriers that are required to make payment of benefits for early intervention services for which coverage is required pursuant to section 10-16-104 (1.3), C.R.S., shall pay benefits to the department in trust for payment to a broker or provider for early intervention services provided to an eligible child. Upon notification from the department that a child is eligible, the child's private health insurance carrier shall have thirty days to make payment to the department.
-
- When a private health insurance carrier makes payments of benefits for an eligible child to the department in trust, those moneys shall be deposited in the early intervention services trust fund, which trust fund is hereby created in the state treasury. Except as provided in paragraph (b) of this subsection (2), the principal of the trust fund shall only be used to pay certified early intervention service brokers or qualified early intervention service providers for early intervention services provided to the eligible child for whom the moneys were paid to the department in trust by the private health insurance carrier. Except as provided in paragraph (b) of this subsection (2), the principal of the trust fund shall not constitute state fiscal year spending for purposes of section 20 of article X of the state constitution, and such moneys shall be deemed custodial funds that are not subject to appropriation by the general assembly.
-
- For the 2008-09 fiscal year and each fiscal year thereafter, the general assembly shall make appropriations to the department from the principal of the early intervention services trust fund for the direct and indirect costs of administering this section. Any moneys appropriated to the department pursuant to this paragraph (b) shall constitute state fiscal year spending for purposes of section 20 of article X of the state constitution.
- All interest derived from the deposit and investment of moneys in the early intervention services trust fund shall be credited to the trust fund, may be appropriated to the department in accordance with this paragraph (b), and shall constitute state fiscal year spending for purposes of section 20 of article X of the state constitution.
- Within ninety days after the department determines that a child is no longer an eligible child for purposes of section 10-16-104 (1.3), C.R.S., the department shall notify the carrier that the child is no longer eligible and that the carrier is no longer required to provide the coverage required by said section for that child. Any moneys deposited in the trust fund on behalf of an eligible child that are not expended on behalf of the child before the child becomes ineligible shall be returned to the carrier that made the payments in trust for the child.
- No later than March 1, 2009, and no later than April 1 each year thereafter, the department shall provide a report to each private health insurance carrier that has made payments of benefits for an eligible child to the department in trust. The report shall specify the total amount of benefits paid to brokers or qualified providers for services provided to the eligible child during the prior calendar year, including the amount paid to each broker or qualified provider and the services provided to the eligible child. The report required by this subsection (3) shall be provided at least annually and more often, as determined by the department and the carrier.
Source: L. 2008: Entire part R&RE, p. 1466, § 11, effective August 5. L. 2009: (1), (2)(a), (2)(c), and (3) amended, (HB 09-1237), ch. 216, p. 979, § 4, effective May 2.
Editor's note: This section is similar to former § 27-10.5-706 as it existed prior to 2008.
27-10.5-710. Annual report - cooperation from certified early intervention service brokers and qualified providers.
- Notwithstanding section 24-1-136 (11)(a)(I), by November 1, 2008, and by November 1 each year thereafter, the department shall submit an annual report to the general assembly regarding the various funding sources used for early intervention services, the number of eligible children served, the average cost of early intervention services, and any other information the department deems appropriate. The department shall submit the report to the joint budget committee as part of the department's annual budget request. The department shall also submit the report to the health and human services committees and the education committees of the senate and house of representatives, or any successor committees.
- The department shall request, and certified early intervention service brokers and qualified early intervention service providers shall provide, information regarding early intervention services that the department needs to prepare the annual report required by this section or other required federal or state reports.
Source: L. 2008: Entire part R&RE, p. 1467, § 11, effective August 5. L. 2017: (1) amended, (SB 17-234), ch. 154, p. 524, § 16, effective August 9.
Editor's note: This section is similar to former § 27-10.5-707 as it existed prior to 2008.
PART 8 OUTCOME-BASED SUPPORTED EMPLOYMENT SYSTEM FOR INTEGRATED EMPLOYMENT SERVICES FOR PERSONS WITH DISABILITIES, INCLUDING DEVELOPMENTAL DISABILITIES
27-10.5-801. Pilot program - creation - goals - implementation - reporting - repeal. (Repealed)
Source: L. 2008: Entire part added, p. 378, § 2, effective April 10. L. 2015: (4) added by revision, (SB 15-239), ch. 160, pp. 488, 490 §§ 7, 14.
Editor's note: Subsection (4) provided for the repeal of this section, effective July 1, 2016. (See L. 2015, pp. 488, 490.)
PART 9 STATE EMPLOYMENT OF PERSONS WITH DEVELOPMENTAL DISABILITIES
27-10.5-901. Legislative declaration.
-
The general assembly hereby finds that:
- Persons with developmental disabilities represent a population that has long been underutilized and often denied employment opportunities within state government, partially due to hiring personnel's perceptions and understanding of the operation and requirements of the state personnel system;
- Some state agencies are unaware of the avenues that are available within the state personnel system by which state agencies can hire and provide training and support for persons with developmental disabilities; and
- Many persons with developmental disabilities, when provided appropriate training and support, can develop sufficient skills and competencies to more than adequately fulfill job expectations in employment positions in state government.
- Therefore, it is the intent of the general assembly to create the state employment program for persons with developmental disabilities to encourage and provide incentives for state agencies to give meaningful employment opportunities to persons with developmental disabilities and to improve the state's practices in employing, supervising, and supporting persons with developmental disabilities.
Source: L. 2008: Entire part added, p. 2182, § 1, effective June 5.
27-10.5-902. State employment program for persons with developmental disabilities - creation - rules.
- There is hereby created within the department the state employment program for persons with developmental disabilities, referred to in this part 9 as the "program". The department shall design and implement the program to coordinate the hiring of interested persons with developmental disabilities into appropriate and meaningful state employment opportunities. The goal of the program is to identify for persons with developmental disabilities permanent and stable employment opportunities that are integrated within and appropriately meet the service goals of state agencies. The department of human services shall collaborate with the department of personnel in designing the program.
-
- On or before July 1, 2008, the executive directors of the department of human services and the department of personnel shall jointly convene a working group to study and recommend how the state's policies and practices in employing, supervising, and supporting persons with developmental disabilities can be improved in order to effectively and successfully implement the program. The executive directors shall include in the working group persons with expertise in implementing the statutes and rules pertaining to the state personnel system, persons with expertise in interpreting and implementing the federal "Americans with Disabilities Act of 1990", 42 U.S.C. sec. 12101 et seq., and persons with experience in employing and placing for employment persons with developmental disabilities.
-
The working group shall complete its work and make recommendations to the executive directors of the department of human services and the department of personnel by January 1, 2009. The recommendations of the working group may include, but need not be
limited to:
- Modifications to rules, statutes, or the state constitution to improve the success of persons with developmental disabilities who are employed through the program; and
- Identification or clarification of the roles and responsibilities of persons in the department of human services and the department of personnel in implementing the program efficiently and successfully.
-
- If the working group finds that implementation of the program may require statutory or constitutional changes, the department of human services and the department of personnel shall not implement the program until the general assembly has considered and rejected said changes or until after a bill enacting said statutory changes or a referred measure enacting said constitutional changes has become law.
-
After the conditions specified in paragraph (a) of this subsection (3) are met, or if the working group finds that neither statutory nor constitutional changes are necessary for implementation of the program, the state board of human services and the
state personnel board shall promulgate rules in accordance with the "State Administrative Procedure Act", article 4 of title 24, C.R.S., as follows:
- The state board of human services shall promulgate rules as necessary for implementation of the program within the department of human services; and
- The state personnel board shall promulgate rules pertaining to the state personnel system as necessary for implementation of the program.
- Following promulgation of rules pursuant to subsection (3) of this section and in accordance with said rules and the provisions of this section, the department of human services, in collaboration with the department of personnel, shall implement the program. A state agency that seeks to employ a person with developmental disabilities through the program shall be responsible for hiring and supervision of the person and payment of the person's salary and benefits. The department, through the program, shall provide guidance to the hiring state agency regarding any additional issues that are pertinent to the person's employment.
- Following adoption of the rules specified in subsection (3) of this section, the department shall regularly provide information to state agencies to explain and promote the program. Upon full implementation of the program, each state agency is strongly encouraged to participate in the program by identifying meaningful and appropriate employment positions for persons with developmental disabilities and working with the department to hire persons with developmental disabilities for these positions.
Source: L. 2008: Entire part added, p. 2183, § 1, effective June 5.
PART 10 GENERAL PROVISIONS
27-10.5-1001. (Repealed)
Source: L. 2009: Entire part repealed, (SB 09-206), ch. 7, p. 59, § 1, effective March 2.
Editor's note: This part 10 was added in 2008 and was not amended prior to its repeal in 2009. For the text of this part 10 prior to 2009, consult the 2008 Colorado Revised Statutes.
ARTICLE 11 COMMUNITY CENTERS - MENTALLY RETARDED AND HANDICAPPED
27-11-101 to 27-11-106. (Repealed)
Source: L. 85: Entire article repealed, p. 1016, § 46, effective July 1.
Editor's note: This article was numbered as article 8 of chapter 71 in C.R.S. 1963. For amendments to this article prior to its repeal in 1985, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
Cross references: For current provisions on community-centered boards that provide services for persons with intellectual and developmental disabilities, see part 1 of article 10.5 of this title 27.
ARTICLE 12 CHARGES FOR PATIENTS
27-12-101 to 27-12-109. (Repealed)
Source: L. 2010: Entire article repealed, (SB 10-175), ch. 188, p. 675, § 1, effective April 29.
Editor's note: This article was numbered as article 7 of chapter 71, C.R.S. 1963. For amendments to this article prior to its repeal in 2010, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume. The provisions of this article were relocated to article 92 of this title. For the location of specific provisions, see the editor's notes following each section in said article and the comparative tables located in the back of the index.
Institutions
ARTICLE 13 COLORADO MENTAL HEALTH INSTITUTE AT PUEBLO
27-13-101 to 27-13-113. (Repealed)
Source: L. 2010: Entire article repealed, (SB 10-175), ch. 188, p. 675, § 1, effective April 29.
Editor's note: This article was numbered as article 3 of chapter 71, C.R.S. 1963. For amendments to this article prior to its repeal in 2010, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume. The provisions of this article were relocated to article 93 of this title. For the location of specific provisions, see the editor's notes following each section in said article and the comparative tables located in the back of the index.
ARTICLE 14 HOMES FOR MENTAL DEFECTIVES
27-14-101 to 27-14-116. (Repealed)
Source: L. 85: Entire article repealed, p. 1016, § 46, effective July 1.
Editor's note: This article was numbered as article 4 of chapter 71 in C.R.S. 1963. For amendments to this article prior to its repeal in 1985, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
Cross references: For current provisions on regional centers, see part 3 of article 10.5 of this title 27.
ARTICLE 15 COLORADO MENTAL HEALTH INSTITUTE AT FORT LOGAN
27-15-101 to 27-15-105. (Repealed)
Source: L. 2010: Entire article repealed, (SB 10-175), ch. 188, p. 675, § 1, effective April 29.
Editor's note: This article was numbered as article 5 of chapter 71, C.R.S. 1963. For amendments to this article prior to its repeal in 2010, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume. The provisions of this article were relocated to article 94 of this title. For the location of specific provisions, see the editor's notes following each section of said article and the comparative tables located in the back of the index.
ARTICLE 16 WESTERN REGIONAL MENTAL HEALTH CENTER
27-16-101 to 27-16-105. (Repealed)
Source: L. 77: Entire article repealed, p. 293, § 7, effective May 26.
Editor's note: This article was numbered as article 9 of chapter 71 in C.R.S. 1963. For amendments to this article prior to its repeal in 1977, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
CORRECTIONS
ARTICLE 20 PENITENTIARY
27-20-101 to 27-20-203. (Repealed)
Source: L. 77: Entire article repealed, p. 955, § 37, effective August 1.
Editor's note:
- The provisions of part 1 concerning the state penitentiary and the provisions of part 2, enacted by L. 77, p. 1377 , § 1, concerning minimum security facilities, are under the department of corrections. (See articles 20 and 25 of title 17.)
- This article was numbered as article 4 of chapter 105 in C.R.S. 1963. For amendments to this article prior to its repeal in 1977, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
ARTICLE 21 WOMEN'S CORRECTIONAL INSTITUTION
27-21-101 and 27-21-102. (Repealed)
Source: L. 77: Entire article repealed, p. 955, § 37, effective August 1.
Editor's note: This article was numbered as articles 3 and 4 of chapter 105 in C.R.S. 1963. For amendments to this article prior to its repeal in 1977, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
ARTICLE 22 REFORMATORY
27-22-101 to 27-22-110. (Repealed)
Source: L. 77: Entire article repealed, p. 955, § 37, effective August 1.
Editor's note: This article was numbered as article 3 of chapter 105 in C.R.S. 1963. For amendments to this article prior to its repeal in 1977, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
ARTICLE 23 MENTALLY ILL OR RETARDED CONVICTS - TRANSFER
27-23-101 to 27-23-103. (Repealed)
Source: L. 77: Entire article repealed, p. 955, § 37, effective August 1.
Editor's note:
- The provisions concerning the transfer of inmates with mental health disorders or intellectual and developmental disabilities are under the department of corrections. (See article 23 of title 17.)
- This article was numbered as article 2 of chapter 71 in C.R.S. 1963. For amendments to this article prior to its repeal in 1977, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
ARTICLE 24 CONVICT LABOR AND GOODS
27-24-101 to 27-24-124. (Repealed)
Source: L. 77: Entire article repealed, p. 955, § 37, effective August 1.
Editor's note: This article was numbered as article 5 of chapter 105 in C.R.S. 1963. For amendments to this article prior to its repeal in 1977, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
ARTICLE 25 CORRECTIONAL INDUSTRIES
27-25-101 to 27-25-203. (Repealed)
Source: L. 77: Entire article repealed, p. 955, § 37, effective August 1.
Editor's note:
- The provisions concerning correctional industries are under the department of corrections. (See article 24 of title 17.)
- This article was numbered as article 8 of chapter 105 in C.R.S. 1963. For amendments to this article prior to its repeal in 1977, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
ARTICLE 26 JAILS
27-26-101 to 27-26-129. (Repealed)
Source: L. 77: Entire article repealed, p. 955, § 37, effective August 1.
Editor's note:
- The provisions concerning jails are under the department of corrections. (See article 26 of title 17.)
- This article was numbered as article 7 of chapter 105 in C.R.S. 1963. For amendments to this article prior to its repeal in 1977, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
ARTICLE 27 COMMUNITY CORRECTIONAL FACILITIES AND PROGRAMS
27-27-101 to 27-27-112. (Repealed)
Source: L. 77: Entire article repealed, p. 955, § 37, effective August 1.
Editor's note:
- The provisions concerning community correctional facilities and programs are under the department of corrections. (See article 27 of title 17.)
- This article was added in 1974. For amendments to this article prior to its repeal in 1977, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
ARTICLE 28 RESTITUTION TO VICTIMS OF CRIME
27-28-101 and 27-28-102. (Repealed)
Source: L. 77: Entire article repealed, p. 955, § 37, effective August 1.
Editor's note:
- The provisions concerning restitution to victims of crime are under the department of corrections. (See article 28 of title 17.)
- This article was added in 1976 and was not amended prior to its repeal in 1977. For the text of this article prior to 1977, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
OTHER INSTITUTIONS
ARTICLE 35 SCHOOL FOR THE DEAF AND THE BLIND
27-35-101 to 27-35-116. (Repealed)
Source: L. 77: Entire article repealed, p. 1095, § 5, effective July 1.
Editor's note:
- The provisions concerning the school for the deaf and the blind have been transferred to article 80 of title 22. (See L. 77, pp. 1090-1095.)
- This article was numbered as article 1 of chapter 16 in C.R.S. 1963. For amendments to this article prior to its repeal in 1977, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
COLORADO DIAGNOSTIC PROGRAM
ARTICLE 40 COLORADO DIAGNOSTIC PROGRAM
27-40-101 to 27-40-107. (Repealed)
Source: L. 77: Entire article repealed, p. 955, § 37, effective August 1.
Editor's note:
- The provisions concerning the Colorado diagnostic program, are under the department of corrections. (See article 40 of title 17.)
- This article was added in 1974. For amendments to this article prior to its repeal in 1977, consult the Colorado statutory research explanatory note and the table itemizing the replacement volumes and supplements to the original volume of C.R.S. 1973 beginning on page vii in the front of this volume.
BEHAVIORAL HEALTH
ARTICLE 60 GENERAL PROVISIONS
Section
PART 1 GENERAL PROVISIONS
27-60-100.3. Definitions.
As used in this article 60, unless the context otherwise requires:
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"Behavioral health" refers to an individual's mental and emotional well-being and actions that affect an individual's overall wellness. Behavioral health problems and disorders include substance use disorders, serious psychological distress, suicide,
and other mental health disorders. Problems ranging from unhealthy stress or subclinical conditions to diagnosable and treatable diseases are included in the term "behavioral health". The term "behavioral health" is also used to
describe service systems that encompass prevention and promotion of emotional health, prevention and treatment services for mental health and substance use disorders, and recovery support.
(1.5) "Criminal justice diversion program" means a program created pursuant to section 27-60-106.5 or programs operated by cities or counties that connect law enforcement officers with behavioral health providers to assist individuals in need of behavioral health interventions or to divert individuals from the criminal justice system.
- "Crisis intervention services" means the array of behavioral health crisis services that are funded by public or private sources and exist to serve individuals who are experiencing a behavioral health crisis.
- "Crisis response system" means the behavioral health crisis response system developed and implemented pursuant to this article 60.
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"Crisis response system contractor" means an entity that has been awarded a contract to provide one or more crisis intervention services pursuant to section 27-60-103.
(4.7) "Office" means the office of behavioral health in the department of human services.
- "State board" means the state board of human services created and authorized pursuant to section 26-1-107.
- "State department" means the state department of human services created pursuant to section 26-1-105.
Source: L. 2017: Entire section added, (SB 17-242), ch. 263, p. 1335, § 226, effective May 25. L. 2018: (4.7) added, (SB 18-250), ch. 403, p. 2376, § 1, effective June 6. L. 2020: (1.5) added, (HB 20-1017), ch. 288, p. 1426, § 11, effective September 14.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-60-101. Behavioral health crisis response system - legislative declaration.
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The general assembly finds and declares that:
- There are people in Colorado communities who are experiencing behavioral health crises and need professional behavioral health crisis care or urgent psychiatric care from skilled mental health clinicians and medical professionals who excel at providing compassionate behavioral health crisis intervention and stabilization;
- A behavioral health crisis can happen any hour of the day and any day of the week;
- Persons in a behavioral health crisis frequently come in contact with community first responders who are often unable to provide necessary behavioral health interventions or who must transport these persons in a behavioral health crisis to emergency rooms for services, or, in cases where a crime is alleged, to jail;
- Colorado ranks fiftieth in the nation in the number of inpatient psychiatric beds;
- Fewer than one-half of the persons who are in a behavioral health crisis and are taken to an emergency room are admitted for inpatient hospitalization, meaning that thousands of people each year return to community streets with little, if any, crisis intervention or treatment for behavioral health disorders; and
- Significant time and resources are required of community first responders in addressing persons in a behavioral health crisis and, in many cases, this community response is neither timely nor safe for the person in crisis nor cost-efficient for the state.
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The general assembly therefore finds that a coordinated behavioral health crisis response system:
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Serves as a comprehensive and preferred response to behavioral health emergencies throughout Colorado by providing for early intervention and effective treatment of individuals who are experiencing a behavioral health crisis;
(I.5) As the appropriate and preferred response to behavioral health crises, eliminates the use of the criminal justice system to hold individuals who are experiencing a mental health crisis and enhances the ability of mental health providers and hospitals to serve individuals who are experiencing a mental health crisis;
- Provides an appropriate first line of response to individuals in need of an emergency seventy-two-hour mental health hold and utilizes first responders and information technology systems to integrate available behavioral health crisis responses;
- Should be available in all Colorado communities;
- Includes community-based, behavioral health crisis centers where individuals who are experiencing a behavioral health crisis may be stabilized and receive short-term treatment, as clinically appropriate;
- Decriminalizes mental health disorders by leading the development of a partnership-supported network of crisis services; and
- Establishes a statewide framework that creates, strengthens, and enhances community partnerships that will facilitate the preferred response to behavioral health crises, including ensuring that peace officers and other first responders are equipped with a variety of options when they encounter a behavioral health crisis.
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Serves as a comprehensive and preferred response to behavioral health emergencies throughout Colorado by providing for early intervention and effective treatment of individuals who are experiencing a behavioral health crisis;
- Therefore, the general assembly declares that it is a matter of statewide concern to incentivize and coordinate existing behavioral health crisis intervention services and to commit resources to expand the crisis response system.
-
The general assembly finds and declares that:
- Repealed.
Source: L. 2010: Entire article added, (HB 10-1032), ch. 316, p. 1475, § 1, effective May 27. L. 2017: (1) amended, (SB 17-242), ch. 263, p. 1336, § 227, effective May 25; (1)(b) amended, (1)(c) added, and (2) repealed, (SB 17-207), ch. 205, p. 761, § 2, effective August 9.
Editor's note:
- This section was added by section 1 of ch. 316, Session Laws of Colorado 2010, as § 27-1-210 but was renumbered on revision for ease of location since article 1 of this title was repealed by Senate Bill 10-175.
- Amendments to subsection (1)(b) by SB 17-207 and SB 17-242 were harmonized.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017. For the legislative declaration in SB 17-207, see section 1 of chapter 205, Session Laws of Colorado 2017.
27-60-102. Civil commitment statute review task force - legislative declaration - creation - duties - repeal. (Repealed)
Source: L. 2013: Entire section added, (HB 13-1296), ch. 232, p. 1109, § 1, effective May 16.
Editor's note: Subsection (10) provided for the repeal of this section, effective November 1, 2014. (See L. 2013, p. 1109 .)
27-60-102.5. Definitions. (Repealed)
Source: L. 2017: Entire section added, (SB 17-207), ch. 205, p. 762, § 3, effective August 9. L. 2018: Entire section repealed, (SB 18-094), ch. 30, p. 332, § 2, effective August 8.
Cross references: For the legislative declaration in SB 18-094, see section 1 of chapter 30, Session Laws of Colorado 2018.
27-60-103. Behavioral health crisis response system - services - request for proposals - criteria - reporting - rules.
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On or before September 1, 2013, the state department shall issue a statewide request for proposals to entities with the capacity to create a coordinated and seamless behavioral health crisis response system to provide crisis intervention services for
communities throughout the state. Separate proposals may be solicited and accepted for each of the five components listed in subsection (1)(b) of this section. The crisis response system created through this request for
proposals process must be based on the following principles:
- Cultural competence;
- Strong community relationships;
- The use of peer support;
- The use of evidence-based practices;
- Building on existing foundations with an eye toward innovation;
- Utilization of an integrated system of care; and
- Outreach to students through school-based clinics.
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The components of the crisis response system must reflect a continuum of care from crisis response through stabilization and safe return to the community, with adequate support for transitions to each stage. Specific components include:
- A twenty-four-hour telephone crisis service that is staffed by skilled professionals who are capable of assessing child, adolescent, and adult crisis situations and making the appropriate referrals;
- Walk-in crisis services and crisis stabilization units with the capacity for immediate clinical intervention, triage, and stabilization. The walk-in crisis services and crisis stabilization units must employ an integrated health model based on evidence-based practices that consider an individual's physical and emotional health, are a part of a continuum of care, and are linked to mobile crisis services and crisis respite services.
- Mobile crisis services and units that are linked to the walk-in crisis services and crisis respite services and that have the ability to initiate a response in a timely fashion to a behavioral health crisis;
- Residential and respite crisis services that are linked to the walk-in crisis services and crisis respite services and that include a range of short-term crisis residential services, including but not limited to community living arrangements; and
- A public information campaign.
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On or before September 1, 2013, the state department shall issue a statewide request for proposals to entities with the capacity to create a coordinated and seamless behavioral health crisis response system to provide crisis intervention services for
communities throughout the state. Separate proposals may be solicited and accepted for each of the five components listed in subsection (1)(b) of this section. The crisis response system created through this request for
proposals process must be based on the following principles:
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The state department shall collaborate with the committee of interested stakeholders established in subsection (3) of this section to develop the request for proposals, including eligibility and award criteria. Priority may be given to entities that have
demonstrated partnerships with Colorado-based resources. Proposals will be evaluated on, at a minimum, an applicant's ability, relative to the specific component involved, to:
- Demonstrate innovation based on evidence-based practices that show evidence of collaboration with existing systems of care to build on current strengths and maximize resources;
- Coordinate closely with community mental health organizations that provide services regardless of the source of payment, such as behavioral health organizations, community mental health centers, regional care collaborative organizations, substance use treatment providers, and managed service organizations;
- Serve individuals regardless of their ability to pay;
- Be part of a continuum of care;
- Utilize peer supports;
- Include key community participants;
- Demonstrate a capacity to meet the demand for services;
- Understand and provide services that are specialized for the unique needs of child and adolescent patients; and
- Reflect an understanding of the different response mechanisms utilized between mental health and substance use disorder crises.
- The state department shall establish a committee of interested stakeholders that will be responsible for reviewing the proposals and awarding contracts pursuant to this section. Representations from the state department of health care policy and financing must be included in the committee of interested stakeholders. A stakeholder participating in the committee must not have a financial or other conflict of interest that would prevent him or her from impartially reviewing proposals.
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- The state department shall issue the initial request for proposals on or before September 1, 2013, subject to available appropriations. Pursuant to the state procurement code, articles 101 and 102 of title 24, the state department shall make awards on or before January 1, 2014. If additional money is appropriated, the state department may issue additional requests for proposals consistent with this section and the state procurement code, articles 101 and 102 of title 24.
- If the full appropriation by the general assembly for the implementation of this section is not dispersed as specified in paragraph (a) of this subsection (4), the committee shall accept and review proposals and award contracts as the proposals are received and not require an application be held until a subsequent request for proposals.
- If necessary, the state board may promulgate rules to implement the provisions of this article 60 or the services to be supplied pursuant to this article 60.
-
- Beginning in January 2014, and every January thereafter, the state department shall report progress on the implementation of the crisis response system, as well as information about and updates to the system, as part of its "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" hearing required by section 2-7-203.
- On or before November 1, 2017, the office of behavioral health within the state department shall prepare a report and submit such report to the joint judiciary committee; the joint health and human services committee; the joint budget committee; the governor; and the commission on criminal and juvenile justice, established in section 16-11.3-102. At a minimum, the report must include details concerning the current status of funding and the implementation of the expansion of behavioral health crisis services.
- On or before May 1, 2018, but after January 31, 2018, the office of behavioral health within the state department shall present a report to the joint judiciary committee and the joint committee on health and human services concerning the current status of funding and the implementation of the expansion of behavioral health crisis services.
- Repealed.
Source: L. 2013: Entire section added, (SB 13-266), ch. 231, p. 1105, § 1, effective May 16. L. 2017: (7) repealed, (SB 17-242), ch. 263, p. 1337, § 228, effective May 25; IP(1)(a), IP(1)(b), (4)(a), (5), and (6) amended and (7) repealed, (SB 17-207), ch. 205, p. 762, § 4, effective August 9. L. 2018: IP(1)(a) and (6)(b) amended, (SB 18-161), ch. 123, p. 830, § 4, effective September 1.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017. For the legislative declaration in SB 17-207, see section 1 of chapter 205, Session Laws of Colorado 2017.
27-60-104. Behavioral health crisis response system - crisis service facilities - walk-in centers - mobile response units - report.
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[ Editor's note: This version of subsection (1) is effective until July 1, 2022.] On or before January 1, 2018, crisis walk-in centers, acute treatment units, and crisis stabilization units within the crisis response system, regardless of facility licensure,
must be able to adequately care for an individual brought to the facility through the emergency mental health procedure described in section 27-65-105 or a voluntary application for mental health services pursuant to section 27-65-103.
The arrangements for care must be completed through the crisis response system or prearranged partnerships with other crisis intervention services.
(1) [ Editor's note: This version of subsection (1) is effective July 1, 2022. ] All behavioral health entities, crisis walk-in centers, acute treatment units, and crisis stabilization units within the crisis response system, regardless of facility licensure, must be able to adequately care for an individual brought to the facility through the emergency mental health procedure described in section 27-65-105 or a voluntary application for mental health services pursuant to section 27-65-103. The arrangements for care must be completed through the crisis response system or prearranged partnerships with other crisis intervention services.
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- On or before January 1, 2018, the state department shall ensure that mobile response units are available to respond to a behavioral health crisis anywhere in the state within no more than two hours, either face-to-face or using telehealth operations, for mobile crisis evaluations.
- Mobile crisis services may be delivered by criminal justice diversion programs approved by the state department or a crisis response system contractor.
-
- On or before January 1, 2018, all walk-in centers throughout the state's crisis response system must be appropriately designated by the executive director for a seventy-two-hour treatment and evaluation, adequately prepared, and properly staffed to accept an individual through the emergency mental health procedure outlined in section 27-65-105 or a voluntary application for mental health services pursuant to section 27-65-103. Priority for individuals receiving emergency placement pursuant to section 27-65-105 is on treating high-acuity individuals in the least restrictive environment without the use of law enforcement.
- Increasing the ability of walk-in centers to accept individuals through the emergency mental health procedure outlined in section 27-65-105 or a voluntary application for mental health services pursuant to section 27-65-103 may include, but is not limited to, purchasing, installing, and using telehealth operations for mobile crisis evaluations in partnership with hospitals, clinics, law enforcement agencies, and other appropriate service providers.
- Rural crisis facilities are encouraged to work collaboratively with other facilities in the region that provide care twenty-four hours a day, seven days a week, to form local arrangements.
- The state department shall encourage crisis response system contractors in each region to develop partnerships with the broad array of crisis intervention services through mobile response units and telehealth-capable walk-in centers in rural communities that offer care twenty-four hours a day, seven days a week.
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[ Editor's note: This version of the introductory portion to subsection (6) is effective until July 1, 2022.] The state department shall ensure crisis response system contractors are responsible for community engagement, coordination, and system navigation
for key partners, including criminal justice agencies, emergency departments, hospitals, primary care facilities, walk-in centers, and other crisis service facilities. The goals of community coordination are to:
(6) [ Editor's note: This version of the introductory portion to subsection (6) is effective July 1, 2022. ] The state department shall ensure crisis response system contractors are responsible for community engagement, coordination, and system navigation for key partners, including criminal justice agencies, emergency departments, hospitals, primary care facilities, behavioral health entities, walk-in centers, and other crisis service facilities. The goals of community coordination are to:
- Formalize relationships with partners in the contractually defined regions;
- Pursue collaborative programming for behavioral health services, including, when possible, embedding crisis clinicians and consultants in first response systems;
- Build close relationships between first responders and dispatch centers and the crisis response system contractor in the region; and
- Coordinate behavioral health crises interventions in the community as early as possible to promote diversion from the criminal justice system and continuity of care.
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The state department shall explore solutions for addressing secure transportation, as defined in section 25-3.5-103 (11.4), of individuals placed on a seventy-two-hour treatment and evaluation hold pursuant to article 65 of this title 27, and shall include
the following information as part of its 2023 "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" presentation required pursuant to section 2-7-203:
- How crisis contractors are facilitating the use of secure transportation or contracting with secure transportation licensees; and
- How the state department has supported and encouraged crisis contractors to include secure transportation in the behavioral health crisis response system.
- The state department shall ensure consistent training for professionals who have regular contact with individuals experiencing a behavioral health crisis.
- The state department shall conduct an assessment of need and capacity of the statewide crisis response system to better understand the state's needs for crisis response and service gaps across the state.
Source: L. 2017: Entire section added, (SB 17-207), ch. 205, p. 764, § 5, effective August 9. L. 2019: (1) and IP(6) amended, (HB 19-1237), ch. 413, p. 3640, § 11, effective July 1, 2022. L. 2020: (2) amended, (HB 20-1017), ch. 288, p. 1426, § 12, effective September 14. L. 2021: (7) amended, (HB 21-1085), ch. 355, p. 2312, § 5, effective June 27.
Cross references: For the legislative declaration in SB 17-207, see section 1 of chapter 205, Session Laws of Colorado 2017.
27-60-104.5. Behavioral health capacity tracking system - legislative declaration - definitions - rules.
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The general assembly finds that:
- There is a shortage of available beds for psychiatric emergencies, withdrawal management for substance use disorders, and intensive residential inpatient and outpatient behavioral health services in Colorado;
- Creating a behavioral health capacity tracking system of available treatment capacity and medication-assisted treatment programs would help families, law enforcement agencies, counties, court personnel, and emergency room personnel locate an appropriate treatment option for individuals experiencing behavioral health crises; and
- Further, a tracking system would decrease the time that individuals wait in emergency rooms, ensure that existing resources are maximized, and increase the likelihood that individuals in crisis receive services closer to their community.
- Therefore, the general assembly declares that the creation of a behavioral health capacity tracking system is an important tool for addressing behavioral health crises, including connecting individuals to treatment for opioid and other substance use disorders.
-
The general assembly finds that:
-
As used in this section, unless the context otherwise requires:
- "Consistent noncompliance" means when a provider does not complete daily required capacity updates for two or more consecutive days or has five or more days of noncompliance in any given month.
- "Tracking system" means the behavioral health capacity tracking system created pursuant to this section.
-
Pursuant to subsection (8) of this section, the state department shall implement a behavioral health capacity tracking system, which must include the following:
- A twenty-four-hour, web-based platform;
- Online access by health-care professionals, law enforcement, and court personnel;
- Coordination with the telephone crisis service that is part of the behavioral health crisis response system pursuant to section 27-60-103;
- Required capacity updates, at least daily, unless the facility is a residential facility and capacity has not changed, with a penalty for consistent noncompliance, for facilities listed under subsection (3)(e) of this section; except that opioid treatment programs licensed pursuant to section 27-80-204 are only required to update daily whether the program is accepting new clients; and
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Capacity reporting for the following facilities and treatment providers statewide:
- Facilities that provide evaluation and treatment to individuals held under an emergency commitment pursuant to section 27-81-111, an involuntary commitment pursuant to section 27-81-112, or a civil commitment pursuant to section 27-65-105, including crisis stabilization units, acute treatment units, community mental health centers, and hospitals, including state mental health institutes;
- Inpatient treatment facilities;
- Residential treatment facilities;
- Withdrawal management facilities; and
- Facilities licensed pursuant to section 27-80-204, including opioid treatment programs and medically managed and clinically managed withdrawal management facilities.
- In addition to reporting by those facilities listed in subsection (3)(e) of this section, the tracking system may allow any medical provider providing behavioral health treatment as part of the provider's medical practice to participate in the tracking system with prior approval by the state department.
-
To the extent possible, the tracking system should be designed to collect the following information:
- The name, address, web address, and telephone number of the facility or treatment program and information as to the process for confirming the current availability of a bed or a slot in a treatment program and for reserving a bed or slot in the facility or treatment program;
- The license type for the facility or treatment program and the licensed bed capacity of the facility;
- The number of beds or slots currently available and staffed for behavioral health services;
- Admission and exclusion criteria, including gender, age, acuity level, medical complications, diagnoses, or behaviors excluded, such as intellectual or developmental disabilities, aggression, substance use disorders, traumatic brain injury, or history of violence or aggressive behavior;
- The type of substance for which the facility or treatment program provides treatment;
- Whether the facility serves involuntary clients;
- Payer sources accepted by each facility or treatment program;
- The time and date of the last update of information for the facility or treatment program; and
- A link to a stable location map.
- The tracking system is designed to provide immediate and accurate information regarding the availability of facility beds or slots in treatment programs but does not guarantee availability. The user shall be directed to contact the facility or treatment program directly to confirm capacity and to arrange placement.
- Prior to contracting for components of the tracking system or its implementation, the state department shall convene a stakeholder process to identify an efficient and effective tracking system design. The state department shall receive input relating to existing information and reporting systems that may be expanded upon for the tracking system, issues relating to data collection and input by facilities and treatment providers, and the most effective interface for tracking system users. In addition to any persons or organizations identified by the state department, the stakeholder process must include input from the department of public health and environment, emergency medical service providers, contractors operating existing information and reporting systems in the state, and facilities required to provide information for the tracking system. The state department shall report to the opioid and other substance use disorders study committee during the legislative interim preceding the 2020 legislative session concerning the results of the stakeholder process.
- Subject to available appropriations, the state department shall implement a centralized, web-based tracking system as described in this section and shall ensure that appropriate tracking system information is available to the public. The contractor of the twenty-four-hour telephone crisis services provided pursuant to section 27-60-103 shall use the tracking system as an available service resource locator.
- Repealed.
- The state department may adopt rules, as necessary, to implement this section.
Source: L. 2019: Entire section added, (HB 19-1287), ch. 175, p. 2012, § 1, effective May 14. L. 2020: (8) amended and (9) repealed, (HB 20-1391), ch. 211, p. 1026, § 1, effective June 30; (3)(e)(I) amended, (SB 20-007), ch. 286, p. 1416, § 52, effective July 13.
27-60-105. Outpatient restoration to competency services - jail-based behavioral health services - responsible entity - duties - report - legislative declaration.
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The general assembly finds and declares that:
- Colorado's statutory scheme does not designate an entity responsible for competency restoration services, nor does it provide a sufficient framework for the provision of outpatient restoration services to adults or juveniles. As a result, there have been deficits and inconsistencies in the administration of the educational component of outpatient competency restoration services and the coordination and integration of that component with existing services and supports to address the underlying causes of incompetency.
- The lack of a designated responsible entity for competency restoration services in Colorado has caused inconsistency in competency restoration services throughout the state and delays in proceedings that impact the due process rights of juveniles and adults involved in the juvenile and criminal justice systems, as well as the interests of victims;
- Competency restoration services must be localized and accessible and take into account the public safety, while still allowing for state-level standards and oversight;
- Competency restoration services for juveniles must be provided in the least restrictive environment, while taking into account the public safety and the best interests of the juvenile; and
- Many services essential to the restoration of competency can be provided through existing programs using existing funding. However, the current system lacks funding and responsibility for the educational component of competency restoration services and case management to access and leverage available services and supports which, combined, will help ensure an integrated approach to competency restoration for juveniles and adults.
- The office of behavioral health serves as a central organizing structure and responsible entity for the provision of competency restoration education services, coordination of competency restoration services ordered by the court pursuant to section 16-8.5-111 (2)(b) or 19-2.5-704 (2), and jail-based behavioral health services pursuant to section 27-60-106.
- On or before December 1, 2017, the office shall develop standardized juvenile and adult curricula for the educational component of competency restoration services. The curricula must have a content and delivery mechanism that allows it to be tailored to meet individual needs, including those of persons with intellectual and developmental disabilities.
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Beginning July 1, 2019, the office has the following duties and responsibilities, subject to available appropriations:
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To oversee providers of the education component of competency restoration services, including:
- Establishing and enforcing qualifications of competency restoration educators, including minimum and ongoing training requirements;
- Evaluating models for the delivery of competency restoration education in a manner that maximizes and expands on available resources while minimizing costs to the state; and
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Maintaining an adequate pool of competency restoration providers, as defined by:
- Qualifications and training;
- Geographical accessibility, in light of the goal of ensuring community-based restoration in the least restrictive environment throughout the state; and
- Ability to provide culturally competent and developmentally appropriate competency restoration education tailored to an individual's unique needs;
- To develop models for providing competency restoration services that integrate competency restoration education with other case management and treatment, ensure continuation of ongoing treatment and services as appropriate, avoid duplication of services, and achieve efficiencies by coordinating with existing community resources and programs;
- To preserve the integrity of the competency evaluation process by ensuring that competency restoration educators operate independently from competency evaluators at the case level;
- To engage with key stakeholders in the juvenile and adult justice systems to develop best practices in the delivery of competency restoration services;
- To make recommendations for legislation; and
- To oversee the functions of the jail-based behavioral health services program created in section 27-60-106.
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To oversee providers of the education component of competency restoration services, including:
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Notwithstanding section 24-1-136 (11)(a)(I), on or before January 1, 2019, and every January 1 thereafter, the office shall submit an annual written report to the general assembly summarizing the office's provision of competency restoration education,
its efforts toward the coordination of competency restoration education with other existing services, and the results of the jail-based behavioral health services program created in section 27-60-106. The report must include:
- Data on the number of individuals ordered to competency restoration services, the average time frame for beginning and ending such services, the types of settings in which competency restoration services are provided, and the outcomes of such services;
- A description of the office's engagement with community partners to coordinate competency restoration services in an effective and efficient manner;
- Identification of best and promising practices for education and coordination of competency restoration services;
- A description of opportunities to maximize and increase available resources and funding;
- A description of gaps in and conflicts with existing funding, services, and programming essential to the effective restoration of competency for juveniles and adults; and
- A description of the services funded through the jail-based behavioral health services program created in section 27-60-106.
- In addition to subsection (4) of this section and subject to available appropriations, the office shall require any county jail to assist in the provision of interim mental health services for individuals who have been court-ordered for inpatient competency restoration and who are waiting admission for an inpatient bed. This section does not toll or otherwise modify the time frames for the department to offer inpatient admission pursuant to the provisions of section 16-8.5-111.
Source: L. 2017: Entire section added, (SB 17-012), ch. 404, p. 2109, § 3, effective August 9. L. 2018: (2), IP(4), (4)(d), (4)(e), IP(5), (5)(d), and (5)(e) amended and (4)(f) and (5)(f) added, (SB 18-250), ch. 403, p. 2376, § 2, effective June 6. L. 2019: (2) and IP(4) amended and (6) added, (SB 19-223), ch. 227, pp. 2293, 2290, §§ 20, 12, effective July 1. L. 2021: (2) amended, (SB 21-059), ch. 136, p. 749, § 131, effective October 1.
Editor's note: Subsection (6) was numbered as (5) in SB 19-223 but has been renumbered on revision for ease of location.
27-60-106. Jail-based behavioral health services program - purpose - created - funding.
- There is created in the office the jail-based behavioral health services program, referred to in this section as the "program". The program may receive money from the correctional treatment cash fund pursuant to section 18-19-103 (5)(c)(V).
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The purpose of the program is to:
- Provide adequate staff to complete behavioral health screenings; prescribe psychiatric medications as necessary; and provide mental health counseling, substance use disorder treatment pursuant to section 18-19-103 (5)(c)(V), and transitional care coordination;
- Train jail staff on behavioral health disorders and best practices in working with individuals with mental health, substance use, and co-occurring disorders; and
- Fund administrative costs to jails that implement the requirements outlined in subsection (3) of this section.
- The office shall prioritize jails with minimal behavioral health services, including but not limited to rural and frontier jails.
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Subject to available appropriations, the office may require a county jail that receives funding through the program to:
- Screen all individuals booked into the jail facility with standardized evidence-based screening tools, as determined by the office, for mental health disorders, substance use disorders, and suicide risk;
- Assess all individuals booked into the jail facility for substance use withdrawal symptoms and develop protocols for medical detoxification monitoring procedures;
- Assess all individuals booked into the jail facility for psychiatric medication needs by requesting and reviewing medical and prescription history;
- Have access to all psychiatric medications, as defined by the medication formulary established pursuant to section 27-70-103;
- Assist in the provision of coordinated services for individuals in jail custody who may require competency restoration services;
- Coordinate services with community behavioral health providers prior to the release of an inmate to ensure continuity of care following his or her release from the jail facility;
- Track performance outcomes for measures developed by the office, including behavioral health disorder prevalence and service data through information-sharing processes, as defined by the office; and
- Partner with the office to develop feasible health information exchange strategies for medical and behavioral health records.
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- The office shall require a county jail that receives funding through the program to have a policy in place on or before January 1, 2020, that describes how medication-assisted treatment, as it is defined in section 23-21-803, will be provided, when necessary, to individuals confined in the county jail.
- A sheriff who is the custodian of a county jail or city and county jail may enter into agreements with community agencies, behavioral health organizations, and substance use disorder treatment organizations to assist in the development and administration of medication-assisted treatment in the jail.
- Subject to available appropriations, nothing in this section prohibits program funds from being used to meet the requirements outlined in sections 17-26-303 and 17-26-304 for local jails, as defined in section 17-26-302 (2), by providing additional staffing, training, robust behavioral health services and supports, or facility changes. Any facility changes must be approved by the office of behavioral health before funds may be expended.
Source: L. 2018: Entire section added, (SB 18-250), ch. 403, p. 2377, § 3, effective June 6. L. 2019: (5) added, (SB 19-008), ch. 275, p. 2599, § 7, effective August 2. L. 2021: (6) added, (HB 21-1211), ch. 322, p. 1982, § 3, effective June 24.
27-60-106.5. Criminal justice diversion programs - rules - report.
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- The office of behavioral health in the state department may contract with cities and counties for the creation, maintenance, or expansion of criminal justice diversion programs. The goal of each program created pursuant to this section should be to connect law enforcement officers with behavioral health providers to assist individuals in need of behavioral health intervention or to divert individuals from the criminal justice system.
- The office of behavioral health in the state department may require criminal justice diversion programs contracted pursuant to subsection (1)(a) of this section to participate as a mobile crisis service in the behavioral health crisis response system, created pursuant to section 27-60-103.
- On or before November 1, 2021, and on or before each November 1 thereafter, the state department shall include an update regarding the current status of funding and the criminal justice diversion programs implemented pursuant to this section in its report to the judiciary committees of the senate and the house of representatives, the health and human services committee of the senate, the public health care and human services committee of the house of representatives, or any successor committees, as part of its "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" presentation required by section 2-7-203.
- The state board of human services, created in section 26-1-107, may promulgate rules to implement the provisions of this section.
Source: L. 2020: Entire section added, (HB 20-1017), ch. 288, p. 1426, § 10, effective September 14.
27-60-107. Behavioral health entity licenses - assistance - transfer of staff.
- Pursuant to article 27.6 of title 25, there is a behavioral health entity license issued by the department of public health and environment. Certain facilities that are licensed by the state department will transition to the behavioral health entity license issued by the department of public health and environment. Prior to the transition, the office shall assist the department of public health and environment and the behavioral health entity implementation and advisory committee established in section 25-27.6-103 in designing and implementing the transition and informing facilities licensed by the state department prior to the transition.
- When one or more types of licenses are transitioned to the department of public health and environment, employees of the office who were previously responsible for issuing licenses by the state department may be offered positions in the department of public health and environment in accordance with department of personnel rules.
Source: L. 2019: Entire section added, (HB 19-1237), ch. 413, p. 3637, § 2, effective August 2.
27-60-108. Peer support professionals - cash fund - fees - requirements - rules - legislative declaration - definitions.
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The general assembly hereby finds and declares that:
- Peer support professionals help people achieve their recovery goals through shared understanding, respect, and empowerment. Peer support offers a form of acceptance, understanding, and validation not often found in other professional relationships.
- The federal centers for medicare and medicaid services recognize that peer support professionals can be an important component in a state's delivery of effective mental health and substance use disorder treatment;
- Peer support services can cut hospitalizations, increase a person's engagement in self-care and wellness, and help to decrease a person's psychotic symptoms;
- The COVID-19 pandemic has exacerbated Colorado's existing behavioral health workforce shortage, particularly in rural areas and communities of color;
- Colorado lacks a behavioral health workforce that reflects the culture, ethnicity, sexual orientation, gender identity, mental health service experiences, and substance use disorder experiences of individuals in the state;
- In the past two years, the number of people who have needed but have not received behavioral health services has nearly doubled. Challenges to the workforce is considered the leading cause for the decreased availability of behavioral health services. Peer support professionals can help fill Colorado's workforce need.
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The substance abuse and mental health services administration has identified peer-run organizations as an evidence-based practice. Peer-run organizations may offer a variety of services, including but not limited to:
- Peer-run drop-in centers;
- Recovery and wellness centers;
- Employment services;
- Prevention and early intervention activities;
- Peer mentoring for children and adolescents;
- Warm lines; or
- Advocacy services.
- Peer-run organizations, including recovery community organizations, are important components in Colorado's behavioral health system. These organizations help individuals define their life goals and find a unique path toward recovery in a holistic manner.
- The general assembly finds, therefore, that it is in the best interest of the state to support the peer support professional workforce through the creation of peer-run recovery support services organizations. Peer-run and peer-led organizations will help expand peer support services throughout the state, expand the behavioral health workforce, and save the state money by reducing the need for crisis services.
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The general assembly hereby finds and declares that:
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As used in this section, unless the context otherwise requires:
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"Licensed mental health provider" means a:
- Mental health professional licensed or certified pursuant to article 245 of title 12, except for unlicensed psychotherapists pursuant to article 245 of title 12;
- Advanced practice registered nurse registered pursuant to section 12-255-111 with training in substance use disorders or mental health;
- Physician assistant licensed pursuant to section 12-240-113 with specific training in substance use disorders or mental health;
- Psychiatric technician licensed pursuant to article 295 of title 12; and
- Medical doctor or doctor of osteopathy licensed pursuant to article 240 of title 12.
- "Peer support professional" means a peer support specialist, recovery coach, peer and family recovery support specialist, peer mentor, family advocate, or family systems navigator who meets the qualifications described in subsection (3)(a)(III) of this section.
- "Recovery support services organization" means an independent entity led and governed by representatives of local communities of recovery and approved by the executive director of the state department pursuant to subsection (3)(a) of this section.
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"Licensed mental health provider" means a:
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On or before July 1, 2022, the state department shall develop a procedure for recovery support services organizations to be approved by the executive director of the state department for reimbursement pursuant to this section. The procedures must ensure
that the recovery support services organization:
- Provides recovery-focused services and supports;
- Employs or contracts with a licensed mental health provider to administer on-going supervision of peer support professionals employed by recovery support services organizations. The licensed mental health provider must be in good standing and must demonstrate having received formal training specific to the provision of peer support services and supervision of peer support professionals;
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Employs or contracts with peer support professionals who must:
- Self-identify as having experienced the process of recovery from a mental health disorder, substance use disorder, trauma, or one or all of such conditions, either as a consumer of recovery services or as the parent or a family member of the consumer;
- Have successfully completed formal training covering all content areas outlined in the core competencies for peer support professionals established by either the state department or the substance abuse and mental health services administration of the United States department of health and human services; and
- Provide nonclinical support services that align with recommendations from the substance abuse and mental health services administration of the United States department of health and human services, including engaging individuals in peer-to-peer relationships that support healing, personal growth, life skills development, self-care, and crisis-strategy development to help achieve recovery, wellness, and life goals;
- Has an established process by which the organization coordinates its services with those rendered by other agencies to ensure an uninterrupted continuum of care to persons with behavioral health disorders; and
- Meets any other standards as determined by rule of the executive director.
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A peer support professional may provide services for a recovery support services organization in various clinical and nonclinical settings, including but not limited to:
- Justice-involved settings;
- Physical health settings, such as pediatrician or obstetric and gynecological health care offices;
- Emergency departments;
- Services delivered via telehealth;
- Agencies serving homeless communities;
- Peer respite homes;
- School-based health centers; and
- Home- and community-based settings.
- The executive director of the state department, in collaboration with the department of health care policy and financing, may promulgate rules establishing minimum standards that recovery support services organizations must meet.
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On or before July 1, 2022, the state department shall develop a procedure for recovery support services organizations to be approved by the executive director of the state department for reimbursement pursuant to this section. The procedures must ensure
that the recovery support services organization:
- The state department may charge a fee for recovery support services organizations seeking approval pursuant to subsection (3)(a) of this section. If the executive director of the state department charges a fee to recovery support services organizations, the executive director shall promulgate rules to establish the fee at an amount not to substantially exceed the amount charged to other behavioral health providers seeking approval from the state department. The state department shall deposit any fees collected into the peer support professional workforce cash fund created in subsection (6) of this section.
- The state department may seek, accept, and expend gifts, grants, or donations from private or public sources for the purposes of this section. The state department shall transfer each gift, grant, and donation to the state treasurer, who shall credit the same to the peer support professional workforce cash fund created in subsection (6) of this section.
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There is created in the state treasury the peer support professional workforce cash fund, referred to in this section as the "fund", which consists of:
- Fees collected pursuant to subsection (4) of this section;
- Gifts, grants, and donations collected pursuant to subsection (5) of this section; and
- Money appropriated to the fund by the general assembly.
- The state treasurer shall credit all interest and income derived from the deposit and investment of money in the fund to the fund.
- Any unexpended and unencumbered money remaining in the fund at the end of a fiscal year remains in the fund and is not transferred to the general fund or any other fund.
- Subject to annual appropriation by the general assembly, the state department may expend state money from the fund for the purpose of implementing this section.
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There is created in the state treasury the peer support professional workforce cash fund, referred to in this section as the "fund", which consists of:
- A peer-run recovery service provider shall not be compelled to seek approval from the state department to become a recovery support services organization. Expanded service funding available for recovery services through recovery support services organizations is intended to supplement existing state investment in the recovery system infrastructure. The state department shall fund recovery services, within existing appropriations, including peer-run organizations that do not seek to be recovery support services organizations.
Source: L. 2021: Entire section added, (HB 21-1021), ch. 256, p. 1505, § 1, effective September 7.
27-60-109. Temporary youth mental health services program - established - rules - report - definitions - repeal.
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As used in this section, unless the context otherwise requires:
- "Portal" means the website or web-based application described in subsection (4) of this section that facilitates the program.
- "Program" means the temporary youth mental health services program established in this section.
- "Provider" means a licensed psychiatrist regulated pursuant to article 240 of title 12 or any of the following licensees, certified professionals, or candidates regulated pursuant to article 245 of title 12: A licensed psychologist or psychologist candidate; licensed social worker, licensed clinical social worker, or clinical social worker candidate; licensed marriage and family therapist or marriage and family therapist candidate; licensed professional counselor or licensed professional counselor candidate; or licensed addiction counselor, certified addiction specialist, or addiction counselor candidate.
- "Telehealth" has the same meaning set forth in section 10-16-123.
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"Youth" means:
- A person eighteen years of age or younger; and
- A person who is twenty-one years of age or younger but older than eighteen years of age who is receiving special education services pursuant to part 1 of article 20 of title 22.
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- There is established in the office the temporary youth mental health services program to facilitate access to mental health services, including substance use disorder services, for youth to respond to mental health needs identified in an initial mental health screening through the portal, including those needs that may have resulted from the COVID-19 pandemic. The program reimburses providers for up to three mental health sessions with a youth.
- The office shall reimburse providers who participate in the program for each mental health session with a youth, either in-person or by telehealth, up to a maximum of three sessions per youth client; except that subject to available money, the state department may reimburse a provider for additional sessions. To be eligible for reimbursement from the program, a provider must be available to provide three mental health sessions to each youth the provider accepts as a client.
- A provider shall maintain client confidentiality pursuant to state or federal law with regard to a youth client who participates in a mental health session with the provider that is reimbursed pursuant to the program.
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The office shall:
- Develop a process consistent with the requirements of this section for providers to apply for, and demonstrate eligibility to receive, reimbursement from the program;
- Determine a reasonable rate of reimbursement for each mental health session with a youth client pursuant to the program, which rate must be the same regardless of whether the appointment is a telehealth or in-person appointment; and
- Implement a statewide public awareness and outreach campaign about the program. The general assembly encourages the office to involve schools, neighborhood youth organizations, health-care providers, faith-based organizations, and any other community-based organizations that interact with youth on the local level in disseminating information about the program.
- The state department may promulgate rules necessary for the administration of this section, including rules to protect the privacy of youth who receive services through the program.
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The office shall:
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As soon as practicable, but no later than August 1, 2021, the state department shall enter into an agreement with a vendor to create, or use an existing, website or web-based application as a portal available to youth and providers to facilitate the program.
The portal must:
- Serve as a platform for initial age-appropriate mental health screenings to determine if a youth may benefit from mental health support;
- Allow providers to register and share in-person or telehealth appointment availability;
- When possible, connect youth with providers who accept the youth's insurance or payment source that may cover the costs of ongoing mental health treatment, if the youth has insurance or a payment source; and
- Allow a youth, regardless of whether the youth has insurance or any other payment source, to schedule telehealth appointments with a provider. An in-person appointment may be provided if and when available.
- The selection of a vendor pursuant to this subsection (4) is exempt from the requirements of the procurement code, articles 101 to 112 of title 24.
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As soon as practicable, but no later than August 1, 2021, the state department shall enter into an agreement with a vendor to create, or use an existing, website or web-based application as a portal available to youth and providers to facilitate the program.
The portal must:
- On or before January 1, 2022, and on or before June 30, 2022, the state department shall report to the house of representatives public and behavioral health and human services committee and the senate health and human services committee, or their successor committees, regarding the number of youth who received services under the program, excluding any personally identifiable information in accordance with state and federal law; information in aggregate about the services provided to youth under the program; and other relevant information regarding the program.
- This section is repealed, effective June 30, 2022.
Source: L. 2021: Entire section added, (HB 21-1258), ch. 265, p. 1542, § 2, effective June 18.
Cross references: For the legislative declaration in HB 21-1258, see section 1 of chapter 265, Session Laws of Colorado 2021.
27-60-110. Behavioral health-care services for rural and agricultural communities - vouchers - contract - appropriation.
- No later than one hundred eighty days after June 28, 2021, the state department, in collaboration with the department of agriculture, shall contract with a nonprofit organization primarily focused on serving agricultural and rural communities in Colorado, as identified by the state department, to provide vouchers to individuals living in rural and frontier communities in need of behavioral health-care services.
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The nonprofit organization awarded the contract pursuant to subsection (1) of this section shall:
- Contract with licensed behavioral health-care providers that have completed training on cultural competencies specific to the Colorado agricultural and rural community lifestyle to provide direct behavioral health-care services to farmers, ranchers, farm and ranch workers and their families, and other underserved populations in rural and agricultural communities. At least sixty percent of the money received pursuant to the contract must be used for direct behavioral health-care services described in this subsection (2)(a).
- Develop training materials and train behavioral health-care providers on cultural competencies specific to the Colorado agricultural and rural community lifestyle.
- For the 2021-22 fiscal year, and each fiscal year thereafter, the general assembly shall annually appropriate fifty thousand dollars for the contract awarded pursuant to subsection (1) of this section.
Source: L. 2021: Entire section added, (SB 21-137), ch. 362, p. 2367, § 14, effective June 28.
Cross references: For the short title ("Behavioral Health Recovery Act of 2021") and the legislative declaration in SB 21-137, see sections 1 and 2 of chapter 362, Session Laws of Colorado 2021.
27-60-111. County-based behavioral health grant program - created - rules - report - repeal.
- There is created in the office the county-based behavioral health grant program, referred to in this section as the "grant program", to provide matching grants to county departments of human or social services for the expansion or improvement of local or regional behavioral health disorder treatment programs.
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Grant recipients may use the money received through the grant program for the following purposes:
- Peer training;
- Augmentation of direct therapy;
- Acute treatment units;
- Inpatient treatment programs;
- Outreach and education;
- Navigation or care coordination;
- Capital investments in behavioral health center infrastructure;
- Services for non-English-speaking individuals;
- Culturally responsive and attuned services;
- Suicide prevention and intervention;
- Crisis response;
- Withdrawal management;
- Workforce development;
- Supporting regional service delivery; or
- Any other purpose the office identifies that will expand or improve local or regional behavioral health disorder treatment programs.
- The office shall administer the grant program and shall award grants as provided in this section.
- The office shall implement the grant program in accordance with this section. At a minimum, the office shall specify the time frames for applying for grants, the form of the grant program application, and the time frames for distributing grant money.
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Each grant applicant shall demonstrate:
- A dedication of local funding to support the expansion or improvement of local behavioral health disorder treatment programs, which may be from the county's local share of the federal "American Rescue Plan Act of 2021", Pub.L. 117-2, as the act may be subsequently amended, or other local revenue sources; or
- A plan for regional collaboration between no fewer than three counties to support the expansion or improvement of regional behavioral health disorder treatment programs.
- No single grant awarded may exceed one million dollars, unless a grant is awarded for a regional effort involving two or more counties.
- A direct service provider that receives a grant shall limit any indirect expenses to no more than ten percent of the total state money awarded, and any entity that receives a grant and oversees a direct service provider shall limit the entity's indirect expenses to no more than five percent of the total state money awarded.
- If any grant money is used for capital projects, the grant recipient shall demonstrate a commitment to continue those services past the grant cycle for at least an additional five years.
- A grant applicant shall disclose if any project or program is receiving money from another payer source, including but not limited to private dollars, county dollars, state block grants, or money awarded by a managed service organization.
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Each grant applicant shall demonstrate:
- To receive a grant, a county department of human or social services shall submit an application to the office. The office shall give priority to applications that demonstrate innovation and collaboration or include rural or frontier communities; address a demonstrated need, as identified by community input and local planning efforts; and demonstrate the ability to rapidly distribute the grant money into the community. The office shall award grant money equitably to reflect the geographic diversity of the state.
- Subject to available appropriations, beginning January 1, 2022, and on or before January 1 each year thereafter for the duration of the grant program, the office shall award grants as provided in this section. The office shall distribute the grant money within ninety days after the office awards the grants.
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- On or before February 1, 2023, and on or before February 1 each year thereafter for the duration of the grant program, each county department of human or social services that receives a grant through the grant program shall submit a report to the office on the use of the grant money received pursuant to this section, including the total number of individuals served, disaggregated by race, ethnicity, and age.
- On or before April 1, 2023, and on or before April 1 each year thereafter for the duration of the grant program, the state department shall submit a summarized report of the information received pursuant to subsection (8)(a) of this section to the joint budget committee, the health and insurance committee and the public and behavioral health and human services committee of the house of representatives, and the health and human services committee of the senate, or any successor committees, on the grant program.
- For the 2021-22 state fiscal year, the general assembly shall appropriate nine million dollars from the behavioral and mental health cash fund created in section 24-75- 230 to the department of human services for use by the office for the purposes of this section. If any unexpended or unencumbered money remains at the end of the fiscal year, the office may expend the money for the same purposes in the next fiscal year without further appropriation.
- This section is repealed, effective July 1, 2023.
Source: L. 2021: Entire section added, (SB 21-137), ch. 362, p. 2368, § 15, effective June 28.
Editor's note: Section 38 of chapter 362 (SB 21-137), Session Laws of Colorado 2021, provides that section 15 of the act adding this section takes effect only if SB 21-288 becomes law and takes effect either upon the effective date of SB 21-137 or one day after the passage of SB 21-288, whichever is later. SB 21-288 became law and took effect June 11, 2021, and SB 21-137 took effect June 28, 2021.
Cross references: For the short title ("Behavioral Health Recovery Act of 2021") and the legislative declaration in SB 21-137, see sections 1 and 2 of chapter 362, Session Laws of Colorado 2021.
27-60-112. Behavioral health-care workforce development program - creation - rules - report.
- There is created in the office the behavioral health-care workforce development program, referred to in this section as the "program". The purpose of the program is to increase the behavioral health-care workforce's ability to treat individuals, including youth, with severe behavioral health disorders.
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To implement the program, the office shall:
- Develop an online training system that allows for accessible statewide training opportunities;
- Develop an online training curriculum for providers in rural and metro areas to increase competencies in mental health and substance use disorders that will support a high-quality, trained, culturally responsive, and diverse behavioral health-care workforce;
- Provide fiscal incentives for lower income individuals to obtain a degree in behavioral health, with funding specifically targeted for rural areas of the state;
- Provide training to the existing behavioral health-care workforce to be certified in federally reimbursed services; and
- Provide capacity-building grants to diversify the safety-net provider workforce and meet the requirements of section 27-63-103.
- The state department may promulgate rules as necessary for the implementation of this section.
- For the state fiscal year 2021-22 and each state fiscal year thereafter for which the program receives funding, the state department shall report a summary of the expenditures from the program, the impact of the expenditures in increasing the behavioral health-care workforce, and any recommendations to strengthen and improve the behavioral health-care workforce as part of its annual presentation to the general assembly required under the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act", part 2 of article 7 of title 2.
Source: L. 2021: Entire section added, (SB 21-137), ch. 362, p. 2370, § 16, effective June 28.
Editor's note: Section 38 of chapter 362 (SB 21-137), Session Laws of Colorado 2021, provides that section 16 of the act adding this section takes effect only if SB 21-288 becomes law and takes effect either upon the effective date of SB 21-137 or one day after the passage of SB 21-288, whichever is later. SB 21-288 became law and took effect June 11, 2021, and SB 21-137 took effect June 28, 2021.
Cross references: For the short title ("Behavioral Health Recovery Act of 2021") and the legislative declaration in SB 21-137, see sections 1 and 2 of chapter 362, Session Laws of Colorado 2021.
27-60-113. Out-of-home placement for children and youth with mental or behavioral needs - rules - report - legislative declaration - repeal.
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The general assembly finds and declares that:
- The COVID-19 pandemic has lead to an emergency need for increased placements for children and youth with behavioral or mental health needs, including those involved with the child welfare system; and
- As the state works to transition to the critical requirements of the federal "Family First Prevention Services Act", it must ensure a smooth transition by helping existing residential child care facilities transition to qualified residential treatment programs or psychiatric residential treatment facilities.
- Therefore, the general assembly declares that the state should provide resources to qualified residential treatment programs, psychiatric residential treatment facilities, or therapeutic foster care providers to address this emergency situation and ensure there are high-quality providers available to meet these needs.
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The general assembly finds and declares that:
- On or before August 1, 2021, the state department shall develop a program to provide emergency resources to licensed providers to help remove barriers such providers face in serving children and youth whose behavioral or mental health needs require services and treatment in a residential child care facility. Any such licensed provider shall meet the requirements of a qualified residential treatment program, as defined in section 26-5.4-102, a psychiatric residential treatment facility, as defined in section 26-5.4-103 (19.5), or therapeutic foster care, as defined in section 26-6-102 (39).
- The state department may promulgate rules concerning the placement of a child or youth in the program. The rules may address quality assurance monitoring, admissions, discharge planning, appropriate length of stay, an appeals process for children and youth who are determined ineligible for the program, and compliance with applicable federal law, including the federal "Family First Prevention Services Act"; except that rules concerning the placement of a child or youth who is not in the custody of a state or county department of human or social services shall not inappropriately apply compliance with such act.
-
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On or before December 31, 2021, the state department shall contract with licensed providers for the delivery of services to children and youth who are determined eligible for and placed in the program. A provider that contracts with the state department
shall not:
- Deny admittance of a child or youth if the child or youth otherwise meets the eligibility criteria for the program; or
- Discharge a child or youth based on the severity or complexity of the child or youth's physical, behavioral, or mental health needs; except that the state department may arrange for the placement of a child or youth with an alternate contracted provider if the placement with the alternate provider is better suited to deliver services that meet the needs of the child or youth.
- The state department shall reimburse a provider directly for the costs associated with the placement of a child or youth in the program for the duration of the treatment, including the costs the provider demonstrates are necessary in order for the provider to operate continuously during this period.
- The state department shall coordinate with the department of health care policy and financing to support continuity of care and payment for services for any children or youth placed in the program.
- The state department shall reimburse the provider one hundred percent of the cost of unutilized beds in the program to ensure available space for emergency residential out-of-home placements.
-
On or before December 31, 2021, the state department shall contract with licensed providers for the delivery of services to children and youth who are determined eligible for and placed in the program. A provider that contracts with the state department
shall not:
-
- A hospital, health-care provider, provider of case management services, school district, managed care entity, or state or county department of human or social services may refer a family for the placement of a child or youth in the program. The entity referring a child or youth for placement in the program shall submit or assist the family with submitting an application to the state department for review. The state department shall consider each application as space becomes available. The state department shall approve admissions into the program and determine admission and discharge criteria for placement.
- The state department shall develop a discharge plan for each child or youth placed in the program. The plan must include the eligible period of placement of the child or youth and shall identify the entity that will be responsible for the placement costs if the child or youth remains with the provider beyond the date of eligibility identified in the plan.
- The entity or family that places the child or youth in the program retains the right to remove the child or youth from the program any time prior to the discharge date specified by the state department.
- Within seven days after submitting an application to the state department for placing a child or youth in the program, the state department shall work with the referring entity and the child's or youth's parents or legal guardians to ensure the child or youth is assessed for eligibility for enrollment into the state medical assistance program. A child or youth who is eligible for enrollment into the state medical assistance program shall be enrolled. Enrollment of a child or youth into the state medical assistance program does not constitute automatic placement into the program.
-
No later than November 1, 2022, 2023, and 2024, the state department shall submit a written report to the house of representatives public and behavioral health and human services committee, the senate health and human services committee, or their successor
committees, and the joint budget committee. At a minimum, the report must include:
- The number of applications received for placement of children and youth in the program;
- The number of children and youth accepted for placement in the program;
- The duration of each placement; and
- The daily rate paid to each provider for placement of children and youth.
- This section is intended to provide enhanced emergency services resulting from the increased need for services due to the COVID-19 pandemic. No later than September 30, 2024, the state department shall submit recommendations to the house of representatives public and behavioral health and human services committee, the senate health and human services committee, or their successor committees, and the joint budget committee about how to provide necessary services for children and youth in need of residential care, including hospital step-down services on an ongoing basis.
- This section is repealed, effective July 1, 2025.
Source: L. 2021: Entire section added, (SB 21-137), ch. 362, p. 2371, § 17, effective June 28.
Editor's note: Section 38 of chapter 362 (SB 21-137), Session Laws of Colorado 2021, provides that section 17 of the act adding this section takes effect only if SB 21-288 becomes law and takes effect either upon the effective date of SB 21-137 or one day after the passage of SB 21-288, whichever is later. SB 21-288 became law and took effect June 11, 2021, and SB 21-137 took effect June 28, 2021.
Cross references: For the short title ("Behavioral Health Recovery Act of 2021") and the legislative declaration in SB 21-137, see sections 1 and 2 of chapter 362, Session Laws of Colorado 2021.
PART 2 BEHAVIORAL HEALTH ADMINISTRATION
27-60-201. Legislative declaration.
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The general assembly finds and declares that:
- On April 8, 2019, the Colorado behavioral health task force was created, bringing together individuals representing diverse and balanced perspectives with respect to issues such as adults, children, and families who are dealing with mental health or substance use issues, key executive agencies representing state, local, and tribal governments, criminal justice experts, advocacy groups, behavioral health experts, and consumers;
- The mission of the behavioral health task force was to evaluate and create a plan to improve the current behavioral health system in Colorado;
- The behavioral health task force focused on creating a behavioral health system that includes equitable access to whole-person care;
- In September 2020, the behavioral health task force released its blueprint, subcommittee, and COVID-19 special committee reports that outline its vision for behavioral health reform; and
-
The findings and recommendations of the task force indicate that it is imperative that an improved behavioral health system in Colorado:
- Provide equitable and meaningful access to services and care for Coloradans, regardless of ability to pay, co-occurring conditions, disability, linguistics, geographic location, racial or ethnic identity, religion, socioeconomic status, sexual orientation, age, gender identity, housing status, history of criminal justice involvement, payer source, culture, or any other factor;
-
Provide access to care that:
- Integrates physical and behavioral health;
- Is culturally and linguistically responsive, trauma-informed, and tailored to the individual and specific family needs; and
- Prioritizes all aspects of health, including wellness, and early interventions and supports that help people stay successfully and meaningfully connected to the community where they live, work, and play;
- Provides a continuum of services for children, youth, and adults, including meeting the unique needs of children and youth. Young people have different needs than adults and should be offered developmentally appropriate and culturally competent services.
- Provides access to quality and affordable services in a variety of methods, including in-person and virtual services;
- Provides access to behavioral health services in regions and communities without necessitating engagement with the criminal or juvenile justice systems;
- Provides Coloradans with access to affordable care that keeps them healthy, and administrative efficiencies across the behavioral health care industry align with payment models and incentives that drive quality and improved outcomes;
- Includes a high-quality, trained, culturally responsive, trauma-informed, and diverse professional behavioral health workforce that delivers outcomes and equitable access to care; and
- Provides Coloradans with an opportunity to achieve and maintain mental wellness by addressing social determinants of health, such as housing, transportation, and employment, in addition to the integration of physical and behavioral health care.
- The general assembly further finds that in implementing the findings and recommendations of the Colorado behavioral health task force it is imperative to rely on all stakeholders working together to hold the behavioral health system accountable to ensure all Coloradans are receiving the care needed to fulfill the task force's aim of ensuring a quality behavioral health system.
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Therefore, the general assembly declares that, to ensure a standard of high-quality, integrated, and consumer-centric access to behavioral health care services, it is imperative that the recommendations and findings included in the blueprint created by
the Colorado behavioral health task force be followed and that a single state agency, known as the behavioral health administration, be established to lead and promote the state's behavioral health priorities. It is imperative
that the behavioral health administration transform the state's current behavioral health system by:
- Coordinating and integrating the delivery of behavioral health services in Colorado;
- Setting standards for the behavioral health system to improve the quality and equity of care;
- Ensuring that behavioral health services respond to the changing needs of communities, monitor state and local outcomes, support tribal needs, and evaluate state efforts;
- Improving equitable access to, quality of, and affordability of behavioral health services for Coloradans;
- Preserving and building upon the integration of behavioral and physical health care that treats the whole person;
- Leading and promoting Colorado's priority of addressing the increasing need for behavioral health services;
- Eliminating unnecessary fragmentation of services and streamlining access;
- Addressing social determinants of health as a core component of behavioral health outcomes;
- Promoting transparency and accountability of behavioral health reform outcomes and spending of taxpayer dollars; and
- Reducing administrative burden on behavioral health care providers so they are able to focus on client care.
Source: L. 2021: Entire part added, (HB 21-1097), ch. 48, p. 198, § 1, effective April 22.
27-60-202. Definitions.
As used in this part 2, unless the context otherwise requires:
- "Behavioral health" has the same meaning as set forth in section 27-60-100.3.
-
"Behavioral health administration" or "BHA" means the behavioral health administration established in section 27-60-203.
(2.5) "Care coordination" means services that support individuals and families and initiate care and navigating crisis supports, mental health and substance use disorder assistance, and services that address the social determinants of health, and preventive care services.
- "Plan" means the proposed plan, as described in section 27-60-203, for the creation of the behavioral health administration.
- "State department" means the state department of human services created pursuant to section 26-1-105.
Source: L. 2021: Entire part added, (HB 21-1097), ch. 48, p. 201, § 1, effective April 22; (2.5) added, (SB 21-137), ch. 362, p. 2374, § 18, effective June 28.
Editor's note: Section 38 of chapter 362 (SB 21-137), Session Laws of Colorado 2021, provides that section 18 of the act adding subsection (2.5) takes effect only if SB 21-288 becomes law and takes effect either upon the effective date of SB 21-137 or one day after the passage of SB 21-288, whichever is later. SB 21-288 became law and took effect June 11, 2021, and SB 21-137 took effect June 28, 2021.
Cross references: For the short title ("Behavioral Health Recovery Act of 2021") and the legislative declaration in SB 21-137, see sections 1 and 2 of chapter 362, Session Laws of Colorado 2021.
27-60-203. Behavioral health administration - plan for creation - proposed duties - timeline.
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- On or before November 1, 2021, based on the September 2020 recommendations from the Colorado behavioral health task force, the state department shall develop a plan for the creation of the behavioral health administration. The plan must include strategies to streamline and improve efforts that address behavioral health needs in the state and reduce behavioral health disparities.
- The state department shall solicit feedback from and engage with demographically diverse community stakeholders in the development of the plan described in this section. This includes, but is not limited to, direct engagement of consumers and consumers' advocates, county governments, municipal governments, tribal governments, managed service organizations, health care providers, managed care entities, insurance carriers, community mental health centers, and substance use disorder services providers.
- On or before November 1, 2021, the state department shall provide the plan as a written report to the joint budget committee, the public and behavioral and human services committee of the house of representatives, and the health and human services committee of the senate, or any successor committees.
-
The plan must include, but is not limited to, the following:
- Recommendations for funding and legislation necessary to appropriately implement the plan and address initial start-up as well as ongoing operational costs for the BHA;
- A list and description of which state programs, both statutory and nonstatutory, along with the associated funding streams and personnel, that should be included or managed by the BHA. The list must specifically address all the functions currently overseen by the office of behavioral health in the state department of human services.
- The governance structure of the BHA, including a recommendation for infrastructure within any governance structure to oversee and be accountable for policy, strategy, and services for all children and youth;
- Potential opportunities for collaboration with local municipalities, counties, and tribes;
- Recommendations for a plan of action regarding grievances, appeals, and ombudsman services within the BHA;
- A data integration plan to create a data and information sharing and legal framework to support an agreed-upon approach and specific use case for information sharing that leverages existing infrastructure, such as health information exchanges, reusable architecture, and data standards to enable and advance coordinated care and services and behavioral health equity while maintaining tribal sovereignty;
- A description of how the BHA will ensure the availability of services and establish a standard of care across Colorado; and
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Specific recommendations as follows:
- Recommendations for the department of health care policy and financing, developed in collaboration with community stakeholders, on how medical assistance programs for behavioral health should be aligned or integrated with the BHA in such a way that consumers of behavioral health services have seamless access to needed services regardless of payer. The recommendations must include a description of how the BHA will ensure that access to services deemed medically necessary pursuant to the early and period screening, diagnostic, and treatment benefit is arranged for eligible children and youth.
- Recommendations for the division of insurance within the department of regulatory agencies, developed in collaboration with the community stakeholders, concerning how private insurance efforts that are specific to behavioral health should be aligned or integrated with the BHA; and
- Recommendations for the department of public health and environment, developed in collaboration with the community stakeholders, concerning how prevention and preventive services should be aligned or integrated with the BHA and the extent to which the BHA will engage in population health.
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The duties of the BHA, once established and fully operational, must include, but are not limited to:
- Serving as the single state agency responsible for state behavioral health programs that were identified as appropriate to transition into the BHA;
- Receiving, coordinating, and distributing appropriate community behavioral health funding throughout the state;
- Monitoring, evaluating, and reporting behavioral health outcomes across the state and within various jurisdictions, while maintaining tribal sovereignty; and
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Promoting a behavioral health system that supports a whole-person approach to ensure Coloradans have the best chance to achieve and maintain wellness. This approach includes:
- Promoting an integrated approach to mental health and substance use treatment;
- Strengthening the integration of behavioral and physical care;
- Enhancing programmatic and funding opportunities in support of the overall well-being of the individual or family;
- Promoting culturally responsive, trauma-informed, and equitable behavioral health care; and
- Promoting coordination of supportive services outside of the behavioral health system to address social determinants of health, and to connect people to services such as housing, transportation, and employment.
- The state department shall work collaboratively with the department of health care policy and financing, community stakeholders, and other state departments, as appropriate, to promulgate rules for the BHA to provide adequate oversight of the quality of services and set standards of care for services for adults as well as children and youth.
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- On or before July 1, 2022, the behavioral health administration is established in the state department. During the time it takes for the BHA to become fully operational, it remains a part of the state department until a determination is made by the general assembly concerning the department it will be permanently located in.
- On or before November 1, 2024, the state department shall provide a report to the joint budget committee, the public and behavioral health and human services committee of the house of representatives, and the health and human services committee of the senate, or any successor committees, concerning recommendations on whether the BHA should remain in the state department or be transferred to a different department within the state.
- If the general assembly takes no additional legislative action on or before June 30, 2025, the BHA will remain in the state department.
Source: L. 2021: Entire part added, (HB 21-1097), ch. 48, p. 201, § 1, effective April 22.
27-60-204. Care coordination infrastructure.
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- The state department, in collaboration with the department of health care policy and financing, shall develop a statewide care coordination infrastructure to drive accountability and more effective behavioral health navigation to care that builds upon and collaborates with existing care coordination services. The infrastructure must include a website and mobile application that serves as a centralized gateway for information for patients, providers, and care coordination and that facilities access and navigation of behavioral health-care services and support.
- The state department shall convene a working group of geographically and demographically diverse partners and stakeholders, including those with lived and professional experience, to provide feedback and recommendations that inform and guide the development of the statewide care coordination infrastructure developed pursuant to subsection (1)(a) of this section.
- The extent to which medicaid and private insurance existing care coordination services are aligned with the statewide care coordination infrastructure described in subsection (1)(a) of this section shall be determined by the department of health care policy and financing, the division of insurance in the department of regulatory agencies, and the working group created pursuant to subsection (1)(b) of this section.
- The state department shall implement, directly or through a contractor, a comprehensive and robust marketing and outreach plan to make Coloradans aware of the website and mobile application and associated care coordination services developed pursuant to subsection (1)(a) of this section.
- On or before July 1, 2022, the statewide care coordination infrastructure developed pursuant to subsection (1)(a) of this section is the responsibility of the behavioral health administration established in section 27-60-203.
Source: L. 2021: Entire section added, (SB 21-137), ch. 362, p. 2374, § 19, effective June 28.
Editor's note: Section 38 of chapter 362 (SB 21-137), Session Laws of Colorado 2021, provides that section 19 of the act adding this section takes effect only if SB 21-288 becomes law and takes effect either upon the effective date of SB 21-137 or one day after the passage of SB 21-288, whichever is later. SB 21-288 became law and took effect June 11, 2021, and SB 21-137 took effect June 28, 2021.
Cross references: For the short title ("Behavioral Health Recovery Act of 2021") and the legislative declaration in SB 21-137, see sections 1 and 2 of chapter 362, Session Laws of Colorado 2021.
ARTICLE 61 BEHAVIORAL HEALTH TRANSFORMATION COUNCIL
27-61-101 and 27-61-102. (Repealed)
Source: L. 2018: Entire article repealed, (SB 18-161), ch. 123, p. 830, § 1, effective September 1.
Editor's note: This article was added in 2010. For amendments to this article prior to its repeal in 2018, consult the 2017 Colorado Revised Statutes and the Colorado statutory research explanatory note beginning on page vii in the front of this volume.
ARTICLE 62 HIGH-FIDELITY WRAPAROUND SERVICES FOR CHILDREN AND YOUTH
Cross references: For the legislative declaration in SB 19-195, see section 1 of chapter 190, Session Laws of Colorado 2019.
Section
27-62-101. Definitions.
As used in this article 62, unless the context otherwise requires:
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"At risk of out-of-home placement" means a child or youth who is eligible for medical assistance pursuant to articles 4, 5, and 6 of title 25.5 and the child or youth:
- Has been diagnosed as having a mental health disorder, as defined in section 27-65-102 (11.5), or a behavioral health disorder; and
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May require a level of care that is provided in a residential child care facility, inpatient psychiatric hospital, or other intensive care setting outside of the child's or youth's home. "At risk of out-of-home placement" includes a child or youth who:
- Is entering the division of youth services; or
- Is at risk of child welfare involvement.
- "Behavioral health disorder" means a substance use disorder, mental health disorder, or one or more substantial disorders of the cognitive, volitional, or emotional processes that grossly impair judgment or capacity to recognize reality or to control behavior, including serious emotional disturbances. "Behavioral health disorder" also includes those mental health disorders listed in the most recent versions of the diagnostic statistical manual of mental health disorders, the diagnostic classification of mental health and developmental disorders of infancy and early childhood, and the international statistical classification of diseases and related health problems.
- "Child and youth" means a person who is twenty-six years of age or younger.
- "Managed care entity" means an entity that enters into a contract to provide services in the statewide managed care system pursuant to articles 4, 5, and 6 of title 25.5.
- "Mental health professional" means an individual licensed as a mental health professional pursuant to article 245 of title 12 or a professional person as defined in section 27-65-102 (17).
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"Out-of-home placement" means a child or youth who is eligible for medical assistance pursuant to articles 4, 5, and 6 of title 25.5 and the child or youth:
- Has been diagnosed as having a mental health disorder, as defined in section 27-65-102 (11.5), or a behavioral health disorder; and
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May require a level of care that is provided in a residential child care facility, inpatient psychiatric hospital, or other intensive care setting outside of the child's or youth's home. "Out-of-home placement" includes a child or youth who:
- Has entered the division of youth services; or
- Is at risk of child welfare involvement.
- "Standardized assessment tool" means a multipurpose instrument that facilitates the link between assessment and level of care and individualized service planning, facilitates quality improvement activities, and allows for monitoring of outcomes of services.
- "State department" means the department of human services created pursuant to section 26-1-105.
- "Wraparound" means a high-fidelity, individualized, family-centered, strengths-based, and intensive care planning and management process used in the delivery of behavioral health services for a child or youth with a behavioral health disorder, commonly utilized as part of the system of care framework.
Source: L. 2019: Entire article added, (SB 19-195), ch. 190, p. 2101, § 4, effective August 2.
27-62-102. High-fidelity wraparound services for children and youth - interagency coordination - reporting.
- Pursuant to section 25.5-5-803 (4), the department of human services shall work collaboratively with the department of health care policy and financing, counties, and other relevant departments, as appropriate, to develop and oversee wraparound services for children and youth at risk of out-of-home placement or in an out-of-home placement. As part of routine collaboration, the department of human services shall assist the department of health care policy and financing in developing a model of sustainable funding for wraparound services. The department of human services and the department of health care policy and financing shall monitor and report the annual cost savings associated with eligible children and youth receiving wraparound services to the public through the annual hearing, pursuant to the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act", part 2 of article 7 of title 2.
- Subject to available appropriations, two full-time staff persons shall be appointed by the executive director of the department of human services to support and facilitate interagency coordination pursuant to this article 62, part 8 of article 5 of title 25.5, and any other related interagency behavioral health efforts as determined by the executive director of the department of human services.
Source: L. 2019: Entire article added, (SB 19-195), ch. 190, p. 2103, § 4, effective August 2. L. 2020: (2) amended, (HB 20-1384), ch. 172, p. 790, § 4, effective June 29.
27-62-103. Standardized assessment tool - standardized screening tools - interagency coordination - single referral and entry point.
- Standardized assessment tool. Subject to available appropriations, the state department shall select a single standardized assessment tool to facilitate identification of behavioral health issues and other related needs in children and youth and to develop a plan to implement the tool for programmatic utilization. The state department shall consult with the department of health care policy and financing, managed care entities, counties, stakeholders, and other relevant departments, as appropriate, prior to selecting the tool.
- Standardized screening tools. Subject to available appropriations, the state department shall select developmentally appropriate and culturally competent statewide behavioral health standardized screening tools for primary care providers serving children, youth, and caregivers in the perinatal period, including postpartum women. The state department and the department of human services may make the tools available electronically for health-care professionals and the public. Prior to the adoption of the standardized assessment tool described in subsection (1) of this section, and the standardized screening tools described in this subsection (2), the state department shall lead a public consultation process involving relevant stakeholders, including health-care professionals and managed care entities, with input from the department of health care policy and financing, the department of public health and environment, and the division of insurance.
- Single statewide referral and entry point. Subject to available appropriations, the state department, in conjunction with the department of health care policy and financing, the department of public health and environment, and other relevant departments and counties, as necessary, shall develop a plan for establishing a single statewide referral and entry point for children and youth who have a positive behavioral health screening or whose needs are identified through a standardized assessment. In developing the single statewide referral and entry point plan, the state department shall seek input from relevant stakeholders, including counties, managed care entities participating in the statewide managed care system, families of children and youth with behavioral health disorders, communities that have previously implemented wraparound services, mental health professionals, and other relevant departments.
Source: L. 2019: Entire article added, (SB 19-195), ch. 190, p. 2103, § 4, effective August 2. L. 2020: Entire section amended, (HB 20-1384), ch. 172, p. 791, § 5, effective June 29.
ARTICLE 63 COMMUNITY BEHAVIORAL HEALTH SAFETY NET SYSTEM
Cross references: For the legislative declaration in SB 19-222, see section 1 of chapter 226, Session Laws of Colorado 2019.
Section
27-63-101. Definitions.
As used in the article 63, unless the context otherwise requires:
- "Behavioral health" refers to an individual's mental and emotional well-being development and actions that affect an individual's overall wellness. Behavioral health problems and disorders include substance use disorders, serious psychological distress, suicidal ideation, and other mental health disorders. Problems ranging from unhealthy stress or subclinical conditions to diagnosable and treatable diseases are included in the term "behavioral health". An intellectual or developmental disability is insufficient to either justify or exclude a finding of a behavioral health disorder.
- "Department" means the department of human services.
Source: L. 2019: Entire article added, (SB 19-222), ch. 226, p. 2266, § 6, effective May 20.
27-63-102. High-intensity behavioral health treatment programs - identification - departments' duties.
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On or before July 1, 2020, the department, in collaboration with the department of health care policy and financing, shall:
-
Define what constitutes a high-intensity behavioral health treatment program, which at a minimum must include:
- A program that has evidence of effectiveness in engaging and treating individuals, including youth, with severe behavioral health disorders; and
- A program that conducts assertive outreach to and engagement with high-risk populations that are known and unknown to current health systems;
- Determine what an adequate network of high-intensity behavioral health treatment services includes by collaborating with stakeholders, which include but are not limited to, counties; law enforcement; community mental health centers; substance use providers; and other behavioral health providers, hospitals, physical health providers, and judicial districts, to understand what services and supports are needed to assist in the diversion and release of individuals with behavioral health disorders from the criminal justice and juvenile justice systems; and
- Identify existing high-intensity behavioral health treatment programs, based on the definition developed by the departments pursuant to subsection (1)(a) of this section, that are available throughout the state and where those programs require additional resources to meet the identified needs or where additional high-intensity behavioral health treatment programs are needed.
-
Define what constitutes a high-intensity behavioral health treatment program, which at a minimum must include:
Source: L. 2019: Entire article added, (SB 19-222), ch. 226, p. 2267, § 6, effective May 20.
27-63-103. Implementation plan - departments' duties - report.
- On or before November 1, 2020, the department, in collaboration with the department of health care policy and financing, shall develop an implementation plan to increase the number of high-intensity behavioral health treatment programs, including programs that serve youth, statewide.
- High-intensity behavioral health treatment programs must be available for both individuals under civil commitment and those involved with or at risk of involvement with the criminal or juvenile justice system, including individuals with co-occurring mental health and substance use disorders.
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The implementation plan must include the following information:
- Funding or legislative recommendations that are needed to appropriately implement the plan;
- Potential costs associated with increasing the number or availability of high-intensity behavioral health treatment programs and expanding statewide capacity;
- Potential cost-sharing opportunities with local municipalities and counties;
- Other recommendations on issues, such as local variables, zoning barriers, transportation, housing, and workforce; and
- How the departments' plan ensures high-intensity behavioral health outpatient treatment programs are available statewide.
- The department shall submit a report outlining the progress made toward ensuring that high-intensity behavioral health treatment programs are available statewide, based on the implementation plan. The report must be submitted to the joint budget committee of the general assembly no later than January 1, 2022.
Source: L. 2019: Entire article added, (SB 19-222), ch. 226, p. 2267, § 6, effective May 20.
27-63-104. Community behavioral health safety net system advisory body - creation - membership - repeal.
- The department shall identify an advisory body, referred to in this article 63 as the "advisory body", to assist the department in creating a comprehensive proposal to strengthen and expand the behavioral health safety net system. The advisory body shall include but not be limited to representatives from other relevant state departments, representatives from counties representing various regions of the state affected by community behavioral health service availability, representatives from law enforcement, consumers, family members of consumers, behavioral health providers, behavioral health administrative organizations, and advocates. Members of the advisory body shall disclose potential conflicts of interest and shall recuse themselves from voting when the member has a financial interest related to the provision of delivering clinical services in the behavioral health safety net system. Voting members of the advisory body shall not include behavioral health providers that have a potential financial interest related to the provision of delivering clinical services in the behavioral health safety net system.
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Safety net system comprehensive proposal.
- No later than July 1, 2021, the department, in collaboration with the advisory body, shall develop a comprehensive proposal to strengthen and expand the safety net system that provides behavioral health services for individuals with severe behavioral health disorders, referred to in this article 63 as a "safety net system", including individuals with co-occurring mental health and substance use disorders.
- The department and advisory body shall solicit feedback from community stakeholders and engage community stakeholders when developing the proposal described in subsection (2)(a) of this section, including direct engagement of consumers and consumers' families, managed service organizations, health-care providers, managed care entities, community mental health centers, and substance use disorder services providers.
-
The safety net system comprehensive proposal must, at a minimum:
- Identify what behavioral health services each community must have access to in each region of the state;
- Develop a funding model to ensure the viability of the safety net system. The funding model must supplement and not supplant any state funding to complement medicaid, federal substance abuse prevention and treatment block grants, federal mental health services block grants, and private pay funding.
- Provide locally responsive recommendations, including legislative recommendations, to address behavioral health provider licensing and regulations, housing, transportation, workforce, and any other barrier that curbs access to care; and
- Set forth criteria and processes, in collaboration with behavioral health providers, for when the needs of an individual referred to a safety net provider exceed the treatment capacity or clinical expertise of that provider.
- This section is repealed, effective July 1, 2024.
Source: L. 2019: Entire article added, (SB 19-222), ch. 226, p. 2268, § 6, effective May 20. L. 2020: (2)(b) amended, (SB 20-136), ch. 70, p. 300, § 57, effective September 14.
Cross references: For the legislative declaration in SB 20-136, see section 1 of chapter 70, Session Laws of Colorado 2020.
27-63-105. Safety net system implementation - safety net system criteria.
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No later than January 1, 2024, the department shall implement the comprehensive proposal and the funding model developed pursuant to section 27-63-104 (2), which shall meet the following criteria:
-
The safety net system must not refuse to treat an individual, including youth, based on the following:
- The individual's insurance coverage, lack of insurance coverage, or ability or inability to pay for behavioral health services;
- The individual's clinical acuity level related to the individual's behavioral health disorder, including whether the individual has been certified pursuant to article 65 of this title 27;
- The individual's readiness to transition out of the Colorado mental health institute at Pueblo, the Colorado mental health institute at Fort Logan, or any other mental health institute because the individual no longer requires inpatient care and treatment;
- The individual's involvement in the criminal or juvenile justice system;
- The individual's current involvement in the child welfare system;
- The individual's co-occurring mental health and substance use disorders, physical disability, or intellectual or developmental disability; or
- The individual's displays of aggressive behavior, or history of aggressive behavior, as a result of a symptom of a diagnosed mental health disorder or substance intoxication;
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The safety net system must:
- Proactively engage hard-to-serve individuals with adequate case management and care coordination throughout the care continuum;
- Promote competency in de-escalation techniques;
- Utilize adequate networks for timely access to treatment, including high-intensity behavioral health treatment and community treatment for children, youth, adults, and other individuals;
- Require collaboration with all local law enforcement jurisdictions and counties in the service area, including county departments of human or social services;
- Triage individuals who need alternative services outside the scope of the safety net system;
- Promote patient-centered care and cultural awareness;
- Update information as requested by the department about available treatment options and outcomes in each region of the state;
- Utilize evidence-based or evidence-informed programming to promote quality services; and
- Meet any other criteria established by the department.
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The safety net system must not refuse to treat an individual, including youth, based on the following:
- The safety net system must have a network of behavioral health-care providers that collectively offer a full continuum of services to ensure individuals with severe behavioral health disorders are triaged in a timely manner to the appropriate care setting if an individual behavioral health-care provider is unable to provide ongoing care and treatment for the individual. The department shall consider community mental health centers, managed service organizations, contractors for the statewide behavioral health crisis response system, and other behavioral health community providers as key elements in the behavioral health safety net system.
Source: L. 2019: Entire article added, (SB 19-222), ch. 226, p. 2269, § 6, effective May 20.
27-63-106. Safety net system - effectiveness - report.
- From January 1, 2022, until July 1, 2024, the department shall provide an annual report on the progress made by the department on the behavioral health safety net system to the public through the annual hearing, pursuant to the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act", part 2 of article 7 of title 2.
- Notwithstanding section 24-1-136 (11)(a)(I), no later than January 1, 2025, the department shall provide an annual report to the joint budget committee of the general assembly related to the expenditures, outcomes, and effectiveness of the safety net system by service area region, including any recommendations to improve the system and the transparency of the system.
Source: L. 2019: Entire article added, (SB 19-222), ch. 226, p. 2271, § 6, effective May 20.
ARTICLE 64 988 CRISIS HOTLINE ENTERPRISE
Section
27-64-101. Legislative declaration.
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The general assembly finds and declares that:
- On July 16, 2020, the federal communications commission adopted rules, and on October 17, 2020, congress passed the "National Suicide Hotline Designation Act of 2020", designating 988 as the three-digit number for the national suicide prevention lifeline to aid rapid access to suicide prevention and mental health support services;
- It is imperative for Colorado to implement 988 as the three-digit number for crisis response services in Colorado in order to comply with federal regulations; improve quality and access to behavioral health crisis services, especially for underserved populations and in rural areas of the state; and reduce stigma surrounding suicide, mental health, and substance use conditions;
- The 988 crisis hotline enterprise provides valuable benefits and services to telephone service users when the enterprise funds the 988 crisis hotline and provides crisis outreach, stabilization, and acute care to individuals calling the 988 crisis hotline from any jurisdiction in Colorado twenty-four hours a day, seven days a week;
- By providing the benefits and services specified in subsection (1)(c) of this section, the 988 crisis hotline enterprise engages in an activity conducted in the pursuit of a benefit, gain, or livelihood, and therefore operates as a business;
- Consistent with the determination of the Colorado supreme court in Nicholl v. E-470 Public Highway Authority, 896 P.2d 859 ( Colo. 1995 ), that the power to impose taxes is inconsistent with enterprise status under section 20 of article X of the state constitution, it is the conclusion of the general assembly that the charges imposed by the enterprise is a fee, not a tax, because the charges are imposed for the specific purpose of allowing the enterprise to defray the costs of providing the benefits and services specified in subsection (1)(c) of this section to telephone service users and the charges are imposed at rates that are reasonably calculated based on the cost of the services received by telephone service users;
- So long as the 988 crisis hotline enterprise qualifies as an enterprise for purposes of section 20 of article X of the state constitution, the revenue from the charges imposed by the enterprise are not state fiscal year spending, as defined in section 24-77-102 (17), or state revenues, as defined in section 24-77-103.6 (6)(c) , and do not count against either the state fiscal year spending limit imposed by section 20 article X of the state constitution or the excess state revenues cap, as defined in section 24-77-103.6 (6)(b)(I) ; and
- No other enterprise created simultaneously or within the preceding five years serves primarily the same purpose as the 988 crisis hotline enterprise and the 988 crisis hotline enterprise will generate revenue from charges of less than one hundred million dollars total in its first five fiscal years. Accordingly, the creation of the 988 crisis hotline enterprise does not require voter approval pursuant to section 24-77-108 .
Source: L. 2021: Entire article added, (SB 21-154), ch. 360, p. 2343, § 1, effective September 7.
27-64-102. Definitions.
As used in this article 64, unless the context otherwise requires:
- "988 crisis hotline" means a state-identified hotline participating in the national suicide prevention lifeline network to respond to statewide or regional behavioral health crisis calls.
- "Charge" means the 988 surcharge imposed by the enterprise pursuant to section 27-64-103 (4)(a) and the prepaid wireless 988 charge imposed by the enterprise pursuant to section 27-64-103 (4)(b).
- "Enterprise" means the 988 crisis hotline enterprise created in section 27-64-103.
- "National suicide prevention lifeline" means a national network of local crisis centers maintained by the federal substance abuse and mental health services administration that provides free and confidential emotional support to people in suicidal crisis or emotional distress twenty-four hours a day, seven days a week.
- "Veterans crisis line" means the veterans crisis line maintained by the United States department of veterans affairs.
Source: L. 2021: Entire article added, (SB 21-154), ch. 360, p. 2344, § 1, effective September 7.
27-64-103. 988 crisis hotline enterprise - creation - powers and duties.
- There is created in the department of human services the 988 crisis hotline enterprise. The enterprise is and operates as a government-owned business within the department of human services for the business purpose of imposing charges pursuant to subsections (4)(a) and (4)(b) of this section, and utilizing the charges' revenue to fund the 988 crisis hotline and provide crisis outreach, stabilization, and acute care to individuals calling the 988 crisis hotline. The enterprise exercises its power and performs its duties as if the same were transferred by a type 1 transfer, as defined in section 24-1-105, to the state department.
- The enterprise constitutes an enterprise for purposes of section 20 of article X of the state constitution so long as it retains the authority to issue revenue bonds and receives less than ten percent of its total revenues in grants from all Colorado state and local governments combined. So long as it constitutes an enterprise pursuant to this subsection (2), the enterprise is not subject to section 20 of article X of the state constitution.
- The enterprise is governed by a board of directors appointed by the governor.
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The enterprise's primary powers and duties are to:
- Effective January 1, 2022, impose a 988 surcharge on service users, as defined in section 40-17.5-101 (13), in an amount to be established annually by the enterprise, in collaboration with the public utilities commission, but not to exceed thirty cents per month per 988 access connection, as defined in section 40-17.5-101 (2). On or before October 1, 2021, and on or before October 1 of each year thereafter, the enterprise, in collaboration with the public utilities commission, shall establish the amount of the surcharge for the next calendar year. The amount of the surcharge must be reasonably calculated based on the cost of the services received by telephone service users. The amount of the surcharge imposed per 988 access connection must be uniform, regardless of the technology used to provide the 988 access connection.
- Effective January 1, 2022, impose a prepaid wireless 988 charge on each retail transaction, as defined in section 40-17.5-104 (1)(d), in an amount to be established annually by the enterprise, in collaboration with the public utilities commission, but not to exceed thirty cents per each retail transaction in which prepaid wireless service is purchased in Colorado. On or before October 1, 2021, and on or before October 1 of each year thereafter, the enterprise, in collaboration with the public utilities commission, shall establish the amount of the charge for the next calendar year. The amount of the charge must be reasonably calculated to meet the needs of the enterprise.
- As required by subsection (5) of this section, fund the 988 crisis hotline to provide intervention services and crisis care coordination to individuals calling the 988 crisis hotline;
-
- Engage the services of third parties serving as crisis vendors to provide crisis outreach, stabilization, acute care, and marketing for the 988 crisis hotline;
- Enter into any other contracts necessary for professional and technical assistance and advice and to supply other services related to the conduct of the affairs of the enterprise, without regard to the "Procurement Code", articles 101 to 112 of title 24.
- The department of human services shall provide office space and administrative staff to the enterprise pursuant to a contract entered into pursuant to subsection (4)(d)(II) of this section.
- By resolution, authorize and issue revenue bonds that are payable only from the money in the 988 crisis hotline cash fund created in section 27-64-104; and
- Adopt, amend, or repeal policies for the regulation of its affairs and the conduct of its business consistent with this section.
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- On or before July 1, 2022, the enterprise shall fund a nonprofit organization to operate the 988 crisis hotline and provide intervention services and crisis care coordination to individuals calling the 988 crisis hotline from any jurisdiction within Colorado twenty-four hours a day, seven days a week.
-
The nonprofit organization shall:
- Have an active agreement with the administrator of the national suicide prevention lifeline for participation within the network;
- Meet the national suicide prevention lifeline requirements and best practice guidelines for operational and clinical standards;
- Meet the national suicide prevention lifeline requirements for serving high-risk and specialized populations;
- Deploy mobile response units and co-responder programs that are part of the behavioral health crisis response system, created pursuant to section 27-60-103, and coordinate access to crisis walk-in centers, as appropriate; and
- Provide follow-up services to individuals accessing the 988 crisis hotline.
- The enterprise shall collaborate with the national suicide prevention lifeline and the veterans crisis line for the purpose of ensuring consistent public messaging about the 988 crisis hotline center and available services.
- The enterprise shall consider recommendations from the state's 988 planning committee to determine how the 988 crisis hotline will interact with the twenty-four-hour telephone crisis services established in section 27-60-103 (1)(b)(I).
- The enterprise is subject to the open meetings provisions of the "Colorado Sunshine Act of 1972", contained in part 4 of article 6 of title 24, and the "Colorado Open Records Act", part 2 of article 72 of title 24.
- For purposes of the "Colorado Open Records Act", part 2 of article 72 of title 24, and except as may otherwise be provided by federal law or regulation or state law, the records of the enterprise are public records, as defined in section 24-72-202 (6), regardless of whether the enterprise receives less than ten percent of its total annual revenue in grants, as defined in section 24-77-102 (7), from all Colorado state and local governments combined.
- The enterprise is a public entity for purposes of part 2 of article 57 of title 11.
Source: L. 2021: Entire article added, (SB 21-154), ch. 360, p. 2345, § 1, effective September 7.
27-64-104. 988 crisis hotline cash fund - creation.
- The 988 crisis hotline cash fund, referred to in this section as the "fund", is created in the state treasury. The fund consists of money credited to the fund in accordance with article 17.5 of title 40.
- The state treasurer shall credit all interest and income derived from the deposit and investment of money in the fund to the fund.
- Subject to annual appropriation by the general assembly, the enterprise may expend money from the fund for the purposes outlined in section 27-64-103 (4)(c) and (4)(d).
- The board may seek, accept, and expend gifts, grants, or donations from private or public sources for the purposes of this section, so long as the combination of grants from state and local governments is less than ten percent of the enterprise's total annual revenue.
Source: L. 2021: Entire article added, (SB 21-154), ch. 360, p. 2347, § 1, effective September 7.
27-64-105. Reports.
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Beginning January 1, 2023, and each January 1 thereafter, the department of human services shall:
- Submit information about the usage of the 988 crisis hotline and services provided to the federal substance abuse and mental health services administration and information about the expenditures of the 988 crisis hotline cash fund to the federal communications commission; and
- Report progress on the implementation of the 988 crisis hotline, including the usage of the 988 crisis hotline, the services provided, and the deposits and expenditures from the 988 crisis hotline cash fund as part of its "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" hearing required by section 2-7-203.
Source: L. 2021: Entire article added, (SB 21-154), ch. 360, p. 2347, § 1, effective September 7.
MENTAL HEALTH AND MENTAL HEALTH DISORDERS
ARTICLE 65 CARE AND TREATMENT OF PERSONS WITH MENTAL HEALTH DISORDERS
Editor's note: This article was added with relocations in 2010 containing provisions of article 10 of this title. Former C.R.S. section numbers are shown in editor's notes following those sections that were relocated. For a detailed comparison of this article, see the comparative tables located in the back of the index.
Cross references: For provisions concerning home- and community-based services for persons with intellectual and developmental disabilities, see part 4 of article 6 of title 25.5; for liability of mental health care providers, see § 13-21-117.
Law reviews: For article, "Expanded Medical Screening for Public Sector Psychiatric Patients", see 13 Colo. Law. 1651 (1984); for article "Medina: Incompetence and the Right to Refuse Medication", see 14 Colo. Law. 1998 (1985); for article, "A Critique of the Model State Law on Civil Commitment of the Mentally Ill", see 14 Colo. Law. 1206 (1985); for article, "Colorado Guardianship and Conservatorship Law: A Status Report", see 16 Colo. Law. 421 (1987); for article, "The Continuing Crisis in Mental Health Care", see 18 Colo. Law. 1533 (1989); for article, "When Worlds Collide: Mentally Ill Criminal Defendants--Part II", see 29 Colo. Law. 101 (July 2000); for article, "Guidance for Attorneys When Children's Mental Health Concerns are Implicated", see 31 Colo. Law. 33 (Oct. 2002).
Section
27-65-101. Legislative declaration.
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The general assembly declares that, subject to available appropriations, the purposes of this article 65 are:
- To secure for each person with a mental health disorder such care and treatment suited to his or her 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;
- To deprive a person of his or her liberty for purposes of care or treatment only when less restrictive alternatives are unavailable and only when his or her safety or the safety of others is endangered;
- To provide the fullest possible measure of privacy, dignity, and other rights to persons undergoing care and treatment for a mental health disorder;
- 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;
- 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;
- 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
- To facilitate the recovery and resiliency of each person who receives care and treatment pursuant to this article 65.
- To carry out these purposes, subject to available appropriations, the provisions of this article shall be liberally construed.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 675, § 2, effective April 29. L. 2017: (1) amended, (SB 17-242), ch. 263, p. 1338, § 232, effective May 25.
Editor's note: This section is similar to former § 27-10-101 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
ANNOTATION
Law reviews. For article, "Patients' Rights vs. Patients' Needs: The Right of the Mentally Ill to Refuse Treatment in Colorado", see 58 Den. L.J. 567 (1981).
Annotator's note. Since § 27-65-101 is similar to § 27-10-101 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
The intent of this article is to provide services to all mentally ill persons, as defined, not just to those persons who are so mentally ill as to be gravely disabled or an imminent danger to themselves or others. Goebel v. Colo. Dept. of Institutions, 830 P.2d 1036 ( Colo. 1992 ).
The statutory scheme for the care and treatment of mentally ill persons is calculated (1) to provide care and treatment adequately suited to the needs of patients in a dignified and least restrictive manner and (2) to ensure against premature release of patients when that release would pose a likely risk of serious bodily harm to the patient or others as a result of the patient's mental condition. Perreira v. State, 768 P.2d 1198 ( Colo. 1989 ); People in Interest of Reynes, 870 P.2d 518 (Colo. App. 1993).
Difference from criminal commitment not violative of equal protection. The differences in the commitment procedures and standards of release for criminal and civil commitments do not violate equal protection of the laws. People v. Chavez, 629 P.2d 1040 (Colo. 1981).
Entire tenor of this article is to recognize and protect the dignity and legal rights of patients treated pursuant to its provisions. Goedecke v. State Dept. of Insts., 198 Colo. 407 , 603 P.2d 123 (1979).
Concern of general assembly was to devise system which protects rights of the individual while, at the same time, creating a method to discover the truth of the patient's mental illness and whether this illness causes the individual to be a danger to others or to himself or to be gravely disabled. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
This article applies to both voluntary and involuntary patients. Goebel v. Colo. Dept. of Institutions, 764 P.2d 785 ( Colo. 1988 ); Goebel v. Colo. Dept. of Institutions, 830 P.2d 1036 ( Colo. 1992 ).
Primary purpose of civil commitment is to secure such treatment as is suited to the needs of the person under conditions which are as least restrictive of liberty as practicable. People v. Chavez, 629 P.2d 1040 (Colo. 1981).
This act applies to those who are mentally ill and seek treatment before they become so mentally ill as to be dangerous or gravely disabled. Goebel v. Colo. Dept. of Institutions, 830 P.2d 1036 ( Colo. 1992 ).
Article is to be strictly construed to see that no limit is placed on a person's right to seek voluntary treatment. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
The provisions of this article must be strictly construed because of their curtailment of personal liberty. People in Interest of Bucholz, 778 P.2d 300 (Colo. App. 1989).
Powers to confine carefully restrained. The state's power to confine persons on the basis of mental illness must be carefully restrained by procedural safeguards, and can be invoked only by conditions great enough to justify such a massive curtailment of liberty. People v. Lane, 196 Colo. 42 , 581 P.2d 719 (1978).
Disability sufficient to justify involuntary commitment must arise as result of mental illness; and in keeping with the statutory purpose, it must be so grave that the person's safety is threatened by his inability to take care of his basic personal needs. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Mere disability alone is insufficient to warrant involuntary commitment. Mere disability alone, even if found in conjunction with mental illness, is not enough to warrant involuntary commitment. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Duty of a therapist to protect third persons from harm must be measured by the foreseeability of the risk and whether the danger created is sufficiently large to embrace the specific harm. Brady v. Hopper, 570 F. Supp. 1333 (D. Colo. 1983) (decided prior to enactment of § 13-21-117).
The therapist-patient relationship is one which under certain circumstances will give rise to a duty on the part of the therapist to protect third persons from harm. Brady v. Hopper, 570 F. Supp. 1333 (D. Colo. 1983) (decided prior to enactment of § 13-21-117).
For due process considerations in civil commitment proceedings, see People v. Chavez, 629 P.2d 1040 (Colo. 1981).
Less restrictive alternatives need not be considered as a condition precedent to certification. Civil commitment constitutes a severe infringement of liberty requiring due process protection. However, the statutory scheme set forth in this article contains a number of procedural safeguards that greatly reduce the inherent risk of erroneous deprivation. Therefore, due process does not require a mandatory hearing at the time of certification since the statute provides for a hearing on request. People v. Stevens, 761 P.2d 768 (Colo. 1988).
Psychologist-client privilege. In keeping with the statutory goal of securing care and treatment on an individual basis, former § 27-10-120 is intended as an authorization for a psychologist to testify to observations concerning an involuntarily detained person when the issue before the court is whether the statutory conditions for certification for short-term treatment have been satisfied. People v. District Court, 797 P.2d 1259 (Colo. 1990).
Applied in People in Interest of Paiz, 43 Colo. App. 352, 603 P.2d 976 (1979); Sisneros v. District Court, 199 Colo. 179 , 606 P.2d 55 (1980); People in Interest of Freeman, 636 P.2d 1334 (Colo. App. 1981); People v. White, 656 P.2d 690 ( Colo. 1983 ).
27-65-102. Definitions.
As used in this article 65, unless the context otherwise requires:
-
"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.
(1.5) [ Editor's note: Subsection (1.5) is effective July 1, 2022. ] "Behavioral health entity" means a facility or provider organization engaged in providing community-based health services, which may include behavioral health disorder services, alcohol use disorder services, or substance use disorder services, including crisis stabilization, acute or ongoing treatment, or community mental health center services as described in section 27-66-101 (2) and (3), but does not include:
- Residential child care facilities as defined in section 26-6-102 (33); or
- Services provided by a licensed or certified mental health-care provider under the provider's individual professional practice act on the provider's own premises.
- "Certified peace officer" means any certified peace officer as described in section 16-2.5-102, C.R.S.
- "Court" means any district court of the state of Colorado and the probate court in the city and county of Denver.
-
"Court-ordered evaluation" means an evaluation ordered by a court pursuant to section 27-65-106.
(4.5) "Danger to self or others" means:
- With respect to an individual, that the individual poses a substantial risk of physical harm to himself or herself as manifested by evidence of recent threats of or attempts at suicide or serious bodily harm to himself or herself; or
- With respect to other persons, that the individual 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.
-
"Department" means the department of human services.
(5.5) "Emergency medical services facility" means a facility licensed pursuant to part 1 of article 3 of title 25 or certified pursuant to section 25-1.5-103, or any other licensed and certified facility that provides emergency medical services. An emergency medical services facility is not required to be, but may elect to become, a facility designated or approved by the executive director for a seventy-two-hour treatment and evaluation pursuant to section 27-65-105.
- "Executive director" means the executive director of the department of human services.
-
[ Editor's note: This version of subsection (7) is effective until July 1, 2022.] "Facility" means a public hospital or a licensed private hospital, clinic, community mental health center or clinic, acute treatment unit, institution, or residential child
care facility that provides treatment for persons with mental health disorders.
(7) [ Editor's note: This version of subsection (7) is effective July 1, 2022. ] "Facility" means a public hospital or a licensed private hospital, clinic, behavioral health entity, community mental health center or clinic, acute treatment unit, institution, or residential child care facility that provides treatment for persons with mental health disorders.
- "Family member" means a spouse, parent, adult child, or adult sibling of a person with a mental health disorder.
- "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 his or her 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 his or her essential needs that could result in substantial bodily harm. A person of any age may be "gravely disabled", but such term does not include a person whose decision-making capabilities are limited solely by his or her developmental disability.
- "Hospitalization" means twenty-four-hour out-of-home placement for treatment in a facility for a person with a mental health disorder.
-
"Independent professional person" means a professional person, as defined in subsection (17) of this section, 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 mental health facility if he or she 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 27-65-103 (3).
(11.3) "Intervening professional" means a person described in section 27-65-105 (1)(a)(II) who may effect a seventy-two-hour hold under the provisions outlined in section 27-65-105.
(11.5) "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.
- "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 his or her parent or legal guardian and is managing his or her financial affairs, regardless of his or her source of income, or who is married and living separately and apart from his or her parent or legal guardian.
- "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 27-65-103 (5).
- Repealed.
- "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.
- "Physician" means a person licensed to practice medicine in this state.
- "Professional person" means a person licensed to practice medicine in this state, a psychologist certified to practice in this state, or a person licensed and in good standing to practice medicine in another state or a psychologist certified 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.
- "Residential child care facility" means a facility licensed by the state department of human services pursuant to article 6 of title 26, C.R.S., to provide group care and treatment for children as such facility is defined in section 26-6-102 (33), C.R.S. A residential child care facility may be eligible for designation by the executive director of the department of human services pursuant to this article.
- "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.
- "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, comprehensive evaluation, treatment, referral, and other appropriate services, either on an inpatient or an outpatient basis.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 676, § 2, effective April 29. L. 2013: (17) amended, (HB 13-1065), ch. 42, p. 115, § 1, effective March 15; (9) amended, (HB 13-1296), ch. 232, p. 1112, § 2, effective July 1, 2014; (4.5) added, (HB 13-1296), ch. 232, p. 1112, § 2, effective October 22. L. 2016: (18) amended, (SB 16-189), ch. 210, p. 783, § 79, effective June 6. L. 2017: IP, (1), (7), (8), (10), (15), and (19) amended, (11.3) and (11.5) added, and (14) repealed, (SB 17-242), ch. 263, p. 1339, § 233, effective May 25; IP amended and (5.5) and (11.3) added, (SB 17-207), ch. 205, p. 765, § 6, effective May 1, 2018. L. 2019: (1.5) added and (7) amended, (HB 19-1237), ch. 413, p. 3641, § 13, effective July 1, 2022.
Editor's note:
- This section is similar to former § 27-10-102 as it existed prior to 2010.
- SB 17-242, adding subsection (11.3) was superseded by SB 17-207, adding subsection (11.3), effective May 1, 2018.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017. For the legislative declaration in SB 17-207, see section 1 of chapter 205, Session Laws of Colorado 2017.
ANNOTATION
Law reviews. For article on commitment of mental patients, see 13 Rocky Mt. L. Rev. 99 (1941). For article, "Liability of Counties for Support of Inmates in State Institutions", see 29 Dicta 27 (1952). For article, "Commitment Procedures in Colorado", see 29 Dicta 273 (1952). For article, "Legal Capacity of Adjudged Incompetents", see 29 Dicta 292 (1952). For article, "Civil Commitment of the Mentally Ill in the Denver Probate Court", see 46 Den. L.J. 496 (1969). For article, "Due Process in Involuntary Civil Commitment and Incompetency Adjudication Proceedings: Where Does Colorado Stand?", see 46 Den. L.J. 516 (1969). For article, "The Supreme Court Sidesteps the Right to Treatment Question; O'Conner v. Donaldson", see 47 U. Colo. L. Rev. 299 (1976). For article, "Patients' Rights vs. Patients' Needs: The Right of the Mentally Ill to Refuse Treatment in Colorado", see 58 Den. L.J. 567 (1981). For article, "The Homeless and the Law", see 14 Colo. Law. 405 (1985). For article, "Group Home Regulations Under State and Federal Law", see 35 Colo. Law. 37 (Feb. 2006). For article, "How to Reconcile Advance Care Directives With Attempted Suicide", see 42 Colo. Law. 97 (July 2013).
Annotator's note. Since § 27-65-102 is similar to § 27-10-102 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
Definitions in former subsections (5) and (7) are sufficiently clear and definite. The definitions of mental illness and of the condition of being gravely disabled in former subsections (5) and (7) are sufficiently clear and definite to apprise both lay and professional persons of the type of conduct necessary for certification for short-term treatment. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Definition of "gravely disabled" in former subsection (5) refers to an existing rather than a prospective inability to provide for one's "basic personal needs". The determination at a certification hearing as to whether a person is "gravely disabled" must focus on the individual's existing condition, and not on the possibility of future relapse. People in Interest of Bucholz, 778 P.2d 300 (Colo. App. 1989).
Phrase "basic personal needs" means those fundamental necessities of human existence, such as food, shelter, clothing, and medical care, which an individual must obtain and maintain in order to live safely. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Statutory definition of mental illness, on its own terms, cannot be read to intend that every idiosyncratic or eccentric person requires involuntary medical intervention. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
It is necessary prerequisite to ordering short-term involuntary psychiatric treatment that the professional treatment and evaluation staff find, after analysis, that the person for whom certification is sought is mentally ill and, as a result of mental illness, is a danger to others or to himself or is gravely disabled. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
For previous definition of "insane person", see Arridy v. People, 103 Colo. 29 , 82 P.2d 757 (1938); Browne v. Smith, 119 Colo. 469 , 205 P.2d 239 (1949).
Applied in People in Interest of Paiz, 43 Colo. App. 352, 603 P.2d 976 (1979).
27-65-103. Voluntary applications for mental health services - treatment of minors.
- Nothing in this article 65 in any way limits the right of any person to make 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 hospital or institutional care and treatment for a mental health disorder by consent of the guardian for so long as the ward agrees to such care and treatment. Within ten days after any such admission, the guardian shall notify in writing the court that appointed the guardian of the admission.
- 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 or by 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 shall not be 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 parent or legal guardian of the minor of the services given or needed.
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A minor who is fifteen years of age or older or a parent or legal guardian of a minor on the minor's behalf may make voluntary application for hospitalization. Application for hospitalization on behalf of a minor who is under fifteen years of age and
who is a ward of the department of human services shall 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 appoint a guardian ad litem forthwith. Procedures for hospitalization of such minor may proceed pursuant to this section once a petition for appointment
of a guardian ad litem has been filed, if necessary. Whenever such 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 parents or legal guardian and the school and any other social agencies. Prior to admitting a minor for hospitalization, the independent professional person shall
make the following findings:
- That the minor has a mental health disorder and is in need of hospitalization;
- That a less restrictive treatment alternative is inappropriate or unavailable; and
- That hospitalization is likely to be beneficial.
- An interview and investigation by an independent professional person shall not be required for a minor who is fifteen years of age or older and who, upon the recommendation of his or her treating professional person, seeks voluntary hospitalization with the consent of his or her 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 his or her right to refuse to sign the admission consent form and his or her right to revoke his or her consent at a later date. If a minor admitted pursuant to this subsection (4) subsequently revokes his or her consent after admission, a review of his or her need for hospitalization pursuant to subsection (5) of this section shall be initiated immediately.
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- The need for continuing hospitalization of all voluntary patients who are minors shall be formally reviewed at least every two months. Review pursuant to this subsection (5) shall fulfill the requirement specified in section 19-1-115 (8), C.R.S., when the minor is fifteen years of age or older and consenting to hospitalization.
- The review shall be conducted by an independent professional person who is not a member of the minor's treating team; or, if the minor, his or her physician, and the minor's parent or guardian do not object to the need for continued hospitalization, the review required pursuant to this subsection (5) may be conducted internally by the hospital staff.
- The independent professional person shall determine whether the minor continues to meet the criteria specified in subsection (3) of this section and whether continued hospitalization is appropriate and shall at least conduct an investigation pursuant to subsection (3) of this section.
- 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 his or her wishes concerning continued hospitalization.
- Nothing in this section shall be construed to limit a minor's right to seek release from the facility pursuant to any other provisions under the law.
- Every six months the review required pursuant to subsection (5) 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 child pursuant to subsection (5) of this section.
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- When a minor does not consent to or objects to continued hospitalization, the need for such continued hospitalization shall, within ten days, be reviewed pursuant to subsection (5) 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 child pursuant to this subsection (7). The minor shall be informed of the results of such review within three days of completion of such review. If the conclusion reached by such professional person is that the minor no longer meets the standards for hospitalization specified in subsection (3) of this section, the minor shall be discharged.
- If, twenty-four hours after being informed of the results of the review specified in paragraph (a) of this subsection (7), a minor continues to affirm the objection to hospitalization, the minor shall be advised by the director of the facility or his or her duly appointed representative that the minor has the right to retain and consult with an attorney at any time and that the director or his or her 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, his or her attorney, if any, and his or her parent, legal guardian, or guardian ad litem, if any, shall also 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 paragraph (d) of this subsection (7).
- Whenever the statement requesting an attorney is filed with the court, the court shall ascertain whether the minor has retained counsel, and, if he or she 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.
- The minor or his or her attorney or guardian ad litem may, at any time after the minor has continued to affirm his or her objection to hospitalization pursuant to subsection (7)(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 to the minor; his or her attorney, if any; his or her parents or legal guardian; his or her guardian ad litem, if any; the independent professional person; and the minor's treating team of the time and place of the hearing. The hearing must be held in accordance with section 27-65-111; 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: That the minor has a mental health disorder and is in need of hospitalization, that a less restrictive treatment alternative is inappropriate or unavailable, and that hospitalization is likely to be beneficial. 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.
- For purposes of this subsection (7), "objects to hospitalization" means that a minor, with the necessary assistance of hospital staff, has written his or her 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.
- A minor may not again object to hospitalization pursuant to this subsection (7) until ninety days after conclusion of proceedings pursuant to this subsection (7).
- In addition to the rights specified under section 27-65-117 for persons receiving evaluation, care, or treatment, a written notice specifying the rights of minor children under this section shall be given to each minor upon admission to hospitalization.
- A minor who no longer meets the standards for hospitalization specified in subsection (3) of this section shall be discharged.
- For the purpose of this article, the treatment by prayer in the practice of the religion of any church which teaches reliance on spiritual means alone for healing shall be considered a form of treatment.
- 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.
- Voluntary patients shall be afforded all the rights and privileges customarily granted by hospitals to their patients.
- If at any time during a seventy-two-hour evaluation of a person who is confined involuntarily the facility staff requests the person to sign in voluntarily and he or she elects to do so, the following advisement shall be given orally and in writing and an appropriate notation shall be made in his or her medical record by the professional person or his or her 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.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 679, § 2, effective April 29. L. 2015: (2) amended, (HB 15-1032), ch. 40, p. 100, § 1, effective March 20. L. 2017: (1), (3)(a), (7)(d), and (10) amended, (SB 17-242), ch. 263, p. 1340, § 234, effective May 25. L. 2019: (2) amended, (HB 19-1172), ch. 136, p. 1713, § 198, effective October 1.
Editor's note: This section is similar to former § 27-10-103 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
ANNOTATION
Law reviews. For article, "Commitment Procedures in Colorado", see 29 Dicta 273 (1952). For article, "Legal But Not Fair: Legal Implications of a Mental Illness Medical Model", see 11 Colo. Law. 1234 (1982). For article, "Legislative Update", see 12 Colo. Law. 1251 (1983). For article, "Legislative Update", see 13 Colo. Law. 1419 (1984). For article, "Consent to Treatment and Access to Minors' Medical Records", see 17 Colo. Law. 1323 (1988). For article, "Nailing Jello to the Wall: Colorado Regulates Psychotherapists", see 19 Colo. Law. 71 (1990).
No limit on right to seek voluntary treatment. This article is to be strictly construed to see that no limit is placed on a person's right to seek voluntary treatment. People v. Taylor, 618 P.2d 1127 (Colo. 1980) (decided prior to 2010 amendments to this article).
Subsection (3) unconstitutional. Subsection (3) cannot withstand constitutional scrutiny because it contains no admission standard to be applied by the hospital staff when determining whether or not to accept a minor for treatment. In re P.F. v. Walsh, 648 P.2d 1067 (Colo. 1982) (decided prior to 1983 repeal of subsection (3)).
27-65-104. Rights of respondents.
Unless specifically stated in an order by the court, a respondent shall not forfeit any legal right or suffer legal disability by reason of the provisions of this article.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 682, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-104 as it existed prior to 2010.
ANNOTATION
Law reviews. For article, "Legal Capacity of Adjudged Incompetents", see 29 Dicta 292 (1952). For article, "Legal But Not Fair: Legal Implications of a Mental Illness Medical Model", see 11 Colo. Law. 1234 (1982).
Annotator's note. Since § 27-65-104 is similar to § 27-10-104 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
Patient's common-law right to decline medical treatment is among those protected by this section and is preserved intact in the absence of some finding that the patient's illness has so impaired his judgment that he is incapable of participating in decisions affecting his health. Goedecke v. State Dept. of Insts., 198 Colo. 407 , 603 P.2d 123 (1979).
Right of incompetent to decline treatment. The right to decline medical treatment is not lost to a patient who is mentally incapable of deciding that question for himself. People in Interest of Medina, 662 P.2d 184 (Colo. App. 1982), aff'd, 705 P.2d 961 ( Colo. 1985 ).
When nonconsensual treatment may be ordered. Treatment with antipsychotic medication should not be ordered unless: (1) The patient is incompetent to effectively participate in the treatment decision; (2) such treatment is necessary to prevent long-term deterioration in the patient's mental condition; (3) a less intrusive treatment is not available; and (4) the patient's need for such treatment overrides any legitimate interest of the patient in refusing treatment. In any event, and the order for involuntary medication cannot exceed six months without further extension. People v. Medina, 705 P.2d 961 (Colo. 1985).
Medina test for forcibly administering medication applies equally to a forcible increase in medication dosage. The second Medina element requires a patient to be deteriorating, which does not mean the same thing as "not improving". A patient who is simply not improving will not satisfy the Medina test for forcible administration of medication. People v. Marquardt, 2016 CO 4, 364 P.3d 499.
The fourth factor dictated in Medina was met when the court reduced dosage of antipsychotic medication to minimize side effects suffered by plaintiff. Clear and convincing evidence existed that the need for the drug, as ordered to be administered by the trial court, outweighed all legitimate interests the petitioner had in refusing such treatment. Donaldson v. District Court for the City and County of Denver, 847 P.2d 632 (Colo. 1993).
For capacity of incompetent to contract and to execute deeds, see Rohrer v. Darrow, 66 Colo. 463 , 182 P. 13 (1919); Davis v. Colo. Kenworth Corp., 156 Colo. 98 , 396 P.2d 958 (1964).
Applied in People in Interest of Freeman, 636 P.2d 1334 (Colo. App. 1981).
27-65-105. Emergency procedure.
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Emergency procedure may be invoked under one of the following conditions:
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- When any person appears to have a mental health disorder and, as a result of such mental health disorder, appears to be an imminent danger to others or to himself or herself or appears to be gravely disabled, then an intervening professional, as specified in subsection (1)(a)(II) of this section, upon probable cause and with such assistance as may be required, may take the person into custody, or cause the person to be taken into custody, and placed in a facility designated or approved by the executive director for a seventy-two-hour treatment and evaluation. If such a facility is not available, the person may be taken to an emergency medical services facility.
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The following persons may act as intervening professionals to effect a seventy-two-hour hold, as provided in subsections (1)(a)(I) and (1)(a)(I.5) of this section:
- A certified peace officer;
- A professional person;
- A registered professional nurse as defined in section 12-255-104 (11) who by reason of postgraduate education and additional nursing preparation has gained knowledge, judgment, and skill in psychiatric or mental health nursing;
- A licensed marriage and family therapist, licensed professional counselor, or addiction counselor licensed under part 5, 6, or 8 of article 245 of title 12 who, by reason of postgraduate education and additional preparation, has gained knowledge, judgment, and skill in psychiatric or clinical mental health therapy, forensic psychotherapy, or the evaluation of mental health disorders; or
- A licensed clinical social worker licensed under the provisions of part 4 of article 245 of title 12.
(I.5) When any person appears to have a mental health disorder and, as a result of such mental health disorder, is in need of immediate evaluation for treatment in order to prevent physical or psychiatric harm to others or to himself or herself, then an intervening professional, as specified in subsection (1)(a)(II) of this section, upon probable cause and with such assistance as may be required, may immediately transport the person to an outpatient mental health facility or other clinically appropriate facility designated or approved by the executive director. If such a facility is not available, the person may be taken to an emergency medical services facility.
- Upon an affidavit sworn to or affirmed before a judge that relates sufficient facts to establish 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 others or to himself or herself or appears to be gravely disabled, the court may order the person described in the affidavit to be taken into custody and placed in a facility designated or approved by the executive director for a seventy-two-hour treatment and evaluation. Whenever in this article 65 a facility is to be designated or approved by the executive director, hospitals, if available, must be approved or designated in each county before other facilities are approved or designated. Whenever in this article 65 a facility is to be designated or approved by the executive director as a facility for a stated purpose and the facility to be designated or approved is a private facility, the consent of the private facility to the enforcement of standards set by the executive director is a prerequisite to the designation or approval.
- Upon an affidavit sworn to or affirmed before a judge that relates sufficient facts to establish that a person appears to have a mental health disorder and, as a result of the mental health disorder, is in need of immediate evaluation for treatment to prevent physical or psychiatric harm to others or to himself or herself, the court may order the person described in the affidavit to be transported to an outpatient mental health facility or other clinically appropriate facility designated or approved by the executive director.
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- When a person is taken into custody pursuant to subsection (1) of this section, he or she must not be detained in a jail, lockup, or other place used for the confinement of persons charged with or convicted of penal offenses.
- When a person is taken into emergency custody by an intervening professional pursuant to subsection (1) of this section and is presented to an emergency medical services facility or a facility that is designated or approved by the executive director, the facility shall require an application in writing, stating the circumstances under which the person's condition was called to the attention of the intervening professional and further stating sufficient facts, obtained from the intervening professional's personal observations or obtained from others whom he or she 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 others or to himself or herself, is gravely disabled, or is in need of immediate evaluation for treatment. 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. A copy of the application must be furnished to the person being evaluated, and the application must be retained in accordance with the provisions of section 27-65-121 (4).
- If the seventy-two-hour treatment and evaluation facility admits the person, it may detain him or her for evaluation and treatment for a period not to exceed seventy-two hours, excluding Saturdays, Sundays, and holidays if evaluation and treatment services are not available on those days. For the purposes of this subsection (4), evaluation and treatment services are not deemed to be available merely because a professional person is on call during weekends or holidays. If, in the opinion of the professional person in charge of the evaluation, the person can be properly cared for without being detained, he or she shall be provided services on a voluntary basis.
- Each person admitted to a seventy-two-hour treatment and evaluation facility under the provisions of this article shall receive an evaluation as soon as possible after he or she is admitted and shall receive such treatment and care as his or her condition requires for the full period that he or she is held. The person shall be released before seventy-two hours have elapsed if, in the opinion of the professional person in charge of the evaluation, the person no longer requires evaluation or treatment. Persons who have been detained for seventy-two-hour evaluation and treatment shall be released, referred for further care and treatment on a voluntary basis, or certified for treatment pursuant to section 27-65-107.
- At any time during emergency custody of an individual pursuant to this section in either an emergency medical services facility or a designated facility, if, in the opinion of a professional person, or an advanced practice nurse licensed pursuant to part 1 of article 255 of title 12 and included in the advanced practice registry pursuant to section 12-255-111 with a population focus in psychiatry or mental health, acting within his or her scope of practice, the person no longer meets the standards for emergency custody or detention and his or her care can be provided in another setting, the person must be appropriately discharged or referred for further care and treatment on a voluntary basis, or certified for treatment pursuant to section 27-65-107.
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On or before July 1, 2019, and each July 1 thereafter, each emergency medical services facility that has treated a person pursuant to this section shall provide an annual report to the department that includes only aggregate and nonidentifying information
concerning persons who were treated at an emergency medical services facility pursuant to this section. The report must comply with the provisions of section 24-1-136 (9) and is exempt from the provisions of section
24-1-136 (11)(a)(I). The report must contain the following:
- The names and counties of the facilities;
- The total number of persons treated pursuant to this section, including a summary of demographic information;
- A summary regarding the different reasons for which persons were treated pursuant to this section; and
- A summary of the disposition of persons transferred to a designated facility.
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- Any information aggregated and provided to the department pursuant to this subsection (7) 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 the collection of data to accomplish the requirements of this subsection (7), the department 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.
- Subsection (7)(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 (7)(a) of this section.
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On or before July 1, 2019, and each July 1 thereafter, each emergency medical services facility that has treated a person pursuant to this section shall provide an annual report to the department that includes only aggregate and nonidentifying information
concerning persons who were treated at an emergency medical services facility pursuant to this section. The report must comply with the provisions of section 24-1-136 (9) and is exempt from the provisions of section
24-1-136 (11)(a)(I). The report must contain the following:
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 682, § 2, effective April 29. L. 2011: (1)(a)(II)(D) amended, (SB 11-187), ch. 285, p. 1329, § 75, effective July 1. L. 2017: (1)(a)(I), IP(1)(a)(II), (1)(b), and (3) amended, (SB 17-242), ch. 263, p. 1341, § 235, effective May 25; (1), (2), and (3) amended and (6) and (7) added, (SB 17-207), ch. 205, p. 766, § 7, effective May 1, 2018. L. 2019: (1)(a)(II)(C), (1)(a)(II)(D), (1)(a)(II)(E), and (6) amended, (HB 19-1172), ch. 136, p. 1713, § 199, effective October 1. L. 2020: (6) amended, (HB 20-1183), ch. 157, p. 705, § 66, effective July 1.
Editor's note:
- This section is similar to former § 27-10-105 as it existed prior to 2010.
- Amendments to subsections (1) and (3) by SB 17-242 and SB 17-207 were harmonized.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017. For the legislative declaration in SB 17-207, see section 1 of chapter 205, Session Laws of Colorado 2017.
ANNOTATION
Law reviews. For article, "Commitment Procedures in Colorado", see 29 Dicta 273 (1952). For article, "One Year Review of Civil Procedure and Appeals", see 38 Dicta 133 (1961). For article, "One Year Review of Torts", see 38 Dicta 93 (1961). For article, "Patients' Rights vs. Patients' Needs: The Right of the Mentally Ill to Refuse Treatment in Colorado", see 58 Den. L.J. 567 (1981). For article, "New Legislation Concerning the Mentally Disabled", see 11 Colo. Law. 2131 (1982). For article, "The Clinton Mental Health Case -- A Civil Procedure Lesson", see 19 Colo. Law. 1809 (1990). For article, "Clinton Redux: A Mental Health and Technical Defense Follow-up", see 22 Colo. Law. 2389 (1993). For article, "How to Reconcile Advance Care Directives With Attempted Suicide", see 42 Colo. Law. 97 (July 2013).
Annotator's note. Since § 27-65-105 is similar to § 27-10-105 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
For constitutional considerations, see Barber v. People, 127 Colo. 90 , 254 P.2d 431 (1953).
Due process considerations do not require an in-person evaluation by an intervening professional prior to placement on an involuntary hold. Tracz v. Centennial Peaks, 9 P.3d 1168 (Colo. App. 2000).
Purpose of section. This section was designed to protect the mentally ill person from himself. Kendall v. People, 126 Colo. 573 , 252 P.2d 91 (1952).
Article necessitates strict compliance. In situations involving involuntary confinement, strict compliance with this article is a necessity. People in Interest of Henderson, 44 Colo. App. 102, 610 P.2d 1350 (1980).
For requirement of strict compliance with statutory procedure, see Okerberg v. People, 119 Colo. 529 , 205 P.2d 224 (1949); Kendall v. People, 126 Colo. 573 , 252 P.2d 91 (1952); Barber v. People, 127 Colo. 90 , 254 P.2d 431 (1953); Rickey v. People, 129 Colo. 174 , 267 P.2d 1021 (1954).
A proceeding under this article is not a criminal action. Kendall v. People, 126 Colo. 573 , 252 P.2d 91 (1952).
An adverse finding in mental illness may bear grave consequences in that the person may be denied his liberty and incapacitated to contract, and while it does not necessarily bring his name or reputation into disrepute, it is, nevertheless, a blot on his life and those he might have brought into being. Kendall v. People, 126 Colo. 573 , 252 P.2d 91 (1952).
Procedure provisions of the C.R.C.P. are not applicable to mental illness proceedings. Hultquist v. People, 77 Colo. 310, 236 P. 995 (1925).
Use of this emergency procedure is not limited to patients who decline voluntary treatment. People in Interest of Paiz, 43 Colo. App. 352, 603 P.2d 976 (1979).
"Probable cause" should not be measured by yardstick of legal technicality, but by the factual and practical considerations upon which a reasonable physician acts. People in Interest of Paiz, 43 Colo. App. 352, 603 P.2d 976 (1979).
Reversible error occurred under subsection (1)(a) where jury instruction included neither the element of "probable cause" nor a definition of "gravely disabled" even though prosecution relied upon that provision as the basis for taking defendant into custody. People v. Marquez-Lopez, 952 P.2d 788 (Colo. App. 1997).
Emergency medical personnel has no duty to make an independent determination as to whether the intervening professional had probable cause to institute the hold-and-treat procedure. Tracz v. Centennial Peaks, 9 P.3d 1168 (Colo. App. 2000).
Subsection (1)(b) does not require prior judicial testing before one who has been a voluntarily committed outpatient can be taken into custody. People in Interest of Henderson, 610 P.2d 1350 (Colo. App. 1980).
Contrary to patient's claim, no court hearing or 24-hour notice is required to take mentally ill person into custody under this section. Nor does this section specify that the patient must designate or approve of the treatment facility to which he is committed. Ketchum v. Cruz, 775 F. Supp. 1399 (D. Colo. 1991).
Voluntary treatment program not terminated when patient taken into custody and then returned to hospital. Where voluntarily committed outpatient was off the hospital premises and was taken into custody by the police and then returned to the hospital, this did not, as a matter of law, terminate his voluntary treatment program. People in Interest of Henderson, 610 P.2d 1350 (Colo. App. 1980).
When a county court judge initiates a 72-hour hold, the result is a defect of process depriving the court of subject matter jurisdiction. People In Interest of Lloyd-Pellman, 844 P.2d 1309 (Colo. App. 1992).
A subsequent certification during the 72-hour hold period does not cure the defect. People In Interest of Lloyd-Pellman, 844 P.2d 1309 (Colo. App. 1992).
Violation of this section, while relevant to claim for malpractice, cannot, by definition, create a claim based on negligence per se. Bauer v. Southwest Denver Mental Health Center, 701 P.2d 114 (Colo. App. 1985).
Private hospital and privately employed doctor and nurse were not "state actors" who could be held liable for a constitutional violation under 42 U.S.C. § 1983. Wittner v. Banner Health, 720 F.3d 770 (10th Cir. 2013).
This section's grant of authority for a short-term involuntary hold in a private hospital does not pass the nexus/compulsion test for turning the private action of the hospital or the certifying doctor into state action. Wittner v. Banner Health, 720 F.3d 770 (10th Cir. 2013).
Involuntary commitment of the mentally ill is not a public function, that is, a traditional and exclusive function of the state, and thus state action. Wittner v. Banner Health, 720 F.3d 770 (10th Cir. 2013).
Private actor not transformed into a state actor under a joint action test. Allowing a hospital to hold a patient does not make the state responsible for a doctor's decision to medicate the patient, depriving the patient of constitutional rights. Wittner v. Banner Health, 720 F.3d 770 (10th Cir. 2013).
State's relationship with a private actor is no more than the mere private purchase of contract services. Public-private relationship did not transcend that of mere client and contractor because the private and public actors did not commingle their responsibilities. The state lacked the authority to unilaterally place patients at the hospital; it merely authorized the hospital to accept patients if it so chose. Wittner v. Banner Health, 720 F.3d 770 (10th Cir. 2013).
Applied in People v. Chavez, 629 P.2d 1040 ( Colo. 1981 ); Brown v. Jensen, 572 F. Supp. 193 (D. Colo. 1983 ); People in Interest of Schmidt, 720 P.2d 629 (Colo. App. 1986); Asten v. City of Boulder, 652 F. Supp. 2d 1188 (D. Colo. 2009 ).
27-65-106. Court-ordered evaluation for persons with mental health disorders.
- Any person alleged to have a mental health disorder and, as a result of the mental health disorder, to be a danger to others or to himself or herself or to be gravely disabled may be given an evaluation of his or her condition under a court order pursuant to this section.
- Any individual may petition the court in the county in which the respondent resides or is physically present alleging that there is a person who appears to have a mental health disorder and, as a result of the mental health disorder, appears to be a danger to others or to himself or herself or appears to be gravely disabled and requesting an evaluation of the person's condition.
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The petition for a court-ordered evaluation must contain the following:
- The name and address of the petitioner and his or her interest in the case;
- The name of the person for whom evaluation is sought, who shall be designated as the respondent, and, if known to the petitioner, the address, age, sex, marital status, and occupation of the respondent;
- 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 others or to himself or herself or be gravely disabled and showing reasonable grounds to warrant an evaluation;
- 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;
- The name, address, and telephone number of the attorney, if any, who has most recently represented the respondent. If there is no attorney, there shall be a statement as to whether, to the best knowledge of the petitioner, the respondent meets the criteria established by the legal aid agency operating in the county or city and county for it to represent a client.
- Upon receipt of a petition satisfying the requirements of subsection (3) of this section, the court shall designate a facility, approved by the executive director, or a professional person to provide screening of the respondent to determine whether there is probable cause to believe the allegations.
- Following screening, the facility or professional person designated by the court shall file his or her report with the court. The report must include a recommendation as to whether there is probable cause to believe that the respondent has a mental health disorder and, as a result of the mental health disorder, is a danger to others or to himself or herself or is gravely disabled and whether the respondent will voluntarily receive evaluation or treatment. The screening report submitted to the court is confidential in accordance with section 27-65-121 and must be furnished to the respondent or his or her attorney or personal representative.
- 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 others or to himself or herself or is gravely disabled and that efforts have been made to secure the cooperation of the respondent, who has refused or failed to accept evaluation voluntarily, the court shall issue an order for evaluation authorizing a certified peace officer to take the respondent into custody and place him or her in a facility designated by the executive director for seventy-two-hour treatment and evaluation. At the time of taking the respondent into custody, a copy of the petition and the order for evaluation must be given to the respondent, and promptly thereafter to any one person designated by the respondent and to the person in charge of the seventy-two-hour treatment and evaluation facility named in the order or his or her designee.
- The respondent shall be evaluated as promptly as possible and shall in no event be detained longer than seventy-two hours under the court order, excluding Saturdays, Sundays, and holidays if treatment and evaluation services are not available on those days. Within that time, the respondent shall be released, referred for further care and treatment on a voluntary basis, or certified for short-term treatment.
- At the time the respondent is taken into custody for evaluation or within a reasonable time thereafter, unless a responsible relative is in possession of the respondent's personal property, the certified peace officer taking him or her into custody shall take reasonable precautions to preserve and safeguard the personal property in the possession of or on the premises occupied by the respondent.
- When a person is involuntarily admitted to a seventy-two-hour treatment and evaluation facility under the provisions of this section or section 27-65-105, the person shall be advised by the facility director or his or her duly appointed representative that the person is going to be examined with regard to his or her mental condition.
- Whenever a person is involuntarily admitted to a seventy-two-hour treatment and evaluation facility, he or she shall be advised by the facility director or his or her duly appointed representative of his or her right to retain and consult with any attorney at any time and that, if he or she cannot afford to pay an attorney, upon proof of indigency, one will be appointed by the court without cost.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 684, § 2, effective April 29. L. 2017: (1), (2), IP(3), (3)(c), (5), and (6) amended, (SB 17-242), ch. 263, p. 1342, § 236, effective May 25.
Editor's note: This section is similar to former § 27-10-106 as it existed prior to 2010.
Cross references: (1) For rights of person under arrest, see part 4 of article 3 of title 16.
(2) For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
ANNOTATION
Law reviews. For article, "Commitment Procedures in Colorado", see 29 Dicta 273 (1952). For article, "The Clinton Mental Health Case -- A Civil Procedure Lesson", see 19 Colo. Law. 1809 (1990).
Annotator's note. Since § 27-65-106 is similar to § 27-10-106 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
For constitutional considerations, see Barber v. People, 127 Colo. 90 , 254 P.2d 431 (1953).
Proceeding has nonadversarial nature. An inquiry into the mental capacity of a person is a statutory proceeding of a nonadversary nature. Young v. Colo. Nat'l Bank, 148 Colo. 104 , 365 P.2d 701 (1961).
Findings of screening facility or professional person are not binding upon the court. In re People in Interest of Hill, 118 Colo. 571 , 198 P.2d 450 (1948).
For requirement of strict compliance with statutory procedure, see Hultquist v. People, 77 Colo. 310 , 236 P. 995 (1925); Okerberg v. People, 119 Colo. 529 , 205 P.2d 224 (1949); Kendall v. People, 126 Colo. 573 , 252 P.2d 91 (1952); Barber v. People, 127 Colo. 90 , 254 P.2d 431 (1953); Rickey v. People, 129 Colo. 174 , 267 P.2d 1021 (1954).
For specificity of required report, see Kendall v. People, 126 Colo. 573 , 252 P.2d 91 (1952).
Applied in People v. Lane, 196 Colo. 42 , 581 P.2d 719 (1978); People in Interest of Paiz, 43 Colo. App. 352, 603 P.2d 976 (1979); People v. Chavez, 629 P.2d 1040 ( Colo. 1981 ).
27-65-107. Certification for short-term treatment - procedure.
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If a person detained for seventy-two hours pursuant to the provisions of section 27-65-105 or a respondent under court order for evaluation pursuant to section 27-65-106 has received an evaluation, he or she may be certified for not more than three months
of short-term treatment under the following conditions:
- The professional staff of the agency or facility providing seventy-two-hour treatment and evaluation has analyzed the person's condition and has found the person has a mental health disorder and, as a result of the mental health disorder, is a danger to others or to himself or herself or is gravely disabled.
- 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, his or her acceptance of voluntary treatment shall not preclude certification.
- The facility which will provide short-term treatment has been designated or approved by the executive director to provide such treatment.
- The notice of certification must be signed by a professional person on the staff of the evaluation facility who participated in the evaluation and must state facts sufficient to establish reasonable grounds to believe that the person has a mental health disorder and, as a result of the mental health disorder, is a danger to others or to himself or herself or is gravely disabled. The certification must be filed with the court within forty-eight hours, excluding Saturdays, Sundays, and court holidays, of the date of certification. The certification must be filed with the court in the county in which the respondent resided or was physically present immediately prior to being taken into custody.
- Within twenty-four hours of certification, copies of the certification shall be personally delivered to the respondent, and a copy shall be kept by the evaluation facility as part of the person's record. The respondent shall also be asked to designate one other person whom he or she wishes informed regarding certification. If he or she is incapable of making such a designation at the time the certification is delivered, he or she shall be asked to designate such person as soon as he or she is capable. In addition to the copy of the certification, the respondent shall be given a written notice that a hearing upon his or her 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.
- Upon certification of the respondent, the facility designated for short-term treatment shall have custody of the respondent.
- Whenever a certification is filed with the court, the court, if it has not already done so under section 27-65-106 (10), shall forthwith appoint an attorney to represent the respondent. The court shall determine whether the respondent is able to afford an attorney. If the respondent cannot afford counsel, the court shall appoint either counsel from the legal services program operating in that jurisdiction or private counsel to represent the respondent. The attorney representing the respondent shall be provided with a copy of the certification immediately upon his or her appointment. Waiver of counsel must be knowingly and intelligently made in writing and filed with the court by the respondent. In the event that a respondent who is able to afford an attorney fails to pay the appointed counsel, such counsel, upon application to the court and after appropriate notice and hearing, may obtain a judgment for reasonable attorney fees against the respondent or person making request for such counsel or both the respondent and such person.
- The respondent for short-term treatment or his or her 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 his or her attorney and the certifying and treating professional person of the time and place thereof. The hearing shall be held in accordance with section 27-65-111. 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, subject to available appropriations.
- Records and papers in proceedings under this section and section 27-65-108 shall be maintained separately by the clerks of the several courts. Upon the release of any respondent in accordance with the provisions of section 27-65-110, the facility shall notify the clerk of the court within five days of the release, and the clerk shall forthwith seal the record in the case and omit the name of the respondent from the index of cases in such court until and unless the respondent becomes subject to an order of long-term care and treatment pursuant to section 27-65-109 or until and unless the court orders them opened for good cause shown. In the event a petition is filed pursuant to section 27-65-109, such 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.
- Whenever it appears to the court, by reason of a report by the treating professional person or any other report satisfactory to the court, that a respondent detained for evaluation and treatment or certified for 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 secure transportation, as defined in section 25-3.5-103 (11.4), or a sheriff, the court may issue an order directing the sheriff or the sheriff's designee to deliver the respondent to the designated facility.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 686, § 2, effective April 29. L. 2017: IP(1), (1)(a), and (2) amended, (SB 17-242), ch. 263, p. 1343, § 237, effective May 25. L. 2021: (8) amended, (HB 21-1085), ch. 355, p. 2312, § 6, effective June 27.
Editor's note: This section is similar to former § 27-10-107 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
ANNOTATION
Analysis
I. GENERAL CONSIDERATION.
Law reviews. For article, "Procedures for Involuntary Commitment on the Basis of Alleged Mental Illness", see 42 U. Colo. L. Rev. 231 (1970). For article, "Patients' Rights vs. Patients' Needs: The Right of the Mentally Ill to Refuse Treatment in Colorado", see 58 Den. L.J. 567 (1981). For article, "New Legislation Concerning the Mentally Disabled", see 11 Colo. Law. 2131 (1982). For article, "Pre-trial Technical Defenses to Mental Health Certification", see 17 Colo. Law. 1327 (1988). For article, "Perreira v. Colorado -- A Psychiatrist's Duty to Protect Others", see 18 Colo. Law. 2323 (1989). For article, "The Clinton Mental Health Case -- A Civil Procedure Lesson", see 19 Colo. Law. 1809 (1990). For article, "Clinton Redux: A Mental Health and Technical Defense Follow-up", see 22 Colo. Law. 2389 (1993).
Annotator's note. Since § 27-65-107 is similar to § 27-10-107 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
Constitutionality. Failure of this section to require a mandatory state-initiated hearing before the involuntary commitment of an individual for up to 90 days does not render the statute unconstitutional. Brown v. Jensen, 572 F. Supp. 193 (D. Colo. 1983 ); Curnow v. Yarbrough, 676 P.2d 1177 ( Colo. 1984 ).
The term "danger" in subsection (1)(a) does not offend due process as long as the state proves by clear and convincing evidence that there is a reasonable basis to believe that the individual's mental illness results in a present danger to herself or others or renders her gravely disabled. People v. Stevens, 761 P.2d 768 (Colo. 1988).
Less restrictive alternatives need not be considered as a condition precedent to certification. Civil commitment constitutes a severe infringement of liberty requiring due process protection. However, the statutory scheme set forth in this article contains a number of procedural safeguards that greatly reduce the inherent risk of erroneous deprivation. Therefore, due process does not require a mandatory hearing at the time of certification since the statute provides for a hearing on request. People v. Stevens, 761 P.2d 768 (Colo. 1988).
Subsequent certification proceedings are not rendered invalid as a result of the certification for short-term treatment being set aside. People in Interest of Dveirin, 755 P.2d 1207 (Colo. 1988).
State's interest in certifying individual for short-term treatment is to provide care to one whose mental condition poses a threat to society or to the person himself. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Civil commitment statute must be liberally construed to promote the legislative purpose of encouraging the "use of voluntary rather than coercive measures to secure treatment and care for mental illness". Sisneros v. District Court, 199 Colo. 179 , 606 P.2d 55 (1980).
This article is to be strictly construed to see that no limit is placed on a person's right to seek voluntary treatment. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Statutory definition of mental illness, on its own terms, cannot be read to intend that every idiosyncratic or eccentric person requires involuntary medical intervention. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Voluntary treatment program not terminated. Where voluntarily committed outpatient was off the hospital premises and was taken into custody by the police and then returned to the hospital, this did not, as a matter of law, terminate his voluntary treatment program. People in Interest of Henderson, 44 Colo. App. 102, 610 P.2d 1350 (1980).
Standard for liability of medical professionals. In determining whether to release an involuntarily committed mental patient, the psychiatrist has a legal duty to exercise due care, consistent with the knowledge and skill ordinarily possessed by psychiatric practitioners under similar circumstances, to determine whether the patient has a propensity for violence and would present an unreasonable risk of serious bodily harm to others. Perreira v. State, 768 P.2d 1198 (Colo. 1989).
In discharging his duty, a psychiatrist may be required to take reasonable precautions to protect the public from the danger created by the release giving due consideration to extending the term of the patient's commitment or placing appropriate conditions and restrictions on such release. Perreira v. State, 768 P.2d 1198 (Colo. 1989).
Standard for liability of medical professionals. No duty exists to prevent a third person from harming another unless a special relation exists between the actor and the wrongdoer or between the actor and the victim. Perreira v. State, 738 P.2d 4 (Colo. App. 1986).
Medical professionals involved in the care and treatment of a mentally ill patient have a legal duty under the "special relation" rule to prevent the patient from harming himself or others only if the patient in their care constitutes a danger to himself or to the safety of others. Perreira v. State, 738 P.2d 4 (Colo. App. 1986).
This danger may be shown by evidence of injurious acts, attempts, or threats by the patient. Perreira v. State, 738 P.2d 4 (Colo. App. 1986).
A psychotherapist treating a mental patient as an outpatient may fall under the special relation rule. Perreira v. State, 738 P.2d 4 (Colo. App. 1986).
Certification for involuntary short-term mental health treatment entered by a professional person under this section is not a court order under § 13-5-142 (1)(c) or § 13-9-123 (1)(c) and a person's information should not be sent to the Colorado bureau of investigation for forwarding on to the National Instant Criminal Background Check System, which would subject the person to federal firearms prohibitions. Ray v. People, 2019 COA 24 , 456 P.3d 54.
Applied in Goedecke v. State Dept. of Insts., 198 Colo. 407 , 603 P.2d 123 (1979); People in Interest of Paiz, 43 Colo. App. 352, 603 P.2d 976 (1979); People v. Chavez, 629 P.2d 1040 ( Colo. 1981 ); In re P.F. v. Walsh, 648 P.2d 1067 ( Colo. 1982 ); People v. Medina, 705 P.2d 961 ( Colo. 1985 ).
II. PROCEDURAL REQUIREMENTS.
Involuntary commitment to mental hospital is deprivation of liberty which the state cannot accomplish without procedural safeguards. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
This section sets out certain procedures which the general assembly and our courts have determined are adequate to protect a respondent's due process rights. These procedures include: (1) a professional decision to initiate the 72-hour evaluation; (2) professional medical evaluation at the time of involuntary short-term commitment; (3) notice concerning certification within 24 hours to the person committed; (4) notice concerning certification to one other person the respondent designates; (5) prompt appointment of an attorney; (6) a hearing within 10 days if requested (7) the burden of proof by clear and convincing evidence upon the petitioner; and (8) optional court appointment of an independent professional person to examine the respondent. Curnow v. Yarbrough, 676 P.2d 1177 ( Colo. 1984 ); People in Interest of Reynes, 870 P.2d 518 (Colo. App. 1993).
Strict adherence to procedural requirements of this section is required because of the curtailment of personal liberty which results from certification for treatment of mental illness. Sisneros v. District Court, 199 Colo. 179 , 606 P.2d 55 (1980).
In situations involving involuntary confinement, strict compliance with this article is a necessity. People in Interest of Henderson, 44 Colo. App. 102, 610 P.2d 1350 (1980).
Procedural prerequisites to obtaining certification must be met for court to have subject matter jurisdiction, so review of such issues is by court not jury. People in Interest of Bailey, 745 P.2d 280 (Colo. App. 1987).
Right to a mental health certification review hearing within 10 days of the filing of a petition for certification is for protection of certified person and may be waived by such person without vitiating jurisdiction of court. People in Interest of Lynch, 783 P.2d 848 (Colo. 1989).
When the procedural provisions of former § 27-10-105 are not followed, even a credible certification cannot cure the jurisdictional defect. People in Interest of Lloyd-Pellman, 844 P.2d 1309 (Colo. App. 1992).
Failure to convene hearing within 10 days after request is made as mandated by this section deprives court of subject matter jurisdiction to certify person for short-term treatment regardless of person's purported waiver. People in Interest of Lynch, 757 P.2d 145 (Colo. App. 1988), rev'd, 783 P.2d 848 ( Colo. 1989 ).
The statutorily defined procedures for civil commitment proceedings have been applied to hearings involving the issue of nonconsensual treatment with antipsychotic medication. People ex rel. Ofengand, 183 P.3d 688 (Colo. App. 2008).
Because a committed patient's right to counsel during civil commitment proceedings is derived from the civil commitment statutes, any defect in respondent's waiver of counsel is analyzed under the standard applicable to statutory defects in civil commitment proceedings. People ex rel. Ofengand, 183 P.3d 688 (Colo. App. 2008).
Where respondent seeks reversal of civil commitment order based on the failure to comply strictly with statutory requirements, and where the defect, if any, does not implicate the jurisdiction of the trial court to grant the order, the appeals court's inquiry is whether the defect concerns a failure to comply with essential statutory provisions grave enough to undermine confidence in the fairness and outcome of the certification proceedings. People ex rel. Ofengand, 183 P.3d 688 (Colo. App. 2008).
This inquiry includes: (1) the evaluation of the gravity of the deviation from statutory provisions, including a consideration of due process concerns; and (2) a determination of any prejudice to respondent caused by the deviation. People ex rel. Ofengand, 183 P.3d 688 (Colo. App. 2008).
Patient to be advised of available, voluntary treatments. A trial court exceeds its jurisdiction in affirming a petitioner's short-term certification, in light of the uncontroverted jury finding that the petitioner had not been properly advised of the availability of voluntary treatment for mental illness, as required by this section. Sisneros v. District Court, 199 Colo. 179 , 606 P.2d 55 (1980).
Privilege against self-incrimination is inapplicable to civil commitment proceedings. Due process does not require that the fifth amendment privilege against self-incrimination be extended to this state's civil commitment proceedings. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Nor does privilege against self-incrimination apply to hearings on the forcible administration of medication, which occur during the civil commitment process. People ex rel. Strodtman, 293 P.3d 123 (Colo. App. 2011).
Former §§ 27-10-111 (1) and 27-10-107 (3), read together, clearly and unambiguously grant a right to a jury hearing to a person being certified for short-term treatment. People in Interest of Hoylman, 865 P.2d 918 (Colo. App. 1993).
Failure to abide by statutory requirement of forthwith appointment of counsel in mental health certification proceeding did not constitute personal jurisdiction defect, as requirement for appointment of counsel did not affect the nature of notice to be given to mentally ill person or statutory requirements for acquisition of jurisdiction over person. People in Interest of Clinton, 762 P.2d 1381 (Colo. 1988).
For the purposes of subsection (7), neither the Eclipse system, the user interface of the judicial branch's computerized case management system, nor its underlying database, ICON, functions as an "index of cases". Therefore, the court clerk is not required to remove an individual's name from either upon discharge. People in Interest of T.T., 2019 CO 54, 442 P.3d 851.
Reversible error where trial court failed to comply with essential statutory provision requiring respondent's waiver of counsel to be made knowingly, intelligently, and in writing in a hearing involving a petition for involuntary administration of medication. People ex rel. Ofengand, 183 P.3d 688 (Colo. App. 2008).
III. FINDINGS NECESSARY.
If it is shown that person is mentally ill, short-term involuntary commitment cannot be justified unless it is shown that, as a result of such illness, the person is: (1) a danger to others; (2) a danger to himself; (3)"gravely disabled" because of an inability to take care of basic personal needs; or (4) "gravely disabled" because the person is "making irrational or grossly irresponsible decisions concerning his person and lacks the capacity to understand this is so". People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Section requires that causal nexus be established between a person's mental illness and the condition of being a danger to others or to himself or gravely disabled. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Disability sufficient to justify involuntary commitment must arise as result of mental illness; and in keeping with the statutory purpose, it must be so grave that the person's safety is threatened by his inability to take care of his basic personal needs. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Mere disability alone is insufficient to warrant involuntary commitment. Mere disability alone, even if found in conjunction with mental illness, is not enough to warrant involuntary commitment. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Dangerousness to others may be shown by evidence of injurious acts, attempts, or threats. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Dangerousness to oneself may be shown by similar evidence, where the individual's injurious behavior is directed toward himself. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Passive injury to oneself, because of an inability to take care of one's most basic personal needs, may be as dangerous or damaging to the individual as the active threat posed by suicide. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Standard of proof necessary to commit for short-term involuntary psychiatric treatment, "clear and convincing evidence", adopted by the general assembly for treatment, strikes a fair balance between the interest of the individual and the interest of the state. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Standard of proof met. Where three medical experts testified at appellant's certification hearing that she was dangerous or potentially dangerous to herself or to others there was clear and convincing evidence that there was a reasonable basis to believe that appellant's mental illness resulted in a present danger to herself or others, thereby satisfying the prerequisite conditions for short-term certification. People v. Stevens, 761 P.2d 768 (Colo. 1988).
27-65-108. Extension of short-term treatment.
If the professional person in charge of the evaluation and treatment believes that a period longer than three months is necessary for treatment of the respondent, he or she shall file with the court an extended certification. No extended certification for treatment shall be for a period of more than three months. The respondent shall be entitled to a hearing on the extended certification under the same conditions as in an original certification. The attorney initially representing the respondent shall continue to represent that person, unless the court appoints another attorney.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 688, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-108 as it existed prior to 2010.
ANNOTATION
Law reviews. For article, "Patients' Rights vs. Patients' Needs: The Right of the Mentally Ill to Refuse Treatment in Colorado", see 58 Den. L.J. 567 (1981).
Annotator's note. Since § 27-65-108 is similar to § 27-10-108 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
Applied in People v. Lane, 196 Colo. 42 , 581 P.2d 719 (1978); People in Interest of Paiz, 43 Colo. App. 352, 603 P.2d 976 (1979); In re P.F. v. Walsh, 648 P.2d 1067 ( Colo. 1982 ); Brown v. Jensen, 572 F. Supp. 193 (D. Colo. 1983 ).
27-65-109. Long-term care and treatment of persons with mental health disorders - procedure.
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Whenever a respondent has received short-term treatment for five consecutive months pursuant to the provisions of sections 27-65-107 and 27-65-108, the professional person in charge of the evaluation and treatment may file a petition with the court for
long-term care and treatment of the respondent under the following conditions:
- 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 others or to himself or herself or is gravely disabled.
- 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, his or her acceptance of voluntary treatment shall not preclude an order pursuant to this section.
- The facility that will provide long-term care and treatment has been designated or approved by the executive director to provide the care and treatment.
- Every petition for long-term care and treatment shall include a request for a hearing before the court prior to the expiration of six months from the date of original certification. A copy of the petition shall be delivered personally to the respondent for whom long-term care and treatment is sought and mailed to his or her attorney of record simultaneously with the filing thereof.
- Within ten days after receipt of the petition, the respondent or his or her attorney may request a jury trial by filing a written request therefor with the court.
- 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 others or to himself or herself or is gravely disabled. The court shall thereupon issue an order of long-term care and treatment for a term not to exceed six months, or it shall discharge the respondent for whom long-term care and treatment was sought, or it shall enter any other appropriate order, subject to available appropriations. An order for long-term care and treatment must grant custody of the respondent to the department for placement with an agency or facility designated by the executive director to provide long-term care and treatment. 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, by reason thereof, the person is unable to competently exercise said right or perform the function as to 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.
- 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 delivered to the respondent and simultaneously mailed to his or her attorney of record. At least twenty days before the expiration of the order, the court shall give written notice to the respondent and his or her 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, it 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 himself or herself 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.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 688, § 2, effective April 29. L. 2017: IP(1), (1)(a), (4), and (5) amended, (SB 17-242), ch. 263, p. 1344, § 238, effective May 25.
Editor's note: This section is similar to former § 27-10-109 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
ANNOTATION
Law reviews. For article, "Patients' Rights vs. Patients' Needs: The Right of the Mentally Ill to Refuse Treatment in Colorado", see 58 Den. L.J. 567 (1981). For article, "Legal But Not Fair: Legal Implications of a Mental Illness Medical Model", see 11 Colo. Law. 1234 (1982). For article, "Pre-trial Technical Defenses to Mental Health Certification", see 17 Colo. Law. 1327 (1988).
Annotator's note. Since § 27-65-109 is similar to § 27-10-109 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
The term "danger" in subsection (1)(a) does not offend due process as long as the state proves by clear and convincing evidence that there is a reasonable basis to believe that the individual's mental illness results in a present danger to herself or others or renders her gravely disabled. People v. Stevens, 761 P.2d 768 (Colo. 1988).
Less restrictive alternatives need not be considered as a condition precedent to certification. Civil commitment constitutes a severe infringement of liberty requiring due process protection. However, the statutory scheme set forth in this article contains a number of procedural safeguards that greatly reduce the inherent risk of erroneous deprivation. Therefore, due process does not require a mandatory hearing at the time of certification since the statute provides for a hearing on request. People v. Stevens, 761 P.2d 768 (Colo. 1988).
These statutory requirements are mandatory and must be strictly carried out. Watkins v. People, 140 Colo. 228 , 344 P.2d 682 (1959).
Thus, the failure to deliver personally to a respondent in a mental health proceeding a copy of the petition for long-term care and treatment, as required by subsection (2), deprives the court of personal jurisdiction over the respondent to proceed on the petition and does not toll the relevant time limits for a hearing on the petition. Gilford v. People, 2 P.3d 120 (Colo. 2000).
But only statutory deviations that are considered serious enough to undermine the confidence in the fairness and outcome of judicial proceedings will justify a dismissal of an order that was not made in strict compliance with procedural aspects of the civil commitment statutes. Hearing for extension of long-term care and treatment and for administration of involuntary medications that took place six days after expiration of respondent's certification was held not to undermine the confidence in the fairness and outcome of the certification proceedings when respondent received a full hearing and had previously declined to have the hearing before the expiration date of the certification. People in Interest of Gilford, 983 P.2d 156 (Colo. App. 1999), cert. denied, No. 99SC404 (Colo. Aug. 23, 1999).
Key inquiry in determining whether a failure to follow the civil commitment statute was a violation of an individual's due process rights is whether the failure violates an "essential condition" of the statute. Such determination is made by evaluating the gravity of the deviation from the statutory procedures and requires consideration of any due process concerns and any prejudice to the respondent. People in Interest of Gilford, 983 P.2d 156 (Colo. App. 1999), cert. denied, No. 99SC404 (Colo. Aug. 23, 1999).
Special statutory proceeding. An action in the district court to inquire into the mental health of a party can best be described as a special statutory proceeding; it is neither a criminal case nor a civil action. Sabon v. People, 142 Colo. 323 , 350 P.2d 576 (1960).
Request for jury trial must be honored. Where the respondent or his attorney requests a jury trial, the court is required to honor the request. Young v. Brofman, 139 Colo. 296 , 338 P.2d 286 (1959).
Defendant held to have been wrongfully deprived of opportunity to demand a jury trial. Hultquist v. People, 77 Colo. 310, 236 P. 995 (1925).
Court may enter judgment notwithstanding the verdict on jury's factual finding under this section as a matter of law when the evidence is undisputed. People in Interest of Lees, 745 P.2d 281 (Colo. App. 1987).
The determination at a certification hearing as to whether a person is "gravely disabled" must focus on the individual's existing condition and not on the possibility of future relapse. People in Interest of Bucholz, 778 P.2d 300 (Colo. App. 1989).
Underlying propensity for dangerousness, even though related to future conduct, is sufficient to meet the test of presenting a danger to one's self and others. People in Interest of King, 795 P.2d 273 (Colo. App. 1990).
Review of commitment order based on erroneous diagnosis. Where an order of commitment is based on an erroneous diagnosis, that order can be reviewed on appeal. Zimmerman v. Angele, 137 Colo. 129 , 321 P.2d 1105 (1958).
Subsection (5) extension runs from expiration of previous order. The period of extension allowed by subsection (5) is to run from the date the previous order expires, and not from the date the extension order is entered. People in Interest of Archuleta, 653 P.2d 93 (Colo. App. 1982).
Person confined only to extent necessary to protect society. A person who is found to be mentally ill is treated and confined only to the extent necessary for the protection of society. Parks v. Denver District Court, 180 Colo. 202 , 503 P.2d 1029 (1972).
Medication not to be given over incompetent's objection absent court order. Absent an emergency situation calling for immediate action (in which event the least intrusive means should be used by the physician to meet the emergency), antipsychotic medication shall not be administered to a mentally incompetent institutionalized patient who has not given his consent to this medication unless ordered by a court following a proper hearing. People in Interest of Medina, 662 P.2d 184 (Colo. App. 1982), aff'd, 705 P.2d 961 ( Colo. 1985 ).
Order for involuntary medication must not extend beyond expiration date of the order of long-term care and treatment. Hopkins v. People, 772 P.2d 624 (Colo. App. 1988).
Applied in People v. Lane, 196 Colo. 42 , 581 P.2d 719 (1978); People in Interest of Paiz, 43 Colo. App. 352, 603 P.2d 976 (1979); People v. Chavez, 629 P.2d 1040 ( Colo. 1981 ); Brown v. Jensen, 572 F. Supp. 193 (D. Colo. 1983 ); People in Interest of Kleinfieldt, 680 P.2d 864 (Colo. App. 1984).
27-65-110. Termination of short-term and long-term treatment - escape.
- An original certification for short-term treatment under section 27-65-107, or an extended certification under section 27-65-108, or an order for long-term care and treatment or any extension thereof shall terminate as soon as, in the opinion of the professional person in charge of treatment of the respondent, the respondent has received sufficient benefit from such treatment for him or her to leave. Whenever a certification or extended certification is terminated under this section, the professional person in charge of providing treatment shall so notify the court in writing within five days of such termination. Such professional person may also prescribe day care, night care, or any other similar mode of treatment prior to termination.
- Before termination, an escaped respondent may be returned to the facility by order of the court without a hearing or by the superintendent or director of such facility without order of court. After termination, a respondent may be returned to the institution only in accordance with the provisions of this article.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 689, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-110 as it existed prior to 2010.
ANNOTATION
Law reviews. For article, "Patients' Rights vs. Patients' Needs: The Right of the Mentally Ill to Refuse Treatment in Colorado", see 58 Den. L.J. 567 (1981). For article, "Perreira v. Colorado -- A Psychiatrist's Duty to Protect Others", see 18 Colo. Law. 2323 (1989).
Annotator's note. Since § 27-65-110 is similar to § 27-10-110 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
Superintendent may release inmate only upon restoration to reason. The only ground upon which the superintendent of the Colorado state hospital can legally release an inmate therefrom is restoration to reason. People ex rel. Best v. County Court, 110 Colo. 249 , 132 P.2d 799 (1942).
When person is no longer insane he is restored to reason, and, consequently, when the court found respondent not mentally ill as charged in the complaint, the court had a duty to order her discharged, and in failing to do so, it committed error. In re People in Interest of Hill, 118 Colo. 571 , 198 P.2d 450 (1948).
Standard of care for determining release. In determining whether to release an involuntarily committed mental patient, the psychiatrist has a legal duty to exercise due care, consistent with the knowledge and skill ordinarily possessed by psychiatric practitioners under similar circumstances to determine whether the patient has a propensity for violence and would present an unreasonable risk of serious bodily harm to others. Perreira v. State, 768 P.2d 1198 (Colo. 1989).
In discharging his duty, a psychiatrist may be required to take reasonable precautions to protect the public from the danger created by the release giving due consideration to extending the term of the patient's commitment or placing appropriate conditions and restrictions on such release. Perreira v. State, 768 P.2d 1198 (Colo. 1989).
Order remanding inmate to asylum without new trial by jury held proper. Where it appeared to the district court that an inmate of the state insane asylum, having received a probationary discharge, was not restored to reason, an order remanding him to the asylum without a new trial by jury was held proper. Metaxos v. People, 76 Colo. 264, 230 P. 608 (1924).
Distinction permitted from escape by person committed by criminal insanity adjudication. Given the state's obvious interest in protecting the public from those who previously have engaged in overt criminal conduct but have been relieved of criminal responsibility by reason of legal insanity, there is no difficulty in finding a rational basis for legislation that proscribes as criminal a knowing escape by a person committed to an institution as a result of an insanity adjudication in a criminal case, but does not impose a similar sanction upon a person who escapes from a facility to which he has been civilly committed. People v. Giles, 662 P.2d 1073 (Colo. 1983).
For continuing jurisdiction of district court, see Zimmerman v. Angele, 137 Colo. 129 , 321 P.2d 1105 (1958).
Applied in People v. Chavez, 629 P.2d 1040 (Colo. 1981).
27-65-111. Hearing procedures - jurisdiction.
- Hearings before the court pursuant to section 27-65-107, 27-65-108, or 27-65-109 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 person has a mental health disorder and, as a result of the mental health disorder, is a danger to others or to himself or herself or is gravely disabled.
- 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 his or her examination. The court-appointed professional person shall act solely in an advisory capacity, and no presumption shall attach to his or her findings.
- Every respondent subject to an order for short-term treatment or long-term care and treatment shall be advised of his or her right to appeal the order by the court at the conclusion of any hearing as a result of which such an order may be entered.
- The court in which the petition is filed under section 27-65-106 or the certification is filed under section 27-65-107 shall be the court of original jurisdiction and of continuing jurisdiction for any further proceedings under this article. 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 shall be the court of continuing jurisdiction.
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- 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), C.R.S., or by reason of insanity pursuant to section 16-8-105 (4) or 16-8-105.5, C.R.S., 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, C.R.S., or the court of the jurisdiction in which the designated facility treating the respondent or person is located shall have 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 him or her. 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.
- In any case brought under paragraph (a) of this subsection (5) 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, C.R.S., 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.
- In the case of a defendant who is found incompetent to proceed pursuant to section 16-8.5-103, C.R.S., and who refuses to accept medication, the jurisdiction for the petition for involuntary treatment procedures shall be as set forth in section 16-8.5-112, C.R.S.
- All proceedings under this article, including proceedings to impose a legal disability pursuant to section 27-65-127, shall 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 shall 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. Upon request of a guardian appointed pursuant to article 14 of title 15, C.R.S., the guardian may intervene in any proceeding under this article concerning his or her ward and, through counsel, may present evidence and represent to the court the views of the guardian concerning the appropriate disposition of the case.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 690, § 2, effective April 29. L. 2017: (1) amended, (SB 17-242), ch. 263, p. 1345, § 239, effective May 25.
Editor's note: This section is similar to former § 27-10-111 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
ANNOTATION
Law reviews. For article, "Commitment Procedures in Colorado", see 29 Dicta 273 (1952). For article, "New Legislation Concerning the Mentally Disabled", see 11 Colo. Law. 2131 (1982). For article, "Respect for the Values and Preferences of Mental Patients: The Medina Trilogy", see 11 Colo. Law. 3014 (1982). For article, "The Clinton Mental Health Case -- A Civil Procedure Lesson", see 19 Colo. Law. 1809 (1990).
Annotator's note. Since § 27-65-111 is similar to § 27-10-111 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
Involuntary commitment to mental hospital is deprivation of liberty which the state cannot accomplish without procedural safeguards. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Privilege against self-incrimination inapplicable to civil commitment proceedings. Due process does not require that the fifth amendment privilege against self-incrimination be extended to Colorado's civil commitment proceedings. People v. Taylor, 618 P.2d 1127 ( Colo. 1980 ).
Former §§ 27-10-111 (1) and 27-10-107 (3), read together, clearly and unambiguously grant a right to a jury hearing to a person being certified for short-term treatment. People in Interest of Hoylman, 865 P.2d 918 (Colo. App. 1993).
The term "danger" in subsection (1) does not offend due process as long as the state proves by clear and convincing evidence that there is a reasonable basis to believe that the individual's mental illness results in a present danger to herself or others or renders her gravely disabled. People v. Stevens, 761 P.2d 768 (Colo. 1988).
Standard of proof meets minimum standards of procedural due process. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Less restrictive alternatives need not be considered as a condition precedent to certification. Civil commitment constitutes a severe infringement of liberty requiring due process protection. However, the statutory scheme set forth in this article contains a number of procedural safeguards that greatly reduce the inherent risk of erroneous deprivation. Therefore, due process does not require a mandatory hearing at the time of certification since the statute provides for a hearing on request. People v. Stevens, 761 P.2d 768 (Colo. 1988).
"Clear and convincing evidence", required by subsection (1), is evidence which is stronger than a preponderance of the evidence, and which is unmistakable and free from serious or substantial doubt. People v. Lane, 196 Colo. 42 , 581 P.2d 719 (1978).
Where three medical experts testified at the certification hearing that appellant was potentially dangerous to herself or to others, there was clear and convincing evidence that there was a reasonable basis to believe that appellant's mental illness resulted in a present danger to herself or others, thereby satisfying the prerequisite conditions for short-term certification pursuant to former § 27-10-107. People v. Stevens, 761 P.2d 768 (Colo. 1988).
The need for electroconvulsive therapy for a person involuntarily committed must be established by clear and convincing evidence. People in Interest of M.K.M., 765 P.2d 1075 (Colo. App. 1988).
If it is shown that person is mentally ill, short-term involuntary commitment cannot be justified unless it is shown that, as a result of such illness, the person is: (1) a danger to others; (2) a danger to himself; (3) "gravely disabled" because of an inability to take care of basic personal needs; or (4) "gravely disabled" because the person is "making irrational or grossly irresponsible decisions concerning his person and lacks the capacity to understand this is so". People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Mere disability alone is insufficient to warrant involuntary commitment. Mere disability alone, even if found in conjunction with mental illness, is not enough to warrant involuntary commitment. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Dangerousness to others may be shown by evidence of injurious acts, attempts, or threats. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Dangerousness to oneself may be shown by similar evidence, where the individual's injurious behavior is directed toward himself. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Passive injury to oneself, because of an inability to take care of one's most basic personal needs, may be as dangerous or damaging to the individual as the active threat posed by suicide. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Former § 27-10-107 requires that a causal nexus be established between a person's mental illness and the condition of being a danger to others or to himself or gravely disabled. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
Uncorroborated psychiatric opinion sufficient. In some cases, a psychiatric opinion, not corroborated by evidence of recent dangerous conduct, may constitute "clear and convincing evidence" of dangerousness, and therefore may be sufficient to sustain a commitment based on dangerousness. People v. Lane, 196 Colo. 42 , 581 P.2d 719 (1978).
Right of indigent appellant to transcript at state expense. An indigent appellant in a mental health proceeding for involuntary confinement and treatment has a right under the due process guarantees of the United States and Colorado constitutions to a transcript at state expense. Goedecke v. State Dept. of Insts., 198 Colo. 407 , 603 P.2d 123 (1979).
Stringent release standards reasonably related to public safety. The more stringent standards of release applicable to the criminally committed defendant reflect the increased risk to the public associated with the release decision, and, as in the case of automatic commitment, they are reasonably related to the state's interest in public safety. People v. Chavez, 629 P.2d 1040 (Colo. 1981).
Court order required for administering medication to incompetent absent his consent. Absent an emergency situation calling for immediate action (in which event the least intrusive means should be used by the physician to meet the emergency), antipsychotic medication shall not be administered to a mentally incompetent institutionalized patient who has not given his consent to this medication unless ordered by a court following a proper hearing. People in Interest of Medina, 662 P.2d 184 (Colo. App. 1982), aff'd, 705 P.2d 961 ( Colo. 1985 ); People v. Pflugbeil, 834 P.2d 843 (Colo. App. 1992).
Test in People v. Medina, 705 P.2d 961 (Colo. 1985), for forcibly administering medication applies equally to a forcible increase in medication dosage. The second Medina element requires a patient to be deteriorating, which does not mean the same thing as "not improving". A patient who is simply not improving will not satisfy the Medina test for forcible administration of medication. People v. Marquardt, 2016 CO 4, 364 P.3d 499.
The statutory authorization to forcibly administer medication related to mental illnesses does not grant the state unlimited authority to administer any medical treatment or medication, even if the four Medina factors are satisfied. The involuntary chemical castration of a person committed by the state to the care of the state hospital by virtue of his mental illness may only be authorized by the general assembly through statute, which it is not. People in Interest of C.J.R., 2016 COA 133 , 409 P.3d 536.
The possibility that a certain medication may no longer be an effective treatment, or may not be taken voluntarily, at some unspecified time in the future is insufficient to justify the entry of an order authorizing the immediate administration of multiple other medications. As such, the people failed to meet the burden set forth under People in Interest of Medina. People in Interest of R.C., 2019 COA 99 M, __ P.3d __.
For presence of respondent at hearing, see Isham v. People, 82 Colo. 550, 262 P. 89 (1927).
For reopening of proceedings under earlier provisions, see Wood v. Throckmorton, 26 Colo. 248 , 57 P. 699 (1899); Ex parte Rainbolt, 64 Colo. 581 , 172 P. 1068 (1918); People ex rel. Best v. County Court, 110 Colo. 249 , 132 P.2d 799 (1942); In re People in Interest of Hill, 118 Colo. 571 , 198 P.2d 450 (1948).
Assistant county attorney is absolutely immune from suit concerning her actions and omissions related to the fulfillment of her statutory obligation pursuant to former subsection (5) to conduct commitment proceedings once the petition for a 72-hour evaluation has been submitted. Scott v. Hern, 216 F.3d 897 (10th Cir. 2000).
Applied in Sisneros v. District Court, 199 Colo. 179 , 606 P.2d 55 (1980); In re A.W., 637 P.2d 366 ( Colo. 1981 ); In re P.F. v. Walsh, 648 P.2d 1067 ( Colo. 1982 ).
27-65-112. 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. Such appeal shall be advanced upon the calendar of the appellate court and shall be decided at the earliest practicable time. Pending disposition by the appellate court, it may make such order as it may consider proper in the premises relating to the care and custody of the respondent.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 691, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-112 as it existed prior to 2010.
ANNOTATION
Applied in Goedecke v. State Dept. of Insts., 198 Colo. 407 , 603 P.2d 123 (1979) (decided prior to 2010 amendments to this article).
27-65-113. Habeas corpus.
Any person detained pursuant to this article shall be 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.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 691, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-113 as it existed prior to 2010.
ANNOTATION
Applied in Goedecke v. State Dept. of Insts., 198 Colo. 407 , 603 P.2d 123 (1979) (decided prior to 2010 amendments to this article).
27-65-114. 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 shall be deemed to have been restored to legal capacity and competency.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 691, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-114 as it existed prior to 2010.
ANNOTATION
Annotator's note. Since § 27-65-114 is similar to § 27-10-111 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
For the unconstitutionality of this section as it existed prior to the 1977 amendment, see Estate of Phillips v. People, 192 Colo. 273 , 558 P.2d 438 (1976).
Applied in People v. Lane, 196 Colo. 42 , 581 P.2d 719 (1978).
27-65-115. Discrimination.
No person who has received evaluation or treatment under any provisions of this article shall be discriminated against because of such status. 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 shall have a civil cause of action.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 692, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-115 as it existed prior to 2010.
ANNOTATION
Applied in Goedecke v. State Dept. of Insts., 198 Colo. 407 , 603 P.2d 123 (1979) (decided prior to 2010 amendments to this article).
27-65-116. Right to treatment.
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- Any person receiving evaluation or treatment under any of the provisions of this article 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 his or her individual needs, delivered in such a way as to keep him or her in the least restrictive environment, and delivered in such a way as to include the opportunity for participation of family members in his or her program of care and treatment when appropriate, all subject to available appropriations. Nothing in this paragraph (a) shall create any right with respect to any person other than the person receiving evaluation, care, or treatment. The professional person and the agency or facility providing evaluation, care, or treatment shall keep records detailing all care and treatment received by such person, and such records shall be made available, upon that person's written authorization, to his or her attorney or his or her personal physician. Such records shall be permanent records and retained in accordance with the provisions of section 27-65-121 (4).
- Any person receiving evaluation or treatment under any of the provisions of this article is entitled to petition the court pursuant to the provisions of section 13-45-102, C.R.S., subject to available appropriations, 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 is not administered.
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The department shall adopt regulations to assure that each agency or facility providing evaluation, care, or treatment shall require the following:
- 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, shall be determined by rules of the department.
- The order of a physician for any treatment or specific therapy based on appropriate medical examinations;
- Notation in the patient's treatment record of periodic examinations, evaluations, orders for treatment, and specific therapies signed by personnel involved;
- Conduct according to the guidelines contained in the regulations of the federal government and the department with regard to clinical investigations, research, experimentation, and testing of any kind; and
- 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 pursuant to section 27-65-121 (1)(g) or (1)(h) and documentation of any information given to a family member.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 692, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-116 as it existed prior to 2010.
ANNOTATION
Law reviews. For article, "Patients' Rights vs. Patients' Needs: The Right of the Mentally Ill to Refuse Treatment in Colorado", see 58 Den. L.J. 567 (1981). For article, "Legal But Not Fair: Legal Implications of a Mental Illness Medical Model", see 11 Colo. Law. 1234 (1982). For article, "Status Report: The "Confidentiality Law"", see 19 Colo. Law. 441 (1990).
Annotator's note. Since § 27-65-116 is similar to § 27-10-116 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
Availability of records. Section 25-1-801 can be read consistently with subsection (1)(a) as a specific exception to a general policy of broad disclosure. Brown v. Jensen, 572 F. Supp. 193 (D. Colo. 1983).
Whether respondent is entitled to treatment in least restrictive possible environment is a matter for court, not jury, to decide under habeas corpus proceeding. People in Interest of Bailey, 745 P.2d 280 (Colo. App. 1987); People in Interest of Lees, 745 P.2d 281 (Colo. App. 1987).
Voluntary patients as well as involuntary patients are entitled to the rights granted by this section. Goebel v. State Dept. of Insts., 764 P.2d 785 ( Colo. 1988 ); Goebel v. Colo. Dept. of Institutions, 830 P.2d 1036 ( Colo. 1992 ).
This section applies to those who voluntarily receive mental health services and could not be voluntarily committed. Goebel v. Colo. Dept. of Institutions, 830 P.2d 1036 ( Colo. 1992 ).
Person need not be so mentally ill as to be gravely disabled or a danger to himself or others for purposes of this section. Goebel v. Colo. Dept. of Institutions, 830 P.2d 1036 ( Colo. 1992 ).
Person need not have been previously hospitalized to be entitled to mental health services. A person who has received either evaluation or treatment services under the Act is entitled to mental health services specified in this section. Goebel v. Colo. Dept. of Institutions, 830 P.2d 1036 ( Colo. 1992 ).
Under the language of this section, chronically mentally ill persons who have received treatment, but who are not gravely disabled or a danger to themselves or others, have a right to treatment if they received evaluation or treatment under any provisions of this article. Goebel v. Colo. Dept. of Institutions, 830 P.2d 1036 ( Colo. 1992 ).
A person need not have had prior hospitalization before such person is entitled to treatment under this section. Such person need only have received either evaluation or treatment services under this act to be eligible for treatment under this section. Goebel v. Colo. Dept. of Institutions, 830 P.2d 1036 ( Colo. 1992 ).
Applied in Romero v. Schauer, 386 F. Supp. 851 (D. Colo. 1974 ); Goedecke v. State Dept. of Insts., 198 Colo. 407 , 603 P.2d 123 (1979).
27-65-117. Rights of persons receiving evaluation, care, or treatment.
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Each person receiving evaluation, care, or treatment under any provision of this article has the following rights and shall be advised of such rights by the facility:
- To receive and send sealed correspondence. No incoming or outgoing correspondence shall be opened, delayed, held, or censored by the personnel of the facility.
- To have access to letter-writing materials, including postage, and to have staff members of the facility assist him or her if unable to write, prepare, and mail correspondence;
- To have ready access to telephones, both to make and to receive calls in privacy;
- To have frequent and convenient opportunities to meet with visitors. Each person may see his or her attorney, clergyman, or physician at any time.
- To wear his or her own clothes, keep and use his or her own personal possessions, and keep and be allowed to spend a reasonable sum of his or her own money.
- A person's rights under subsection (1) of this section may be denied for good cause only by the professional person providing treatment. Denial of any right shall in all cases be entered into the person's treatment record. Information pertaining to a denial of rights contained in the person's treatment record shall be made available, upon request, to the person or his or her attorney.
- No person admitted to or in a facility shall be fingerprinted unless required by other provisions of law.
- A person may be photographed upon admission for identification and the administrative purposes of the facility. The photographs shall be confidential and shall not be released by the facility except pursuant to court order. No other nonmedical photographs shall be taken or used without appropriate consent or authorization.
- Any person receiving evaluation or treatment under any of the provisions of this article is entitled to a written copy of all his or her rights enumerated in this section, and a minor child shall receive written notice of his or her rights as provided in section 27-65-103 (7)(g). A list of such rights shall be prominently posted in all evaluation and treatment facilities.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 693, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-117 as it existed prior to 2010.
Cross references: For rights of persons in custody upon criminal charges, see part 4 of article 3 of title 16.
ANNOTATION
Law reviews. For article, "Patients' Rights vs. Patients' Needs: The Right of the Mentally Ill to Refuse Treatment in Colorado", see 58 Den. L.J. 567 (1981). For article, "Legislative Update", see 13 Colo. Law. 1419 (1984). For article, "In re Romero: Sterilization and Competency", see 68 Den. U. L. Rev. 105 (1991).
Annotator's note. Since § 27-65-117 is similar to § 27-10-117 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
Treatment to be as minimally restrictive as practicable. The primary purpose of a civil commitment is to secure such treatment as is suited to the needs of the person under conditions which are as least restrictive of liberty as practicable. People v. Chavez, 629 P.2d 1040 (Colo. 1981).
Applied in Goedecke v. State Dept. of Insts., 198 Colo. 407 , 603 P.2d 123 (1979).
27-65-118. Administration or monitoring of medications to persons receiving care.
The executive director has the power to direct the administration or monitoring of medications in conformity with part 3 of article 1.5 of title 25, C.R.S., to persons receiving treatment in facilities created pursuant to this article.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 693, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-117.5 as it existed prior to 2010.
27-65-119. Employment of persons in a facility - rules.
The department shall adopt rules governing the employment and compensation therefor of persons receiving care or treatment under any provision of this article. The department shall establish standards for reasonable compensation for such employment.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 694, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-118 as it existed prior to 2010.
27-65-120. Voting in public elections.
Any person receiving evaluation, care, or treatment under this article shall be given the opportunity to exercise his or her right to register and to vote in primary and general elections. The agency or facility providing evaluation, care, or treatment shall assist such persons, upon their request, to obtain voter registration forms and mail ballots and to comply with any other prerequisite for voting.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 694, § 2, effective April 29. L. 2013: Entire section amended, (HB 13-1303), ch. 185, p. 750, § 131, effective May 10.
Editor's note: This section is similar to former § 27-10-119 as it existed prior to 2010.
Cross references: In 2013, this section was amended by the "Voter Access and Modernized Elections Act". For the short title and legislative declaration, see sections 1 and 2 of chapter 185, Session Laws of Colorado 2013.
ANNOTATION
Law reviews. For article, "Patients' Rights vs. Patients' Needs: The Right of the Mentally Ill to Refuse Treatment in Colorado", see 58 Den. L.J. 567 (1981).
Applied in Goedecke v. State Dept. of Insts., 198 Colo. 407 , 603 P.2d 123 (1979) (decided prior to 2010 amendments to this article).
27-65-121. Records.
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Except as provided in subsection (2) of this section, all information obtained and records prepared in the course of providing any services pursuant to this article 65 to individuals pursuant to any provision of this article 65 are confidential and privileged
matter. The information and records may be disclosed only:
- In communications between qualified professional personnel in the provision of services or appropriate referrals;
- 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 his or her guardian or conservator designates, in writing, persons to whom records or information may be disclosed, the designation shall be valid in lieu of the designation by the recipient; except that nothing in this section shall be construed to compel a physician, psychologist, social worker, nurse, attorney, or other professional personnel to reveal information that has been given to him or her in confidence by members of a patient's family or other informants;
- To the extent necessary to make claims on behalf of a recipient of aid, insurance, or medical assistance to which he or she may be entitled;
- If the department has promulgated rules for the conduct of research. Such rules shall include, but not be 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, shall not be disclosed for research purposes.
- To the courts, as necessary to the administration of the provisions of this article;
- 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;
- To adult 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 27-65-122 and is subject to review pursuant to section 27-65-122.
- To adult family members 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 27-65-122 (2) and is subject to review pursuant to section 27-65-122.
- 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.
- Nothing in paragraph (g) or (h) of subsection (1) of this section shall be deemed to preclude the release of information to a parent concerning his or her minor child.
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- Nothing in this article shall be construed as rendering privileged or confidential any information, except written medical records and information that is privileged under section 13-90-107, C.R.S., concerning observed behavior that constitutes a criminal offense committed upon the premises of any facility providing services under this article or any criminal offense committed against any person while performing or receiving services under this article.
- The provisions of subsection (1) of this section shall not apply to physicians or psychologists eligible to testify concerning a criminal defendant's mental condition pursuant to section 16-8-103.6, C.R.S.
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- All facilities shall maintain and retain permanent records, including all applications as required pursuant to section 27-65-105 (3).
- 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.
- 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.
- Nothing in this section shall be construed to prohibit or limit the sharing of information by a state institution of higher education police department to authorized university administrators pursuant to section 23-5-141, C.R.S.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 694, § 2, effective April 29. L. 2011: (5) added, (HB 11-1169), ch. 119, p. 374, § 3, effective April 20. L. 2017: IP(1), (1)(g), and (1)(h) amended, (SB 17-242), ch. 263, p. 1345, § 240, effective May 25. L. 2018: (1)(i) amended, (SB 18-091), ch. 35, p. 390, § 35, effective August 8.
Editor's note: This section is similar to former § 27-10-120 as it existed prior to 2010.
Cross references: (1) For privilege of communication of physicians generally, see §§ 13-90-107 (1)(d) and 13-90-108.
(2) For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017. For the legislative declaration in SB 18-091, see section 1 of chapter 35, Session Laws of Colorado 2018.
ANNOTATION
Law reviews. For article, "Patients' Rights vs. Patients' Needs: The Right of the Mentally Ill to Refuse Treatment in Colorado", see 58 Den. L.J. 567 (1981). For article, "Status Report: The "Confidentiality Law"", see 19 Colo. Law. 441 (1990).
Annotator's note. Since § 27-65-121 is similar to § 27-10-120 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
Use of information in criminal proceeding limited. No information produced at a hearing on involuntary short-term certification for psychiatric treatment can be used to incriminate the person sought to be committed in future criminal proceedings, unless it is available to the prosecution from other sources. People v. Taylor, 618 P.2d 1127 (Colo. 1980).
In a federal criminal prosecution and investigation, federal privilege law preempts this more protective Colorado privilege statute. In Re Grand Jury No. 91-1, 795 F. Supp. 1057 (D. Colo. 1992).
Because of the curtailment of personal liberty that results from certification of mental illness, strict adherence to the procedural requirements in civil commitment statutes is required. People in Interest of Dveirin, 755 P.2d 1207 ( Colo. 1988 ); People in Interest of Reynes, 870 P.2d 518 (Colo. App. 1993).
Psychologist-client privilege. In keeping with the statutory goal of securing care and treatment on an individual basis, this section is intended as an authorization for a psychologist to testify to observations concerning an involuntarily detained person when the issue before the court is whether the statutory conditions for certification for short-term treatment have been satisfied. People v. District Court, 797 P.2d 1259 ( Colo. 1990 ); People v. Hynes, 917 P.2d 328 (Colo. App. 1996).
Applied in Brady v. Hopper, 570 F. Supp. 1333 (D. Colo. 1983).
27-65-122. Request for release of information - procedures - review of a decision concerning release of information.
- When a family member requests the location and fact of admission of a person with a mental health disorder pursuant to section 27-65-121 (1)(g), the treating professional person or his or her 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 his or her 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 27-65-121 (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, 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.
-
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When a family member requests information pursuant to section 27-65-121 (1)(h) concerning a person with a mental health disorder, the treating professional person or his or her designee shall determine whether the person with a mental health disorder
is capable of making a rational decision in weighing his or her confidentiality interests and the care and treatment interests implicated by the release of information. The treating professional person or his or her
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:
- If the treating professional person or his or her designee makes a finding that the person with a mental health disorder is capable of making a rational decision concerning his or her interests and the person with a mental health disorder consents to the release of information, the treating professional person or his or her designee shall order the release of the information unless he or she determines that the release would not be in the best interests of the person with a mental health disorder.
- If the treating professional person or his or her designee makes a finding that the person with a mental health disorder is capable of making a rational decision concerning his or her interests and the person with a mental health disorder objects to the release of information, the treating professional person or his or her designee shall not order the release of the information.
- If the treating professional person or his or her designee makes a finding that the person with a mental health disorder is not capable of making a rational decision concerning his or her interests, the treating professional person or his or her designee may order the release of the information if he or she determines that the release would be in the best interests of the person with a mental health disorder.
- Any determination as to capacity pursuant to this subsection (2)(a) must be used only for the limited purpose of this subsection (2)(a).
- A decision by a treating professional person or his or her 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 his or her 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.
- 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 27-65-121 (1)(h).
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When a family member requests information pursuant to section 27-65-121 (1)(h) concerning a person with a mental health disorder, the treating professional person or his or her designee shall determine whether the person with a mental health disorder
is capable of making a rational decision in weighing his or her confidentiality interests and the care and treatment interests implicated by the release of information. The treating professional person or his or her
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:
- When administrative review is requested either pursuant to subsection (1) or subsection (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 he or she is a professional person. If the director is not available or if the director cannot provide an objective and impartial review, the review shall 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.
- If a person with a mental health disorder objects to the release or withholding of information, the person with a mental health disorder and his or her 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 his or her care and treatment is released.
- A family member whose request for information is denied shall be provided with information concerning the procedures for administrative review of a decision to release or withhold information.
- 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 27-65-121 (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 his or her 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.
- 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 his or her designee shall not release information requested pursuant to section 27-65-121 (1)(h) until five days after the determination upon administrative review of the director or his or her 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 his or her 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 him or her 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.
- This section provides for the release of information only and shall not be deemed to authorize the release of the written medical record without authorization by the patient or as otherwise provided by law.
- For purposes of this section, the treating professional person's designee shall be a professional person.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 695, § 2, effective April 29. L. 2017: (1), (2), (3), (4), (6), and (7) amended, (SB 17-242), ch. 263, p. 1345, § 241, effective May 25.
Editor's note: This section is similar to former § 27-10-120.5 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
ANNOTATION
Law reviews. For article, "Status Report: The "Confidentiality Law"", see 19 Colo. Law. 441 (1990).
27-65-123. Treatment in federal facilities.
- If a person is certified under the provisions of this article and is eligible for hospital care or treatment by an agency of the United States and if a certificate of notification from said agency, showing that facilities are available and that the person is eligible for care or treatment therein, is received, the court may order him or her 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 without this state, the person shall be subject to the rules and regulations of the agency. The chief officer of any hospital or institution operated by an agency and 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 shall be retained in the appropriate courts of this state to inquire into the mental condition of persons so hospitalized and to determine the necessity for continuance of their hospitalization.
- 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, shall have the same effect as to said 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 shall be deemed to have retained jurisdiction of the person so hospitalized for the purpose of inquiring into his or her mental condition and of determining the necessity for continuance of his or her hospitalization. Consent is hereby 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, to transfer, to conditionally release, or to discharge the person hospitalized.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 698, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-121 as it existed prior to 2010.
27-65-124. Transfer of persons into and out of Colorado - reciprocal agreements.
The transfer of persons hospitalized voluntarily under the provisions of this article out of Colorado or under the laws of another jurisdiction into Colorado shall be governed by the provisions of the interstate compact on mental health.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 698, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-122 as it existed prior to 2010.
Cross references: For the interstate compact on mental health, see part 10 of article 60 of title 24.
27-65-125. Criminal proceedings. (Repealed)
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 698, § 2, effective April 29. L. 2019: Entire section repealed, (SB 19-223), ch. 227, p. 2290, § 13, effective July 1.
Editor's note: This section was similar to former § 27-10-123 as it existed prior to 2010.
27-65-126. Application of this article.
The provisions of this article do not apply to or govern any proceedings commenced or concluded prior to July 1, 1975, with the exception of section 27-65-114. Any proceeding commenced prior to July 1, 1975, shall be administered and disposed of according to the provisions of law existing prior to July 1, 1975, in the same manner as if this article had not been enacted.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 699, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-124 as it existed prior to 2010.
27-65-127. Imposition of legal disability - deprivation of legal right - restoration.
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- 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 himself or herself 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.
- The petition shall set forth the disability to be imposed or the legal right to be deprived and the reasons therefor.
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The court may impose a legal disability or may deprive a person of a legal right only upon finding both of the following:
- That the respondent is a person with a mental health disorder and is a danger to himself or herself or others, gravely disabled, or insane, as defined in section 16-8-101;
- That the requested disability or deprivation is both necessary and desirable.
- To have a legal disability removed or a legal right restored, any interested person may file a petition with the court which made the original finding. No legal disability shall 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 the findings specified in subsection (2) of this section shall be reaffirmed to justify continuance of the disability or deprivation. A copy of the petition shall be served on the person who filed the original petition, on the person whose rights are affected if he or she is not the petitioner, and upon the facility where the person whose rights are affected resides, if any.
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Whenever any proceedings are instituted or conducted pursuant to this section, the following procedures shall apply:
- Upon the filing of a petition, the court shall appoint an attorney-at-law to represent the respondent. The respondent may replace said attorney with an attorney of the respondent's own selection at any time. Attorney fees for an indigent respondent shall be paid by the court.
- The court, upon request of an indigent respondent or his or her attorney, shall appoint, at the court's expense, one or more professional persons of the respondent's selection to assist the respondent in the preparation of his or her case.
- Upon demand made at least five days prior to the date of hearing, the respondent shall have the right to a trial of all issues by a jury of six.
- At all times the burden shall be 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.
- 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 shall be required prior to the issuance of such order.
- Except as otherwise provided in this subsection (4), all proceedings shall be held in conformance with the Colorado rules of civil procedure, but no costs shall be assessed against the respondent.
- Any person who, by reason of a judicial decree or order entered by a court of this state prior to July 1, 1979, is under the imposition of a legal disability or has been deprived of a legal right pursuant to this section as it existed prior to July 1, 1979, shall be released from such decree or order on December 31, 1979.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 699, § 2, effective April 29. L. 2017: (1)(a) and (2)(a) amended, (SB 17-242), ch. 263, p. 1348, § 242, effective May 25.
Editor's note: This section is similar to former § 27-10-125 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
ANNOTATION
Annotator's note. Since § 27-65-127 is similar to § 27-10-125 as it existed prior to the 2010 amendments to this article, relevant cases construing that provision have been included in the annotations to this section.
Equal protection not violated. There is a rational basis for distinguishing between this section and former § 27-10-107; the sections address parties who are not similarly situated. Curnow v. Yarbrough, 676 P.2d 1177 (Colo. 1984).
Court may issue order depriving involuntarily committed person of the legal right to possess weapons pursuant to this section. People v. Pflugbeil, 834 P.2d 843 (Colo. App. 1992).
Subsection (1)(a)'s plain meaning provides that an interested person may initiate a court proceeding when (1) the subject is insane, as defined in § 16-8-101, and (2) the person is not then subject to proceedings under this article. The statute presupposes that a not guilty by reason of insanity adjudicated patient could be subject to provisions under this article. The statute also presupposes that not every not guilty by reason of insanity patient is subject to this article. Neiberger v. Hawkins, 239 F. Supp. 2d 1140 (D. Colo. 2002).
Applied in Brown v. Jensen, 572 F. Supp. 193 (D. Colo. 1983).
27-65-128. Administration - rules.
The department shall make such rules as will consistently enforce the provisions of this article.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 700, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-126 as it existed prior to 2010.
27-65-129. Payment for counsel.
In order to provide legal representation to persons eligible therefor as provided in this article, the judicial department is authorized to pay, out of appropriations made therefor by the general assembly, sums directly to appointed counsel on a case-by-case basis or, on behalf of the state, to make lump-sum grants to and contract with individual attorneys, legal partnerships, legal professional corporations, public interest law firms, or nonprofit legal services corporations.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 700, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10-127 as it existed prior to 2010.
27-65-130. Mental health service standards for health-care facilities.
The advisory board created by section 27-65-131 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 their only purpose the care and treatment of such persons.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 700, § 2, effective April 29. L. 2017: Entire section amended, (SB 17-242), ch. 263, p. 1348, § 243, effective May 25.
Editor's note: This section is similar to former § 27-10-128 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-65-131. Advisory board - service standards and rules.
An advisory board, referred to as the "board" in this section, to the department is established for the purpose of assisting and advising the executive director in accordance with section 27-65-130 in the development of service standards and rules. The board consists of not less than eleven nor more than fifteen members appointed by the governor. The board includes one representative each from the office of behavioral health, the department of human services, the department of public health and environment, the university of Colorado health sciences center, and a leading professional association of psychiatrists in this state; at least one member representing proprietary skilled health-care facilities; one member representing nonprofit health-care facilities; one member representing the Colorado bar association; one member representing consumers of services for persons with mental health disorders; one member representing families of persons with mental health disorders; one member representing children's health-care facilities; and 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. 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 (2.5), 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.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 701, § 2, effective April 29. L. 2017: Entire section amended, (SB 17-242), ch. 263, p. 1348, § 244, effective May 25. L. 2018: Entire section amended, (HB 18-1364), ch. 351, p. 2082, § 9, effective July 1.
Editor's note: This section is similar to former § 27-10-129 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
ANNOTATION
Law reviews. For article, "Patients' Rights vs. Patients' Needs: The Right of the Mentally Ill to Refuse Treatment in Colorado", see 58 Den. L.J. 567 (1981).
ARTICLE 66 COMMUNITY MENTAL HEALTH SERVICES - PURCHASE
Editor's note: This article was added with relocations in 2010 containing provisions of part 2 of article 1 of this title. Former C.R.S. section numbers are shown in editor's notes following those sections that were relocated. For a detailed comparison of this article, see the comparative tables located in the back of the index.
Section
27-66-101. Definitions.
As used in this article 66, unless the context otherwise requires:
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"Acute treatment unit" means a facility or a distinct part of a facility for short-term psychiatric care, which may include substance abuse treatment and 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.
(1.5) [ Editor's note: Subsection (1.5) is effective July 1, 2022. ] "Behavioral health entity" means a facility or provider organization engaged in providing community-based health services, which may include behavioral health disorder services, alcohol use disorder services, or substance use disorder services, including crisis stabilization, acute or ongoing treatment, or community mental health center services as described in subsections (2) and (3) of this section, but does not include:
- Residential child care facilities as defined in section 26-6-102 (33); or
- Services provided by a licensed or certified mental health-care provider under the provider's individual professional practice act on the provider's own premises.
-
"Community mental health center" means either a physical plant or a group of services under unified administration or affiliated with one another, and including at least the following services provided for the prevention and treatment of behavioral or
mental health disorders in persons residing in a particular community in or near the facility so situated:
- Inpatient services;
- Outpatient services;
- Partial hospitalization;
- Emergency services;
- Consultative and educational services.
- "Community mental health clinic" means a health institution planned, organized, operated, and maintained to provide basic community services for the prevention, diagnosis, and treatment of emotional, behavioral, or mental health disorders, such services being rendered primarily on an outpatient and consultative basis.
- "Department" means the department of human services created in section 26-1-105, C.R.S.
- "Executive director" means the executive director of the department of human services.
- "Office of behavioral health" means the office of behavioral health in the department.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 701, § 2, effective April 29. L. 2017: IP, (1), IP(2), (3), and (6) amended, (SB 17-242), ch. 263, p. 1349, § 245, effective May 25. L. 2019: (1.5) added, (HB 19-1237), ch. 413, p. 3642, § 14, effective July 1, 2022.
Editor's note: This section is similar to former § 27-1-201 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-66-102. Administration - rules.
- The executive director has the power and duty to administer and enforce the provisions of this article.
- The department may adopt reasonable and proper rules to implement this article in accordance with the provisions of section 24-4-103, C.R.S., and consistent with sections 27-90-102 and 27-90-103.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 702, § 2, effective April 29.
Editor's note: This section is similar to former § 27-1-202 as it existed prior to 2010.
27-66-103. Community mental health services - purchase program.
In order to encourage the development of preventive, treatment, and rehabilitative services through new community mental health programs, the improvement and expansion of existing community mental health services, and the integration of community with state mental health services, there is established a program to purchase community mental health services by the department.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 702, § 2, effective April 29.
Editor's note: This section is similar to former § 27-1-203 as it existed prior to 2010.
Cross references: For provisions on community-centered boards that provide services for persons with developmental disabilities, see part 1 of article 10.5 of this title 27.
ANNOTATION
This program does not provide substantive rights to community treatment for chronically ill persons. Goebel v. State Dept. of Insts., 764 P.2d 785 (Colo. 1988) (decided prior to 2010 amendments to this article).
27-66-104. Types of services purchased - limitation on payments.
-
[ Editor's note: This version of subsection (1) is effective until July 1, 2022.] Community mental health services may be purchased from clinics, community mental health centers, local general or psychiatric hospitals, and other agencies that have been
approved by the executive director.
(1) [ Editor's note: This version of subsection (1) is effective July 1, 2022. ] Community mental health services may be purchased from behavioral health entities, clinics, community mental health centers, local general or psychiatric hospitals, and other agencies that have been approved by the executive director.
-
-
[ Editor's note: This version of the introductory portion to subsection (2)(a) is effective until July 1, 2022.] Each year the general assembly shall appropriate funds for the purchase of mental health services from:
(2) (a) [ Editor's note: This version of the introductory portion to subsection (2)(a) is effective July 1, 2022. ] Each year the general assembly shall appropriate money for the purchase of mental health services from:
- Community mental health centers;
-
[ Editor's note: This version of subsection (2)(a)(II) is effective until July 1, 2022.] Agencies that provide specialized clinic-type services but do not serve a specific designated service area; and
(II) [ Editor's note: This version of subsection (2)(a)(II) is effective July 1, 2022. ] Agencies that provide specialized clinic-type services but do not serve a specific designated service area;
-
[ Editor's note: This version of subsection (2)(a)(III) is effective until July 1, 2022.] Acute treatment units;
(III) [ Editor's note: This version of subsection (2)(a)(III) is effective July 1, 2022. ] Acute treatment units; and
- [ Editor's note: Subsection (2)(a)(IV) is effective July 1, 2022.] Behavioral health entities.
-
[ Editor's note: This version of subsection (2)(b) is effective until July 1, 2022.] The funds appropriated for the purposes of this subsection (2) shall be distributed by the executive director to approved community mental health centers and other agencies
on the basis of need and in accordance with the services provided.
(b) [ Editor's note: This version of subsection (2)(b) is effective July 1, 2022. ] The money appropriated for the purposes of this subsection (2) shall be distributed by the executive director to approved behavioral health entities, community mental health centers, and other agencies on the basis of need and in accordance with the services provided.
-
[ Editor's note: This version of the introductory portion to subsection (2)(a) is effective until July 1, 2022.] Each year the general assembly shall appropriate funds for the purchase of mental health services from:
-
[ Editor's note: This version of subsection (3) is effective until July 1, 2022.] Each year the general assembly may appropriate funds in addition to those appropriated for purposes of subsection (2) of this section, which funds may be used by the executive
director to assist community mental health clinics and centers in instituting innovative programs, in providing mental health services to impoverished areas, and in dealing with crisis situations. The executive director shall require
that any innovative or crisis programs for which funds are allocated under this subsection (3) be clearly defined in terms of services to be rendered, program objectives, scope and duration of the program, and the maximum amount
of funds to be provided.
(3) [ Editor's note: This version of subsection (3) is effective July 1, 2022. ] Each year the general assembly may appropriate money in addition to the money appropriated for purposes of subsection (2) of this section, which money may be used by the executive director to assist behavioral health entities and community mental health clinics and centers in instituting innovative programs, in providing mental health services to impoverished areas, and in dealing with crisis situations. The executive director shall require that any innovative or crisis programs for which money is allocated pursuant to this subsection (3) be clearly defined in terms of services to be rendered, program objectives, scope and duration of the program, and the maximum amount of money to be provided.
- Repealed.
- If there is a reduction in the financial support of local governmental bodies for community mental health services, the executive director is authorized to reduce state payments for services in an amount proportional to the reduction in such local financial support.
-
[ Editor's note: This version of subsection (6) is effective until July 1, 2022.] For purposes of entering into a cooperative purchasing agreement pursuant to section 24-110-201, C.R.S., a nonprofit community mental health center or a nonprofit community
mental health clinic may be certified as a local public procurement unit as provided in section 24-110-207.5, C.R.S.
(6) [ Editor's note: This version of subsection (6) is effective July 1, 2022. ] For purposes of entering into a cooperative purchasing agreement pursuant to section 24-110-201, a nonprofit behavioral health entity, nonprofit community mental health center, or nonprofit community mental health clinic may be certified as a local public procurement unit as provided in section 24-110-207.5.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 702, § 2, effective April 29. L. 2011: (4)(a) amended, (SB 11-225), ch. 189, p. 731, § 5, effective May 19. L. 2012: (4)(a) amended, (HB 12-1247), ch. 53, p. 197, § 8, effective March 22. L. 2013: (4)(a) amended, (HB 13-1181), ch. 74, p. 241, § 9, effective March 22. L. 2016: (4)(a) amended, (HB 16-1408), ch. 153, p. 471, § 23, effective May 4; (4)(b) repealed, (HB 16-1408), ch. 153, p. 472, § 26, effective July 1. L. 2017: (4) amended, (SB 17-264), ch. 353, p. 1839, § 2, effective June 5. L. 2019: (1), IP(2)(a), (2)(a)(II), (2)(a)(III), (2)(b), (3), and (6) amended and (2)(a)(IV) added, (HB 19-1237), ch. 413, p. 3642, § 15, effective July 1, 2022.
Editor's note:
- This section is similar to former § 27-1-204 as it existed prior to 2010.
- Subsection (4)(c) provided for the repeal of subsection (4), effective September 1, 2017. (See L. 2017, p. 1839 .)
27-66-105. Standards for approval.
-
In approving or rejecting community mental health clinics for the purchase of behavioral or mental health services, the executive director shall:
-
[ Editor's note: This version of subsection (1)(a) is effective until July 1, 2022.] Consider the adequacy of mental health services provided by such clinics, taking into consideration such factors as geographic location, local economic conditions, and
availability of manpower;
(a) [ Editor's note: This version of subsection (1)(a) is effective July 1, 2022. ] Consider the adequacy and quality of mental health services provided by such clinics, taking into consideration such factors as geographic location, local economic conditions, and availability of manpower;
- Require that overall responsibility for the administration of a community mental health clinic be vested in a director who is a physician or a member of one of the mental health professions;
- Require that the treatment programs of the clinic be under the overall direction of a psychiatrist who is a physician licensed to practice medicine in the state of Colorado;
- Require that the clinic staff include, wherever feasible, other professional staff workers, such as psychologists, social workers, educational consultants, and nurses, with such qualifications, responsibilities, and time on the job as correspond with the size and capacity of the clinic. The clinic staff may include, with the approval of the executive director, such other nonprofessional persons as may be deemed necessary by the clinic board for the proper discharge of its functions.
- Require that each clinic from which services may be purchased be under the control and direction of a county or community board of health, a board of directors or trustees of a corporation, for profit or not for profit, a regional mental health board, or a political subdivision of the state;
- Consider the existence of facilities that provide an emphasis on the care and treatment of persons recently released from hospitals or facilities directed toward assisting persons with behavioral or mental health disorders in their adjustment to and functioning within society as a whole;
- [ Editor's note: Subsection (1)(g) is effective July 1, 2022.] On and after July 1, 2022, require licensure by the department of public health and environment pursuant to section 25-27.6-104.
-
[ Editor's note: This version of subsection (1)(a) is effective until July 1, 2022.] Consider the adequacy of mental health services provided by such clinics, taking into consideration such factors as geographic location, local economic conditions, and
availability of manpower;
-
[ Editor's note: This version of the introductory portion to subsection (2) is effective until July 1, 2022.] In approving or rejecting local general or psychiatric hospitals, community mental health centers, acute treatment units, and other agencies
for the purchase of services not provided by local mental health clinics, including, but not limited to, twenty-four-hour and partial hospitalization, the executive director shall consider the following factors:
(2) [ Editor's note: This version of the introductory portion to subsection (2) is effective July 1, 2022. ] In approving or rejecting local general or psychiatric hospitals, behavioral health entities, community mental health centers, acute treatment units, and other agencies for the purchase of services not provided by local mental health clinics, including, but not limited to, twenty-four-hour and partial hospitalization, the executive director shall consider the following factors:
- The general quality of care provided to patients by such agencies;
- The organization of the medical staff to provide for the integration and coordination of the psychiatric treatment program;
- The provisions for the availability of nursing, psychological, and social services and the existence of an organized program of activities under the direction of an occupational therapist or of another qualified person;
- The licensure by the department of public health and environment or another state agency where applicable;
- The methods by which the agency coordinates its services with those rendered by other agencies to ensure an uninterrupted continuum of care to persons with behavioral or mental health disorders; and
- The availability of such services to the general public.
-
[ Editor's note: This version of subsection (3) is effective until July 1, 2022.] In the purchase of services from community mental health centers, the executive director shall specify levels and types of inpatient, outpatient, consultation, education,
and training services and expenditures and shall establish minimum standards for other programs of such centers that are to be supported with state funds.
(3) [ Editor's note: This version of subsection (3) is effective July 1, 2022. ] In the purchase of services from behavioral health entities or community mental health centers, the executive director shall specify levels and types of inpatient, outpatient, consultation, education, and training services and expenditures and shall establish minimum standards for other programs of such centers that are to be supported with state funds.
- [ Editor's note: Subsection (4) is effective July 1, 2022.] In approving or rejecting behavioral health entities, community mental health clinics, community mental health centers, acute treatment units, local general or psychiatric hospitals, and other agencies for the purchase of services, the executive director shall ensure the agencies comply with federal financial participation requirements for department-administered programs.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 704, § 2, effective April 29. L. 2017: IP(1), (1)(f), and (2)(e) amended, (SB 17-242), ch. 263, p. 1350, § 246, effective May 25. L. 2018: (1)(e) amended, (SB 18-096), ch. 44, p. 475, § 19, effective August 8. L. 2019: (1)(a), IP(2), and (3) amended and (1)(g) and (4) added, (HB 19-1237), ch. 413, p. 3643, § 16, effective July 1, 2022.
Editor's note: This section is similar to former § 27-1-205 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017. For the legislative declaration in SB 18-096, see section 1 of chapter 44, Session Laws of Colorado 2018.
ANNOTATION
Subsection (1)(b) does not impose individual liability upon the director of a mental health center for acts or omissions of the center's staff. Bauer v. Southwest Denver Mental Health Center, 701 P.2d 114 (Colo. App. 1985) (decided prior to 2010 amendments to this article).
27-66-106. Federal grants-in-aid - administration.
[ Editor's note: This version of this section is effective until July 1, 2022.]
- The department is designated the official mental health authority, and is authorized to receive grants-in-aid from the federal government under the provisions of 42 U.S.C. sec. 246, and shall administer said grants in accordance therewith.
- The department shall continue to fund the costs of licensing activities related to the behavioral health entity license across the department of human services and the department of public health and environment, less the money collected by the behavioral health entity cash fund created in section 25-27.6-108 through June 30, 2024.
27-66-106. Federal grants-in-aid and other grants for mental health and integrated behavioral health services - administration.
[ Editor's note: This version of this section is effective July 1, 2022.]
-
The department is designated the official mental health authority and is authorized to:
- Receive grants-in-aid from the federal government under the provisions of 42 U.S.C. sec. 246 and shall administer said grants in accordance therewith; and
- Receive other grants from the federal government for the provision of mental health or integrated behavioral health services and shall administer such grants in accordance therewith.
- The department shall continue to fund the costs of licensing activities related to the behavioral health entity license across the department of human services and the department of public health and environment, less the money collected by the behavioral health entity cash fund created in section 25-27.6-108 through June 30, 2024.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 705, § 2, effective April 29. L. 2018: Entire section amended, (SB 18-096), ch. 44, p. 475, § 20, effective August 8. L. 2019: Entire section amended, (HB 19-1237), ch. 413, p. 3638, § 4, effective August 2; entire section amended, (HB 19-1237), ch. 413, p. 3643, § 17, effective July 1, 2022.
Editor's note:
- This section is similar to former § 27-1-206 as it existed prior to 2010.
- Amendments to this section by sections 4 and 17 of HB 19-1237 were harmonized, effective July 1, 2022.
Cross references: For the legislative declaration in SB 18-096, see section 1 of chapter 44, Session Laws of Colorado 2018.
27-66-107. Purchase of services by courts, counties, municipalities, school districts, and other political subdivisions.
[ Editor's note: This version of this section is effective until July 1, 2022. ] Any county, municipality, school district, health service district, or other political subdivision of the state or any county, district, or juvenile court may enter into intergovernmental agreements with any municipality, school district, health service district, or other political subdivision of the state or may enter into contractual agreements with any private provider, community mental health clinics, and such other community agencies for the purchase of mental health services. For the purchase of mental health services by counties or city and counties as authorized by this section, the board of county commissioners of any county or the city council of any city and county may levy a tax not to exceed two mills upon real property within the county or city and county if the board first submits the question of such levy to a vote of the qualified electors at a general election and receives their approval of such levy.
27-66-107. Purchase of services by courts, counties, municipalities, school districts, and other political subdivisions.
[ Editor's note: This version of this section is effective July 1, 2022. ] Any county, municipality, school district, health service district, or other political subdivision of the state or any county, district, or juvenile court may enter into intergovernmental agreements with any municipality, school district, health service district, or other political subdivision of the state or may enter into contractual agreements with any private provider, behavioral health entities, community mental health clinics, and other community agencies for the purchase of mental health services. For the purchase of mental health services by counties or city and counties as authorized by this section, the board of county commissioners of any county or the city council of any city and county may levy a tax not to exceed two mills upon real property within the county or city and county if the board first submits the question of the levy to a vote of the qualified electors at a general election and receives their approval of the levy.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 705, § 2, effective April 29. L. 2019: Entire section amended, (HB 19-1287), ch. 175, p. 2015, § 2, effective May 14; entire section amended, (HB 19-1237), ch. 413, p. 3644, § 18, effective July 1, 2022.
Editor's note:
- This section is similar to former § 27-1-207 as it existed prior to 2010.
- Amendments to this section by HB 19-1287 and HB 19-1237 were harmonized, effective July 1, 2022.
27-66-108. Institutes and training programs.
The department may, from time to time during each year, provide consultation and conduct institutes and training programs on a state, regional, district, county, or community level as necessary to coordinate, inform, and assist in the training of staff members of the various approved community mental health programs of the state. The department may reimburse staff members for reasonable and necessary expenses incurred in attending the institutes and training programs.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 705, § 2, effective April 29.
Editor's note: This section is similar to former § 27-1-208 as it existed prior to 2010.
27-66-109. Family mental health services grant program - rural areas - creation - administration - report - repeal. (Repealed)
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 705, § 2, effective April 29.
Editor's note:
- Subsection (5) provided for the repeal of this section, effective July 1, 2010. (See L. 2010, p. 705 .)
- This section was similar to former § 27-1-209 as it existed prior to 2010.
27-66-110. Trauma-informed care standards of approval.
The office of behavioral health shall establish care standards and an approval process that a qualified residential treatment program, as defined in section 26-6-102 (30.5), must meet to ensure that qualified residential treatment programs have a trauma-informed treatment model that addresses the needs of children and youth with serious emotional or behavioral health disorders or disturbances.
Source: L. 2019: Entire section added, (HB 19-1308), ch. 256, p. 2462, § 12, effective August 2.
ARTICLE 66.5 COMMUNITY TRANSITION SPECIALIST PROGRAM
Section
27-66.5-101. Short title.
The short title of this article 66.5 is the "Community Transition Specialist Program Act".
Source: L. 2018: Entire article added, (SB 18-270), ch. 223, p. 1421, § 1, effective May 21.
27-66.5-102. Definitions.
As used in this article 66.5, unless the context otherwise requires:
- "Department" means the Colorado department of human services created in section 26-1-105.
- "Director" means the director of the office of behavioral health.
-
"High-risk individual" means a person who:
-
Has a significant mental health or substance use disorder, as evidenced by:
- An emergency procedure for a seventy-two-hour hold pursuant to section 27-65-105;
- A certification for short-term treatment or extended short-term treatment pursuant to section 27-65-107 or 27-65-108;
- Long-term care and treatment pursuant to section 27-65-109;
- An emergency commitment pursuant to section 27-81-111;
- An involuntary commitment pursuant to section 27-81-112; or
- Receiving voluntary behavioral health services pursuant to section 27-65-103, 27-81-109, or 27-81-110; and
- Repealed.
- Is not currently engaged or actively enrolled in consistent community-based behavioral health treatment.
-
Has a significant mental health or substance use disorder, as evidenced by:
-
"Office" means the office of behavioral health in the department of human services.
(4.5) "Transition services" include, but are not limited to, one or more of the following services:
- Access to housing or residential program placement;
- Access to behavioral health treatment or benefits;
- Advocacy to insurance companies and providers for the appropriate type and intensity of mental health or substance use disorder services;
- Planning for follow-up services and coordination within the behavioral health system after hospitalization or discharge from a withdrawal management facility, acute treatment service facility, crisis stabilization service facility, or a hospital or an emergency department following a visit for behavioral health reasons;
- Assistance with preparing advance directives;
- Obtaining a representative payee or guardian;
- Family supportive services; or
- Compliance with court appearances or probation.
- "Transition specialist" means a person who assists high-risk individuals with transition services.
- "Withdrawal management facility" means a facility that provides twenty-four-hour supervised withdrawal from alcohol or drugs in a residential setting.
Source: L. 2018: Entire article added, (SB 18-270), ch. 223, p. 1421, § 1, effective May 21. L. 2020: (3)(a)(IV) and (3)(a)(V) amended, (SB 20-007), ch. 286, p. 1416, § 53, effective July 13. L. 2021: IP(3)(a), (3)(a)(IV), (3)(a)(V), (3)(c), and (5) amended, (3)(a)(VI) and (4.5) added, and (3)(b) repealed, (HB 21-1130), ch. 45, p. 190, § 1, effective April 20.
27-66.5-103. Community transition specialist program - program requirements - acceptance of referrals - contract for services - rules.
- The community transition specialist program is established in the office of behavioral health. The program coordinates referrals of high-risk individuals from withdrawal management facilities, facilities providing acute treatment services, facilities providing crisis stabilization services, and hospitals or emergency departments to appropriate transition specialists.
- On or before January 1, 2019, the program must be available statewide, subject to available appropriations. The program must have a process to accept referrals for high-risk individuals and coordinate contact between referred high-risk individuals and appropriate transition specialists. To the extent possible, the coordinated contact must take place prior to the release or discharge of the high-risk individual from a facility.
- The program must encourage, but cannot require, withdrawal management facilities, facilities providing acute treatment services, facilities providing crisis stabilization services, and hospitals or emergency departments to contact the program before releasing or discharging a high-risk individual.
- The program may encourage, but cannot require, a high-risk individual to accept services from a transition specialist. Participation by a high-risk individual is voluntary and the individual has the right to decline community transition specialist services.
- The office may contract with a vendor to provide the referral and coordination services required by this article 66.5.
- The department may promulgate rules necessary for the implementation of this article 66.5.
Source: L. 2018: Entire article added, (SB 18-270), ch. 223, p. 1423, § 1, effective May 21. L. 2021: (1), (2), (3), and (6) amended, (HB 21-1130), ch. 45, p. 191, § 2, effective April 20.
27-66.5-104. Data collection and recommendations.
-
The office shall collect information on the following:
- Current practices, criteria, and procedures regarding follow-up care for high-risk individuals released or discharged from emergency or involuntary holds, certifications, or commitments; and
- Existing capacity to serve high-risk individuals after release or discharge.
- On or before January 1, 2020, and on or before January 1 each year thereafter, the office shall analyze the data collected in accordance with subsection (1) of this section and prepare recommendations to increase access to, and coordination of, transition specialist services for high-risk individuals. The recommendations shall be reported to the executive director of the department and shall be included in the reporting requirements in section 27-66.5-105.
Source: L. 2018: Entire article added, (SB 18-270), ch. 223, p. 1423, § 1, effective May 21.
27-66.5-105. Reporting requirements - "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" report.
The office shall report information on the community transition specialist program in the department's annual presentation to the general assembly required under the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act", part 2 of article 7 of title 2.
Source: L. 2018: Entire article added, (SB 18-270), ch. 223, p. 1423, § 1, effective May 21.
ARTICLE 67 CHILDREN AND YOUTH MENTAL HEALTH TREATMENT ACT
Editor's note: This article was added with relocations in 2010 containing provisions of article 10.3 of this title. Former C.R.S. section numbers are shown in editor's notes following those sections that were relocated. For a detailed comparison of this article, see the comparative tables located in the back of the index.
Law reviews: For article, "Guidance for Attorneys When Children's Mental Health Concerns are Implicated", see 31 Colo. Law. 33 (Oct. 2002).
Section
27-67-101. Short title.
The short title of this article 67 is the "Children and Youth Mental Health Treatment Act".
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 708, § 2, effective April 29. L. 2018: Entire section amended, (HB 18-1094), ch. 343, p. 2037, § 1, effective June 30.
Editor's note: This section is similar to former § 27-10.3-101 as it existed prior to 2010.
27-67-102. Legislative declaration.
- The general assembly finds that many parents in Colorado experience challenging circumstances because their children have significant mental health needs. Many times, the parents are loving, caring parents who have become increasingly frustrated in their attempts to navigate the various governmental systems, including child welfare, mental health, law enforcement, juvenile justice, education, and youth services, in an attempt to find help for their children. Frequently in these situations, an action in dependency or neglect under article 3 of title 19 is neither appropriate nor warranted.
- The general assembly finds that it is desirable to assist children and youth with mental health needs and their families. The general assembly further finds that it is desirable to make mental health services more available to families who want treatment for their children. The general assembly finds that it is in the best interest of the state to provide a full range of mental health treatment services, including residential care, to children and youth who are not eligible for medicaid. The general assembly further finds that, although the mental health agencies are responsible for providing or coordinating the full range of mental health treatment services, including residential care, for those children and youth who have been found to be categorically eligible for medicaid, there remains a population of children and youth in need of mental health services who are not categorically eligible for medicaid. Accordingly, the general assembly determines that it is appropriate to adopt a program pursuant to which a continuum of services would be provided to these children and youth.
- The general assembly therefore finds that children and youth who are categorically eligible for medicaid and who may be eligible for mental health treatment services, including residential care, may need support in identifying clear appeals processes.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 708, § 2, effective April 29. L. 2017: (1) amended, (HB 17-1329), ch. 381, p. 1984, § 64, effective June 6. L. 2018: Entire section amended, (HB 18-1094), ch. 343, p. 2037, § 2, effective June 30.
Editor's note: This section is similar to former § 27-10.3-102 as it existed prior to 2010.
27-67-103. Definitions.
As used in this article 67, unless the context otherwise requires:
- "Care management" includes, but is not limited to, consideration of the continuity of care and array of services necessary for appropriately treating a child or youth and the decision-making authority regarding the child's or youth's placement in and discharge from behavioral health services.
-
"Child or youth at risk of out-of-home placement" means a child or youth who, although not otherwise categorically eligible for medicaid, meets the following criteria:
- The child or youth has been diagnosed as having a mental health disorder, as defined in section 27-65-102 (11.5);
- The child or youth requires a level of care that is provided in a residential child care facility pursuant to section 25.5-6-903, or that is provided through community-based programs, and who, without such care, is at risk of unwarranted child welfare involvement or other system involvement, as described in section 27-67-102, in order to receive funding for treatment;
- If the child or youth is determined to be in need of placement in a residential child care facility, he or she shall apply for supplemental security income, but any determination for supplemental security income must not be a criterion for a child or youth to receive services pursuant to this article 67;
- The child or youth is a person for whom there is no pending or current action in dependency or neglect pursuant to article 3 of title 19; and
- The child or youth is younger than eighteen years of age, but he or she may continue to remain eligible for services until his or her twenty-first birthday.
- "Community-based care" means any intervention that is designed to be an alternative to residential or hospital level of care in which the child or youth resides within a noninstitutional setting.
- "Community mental health center" has the same meaning as provided in section 27-66-101 (2).
- "County department" means the county or district department of human or social services.
- "Family advocate" has the same meaning as provided in section 27-69-102 (5).
- "Family systems navigator" has the same meaning as provided in section 27-69-102 (5.5).
- "First-level appeal" means the initial process a medicaid member is required to enact to contest a benefit, service, or eligibility decision made by medicaid or a medicaid managed care entity.
- "Medicaid child or youth who is at risk of out-of-home placement" means a child or youth who is categorically eligible for medicaid but who otherwise meets the definition of a child or youth who is at risk of out-of-home placement as defined in subsection (2) of this section.
- "Mental health agency" means a behavioral health services contractor through the state department of human services serving children and youth statewide or in a particular geographic area, including but not limited to community mental health centers, and with the ability to meet all expectations of this article 67.
- "Professional person" means a person licensed to practice medicine in this state, a psychologist certified to practice in this state, or a person licensed and in good standing to practice medicine in another state or a psychologist certified 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.
- "State department" means the state department of human services.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 708, § 2, effective April 29. L. 2017: IP, (2)(a), and IP(3) amended, (SB 17-242), ch. 263, p. 1350, § 247, effective May 25. L. 2018: Entire section R&RE, (HB 18-1094), ch. 343, p. 2038, § 3, effective June 30; (5) amended, (SB 18-092), ch. 38, p. 453, § 139, effective August 8; (2)(b) amended, (HB 18-1328), ch. 184, p. 1244, § 7, effective June 7, 2019.
Editor's note:
- This section is similar to former § 27-10.3-103 as it existed prior to 2010.
- Section 10 of chapter 184 (HB 18-1328), Session Laws of Colorado 2018, provides that section 7 of the act changing subsection (2)(b) takes effect upon notice to the revisor of statutes pursuant to section 25.5-5-306 (6) as enacted in section 2 of the act. For more information, see HB 18-1328. ( L. 2018, p. 1247 .) On August 14, 2019, the revisor of statutes received the notice referred to in § 25.5-5-306 (6) that the federal department of health and human services approved the waiver on June 7, 2019.
-
- Subsection (5) was numbered as subsection (4) in SB 18-092. That provision was harmonized with and relocated to subsection (5) as it appears in HB 18-1094.
- Amendments to subsection (2)(b) by HB 18-1094 and HB 18-1328 were harmonized, effective June 7, 2019.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017. For the legislative declaration in SB 18-092, see section 1 of chapter 38, Session Laws of Colorado 2018. For the legislative declaration in HB 18-1328, see section 1 of chapter 184, Session Laws of Colorado 2018.
27-67-104. Provision of mental health treatment services for children and youth.
-
- A parent or guardian may apply to a mental health agency on behalf of a child or youth for mental health treatment services for the child or youth pursuant to this section, if the parent or guardian believes the child or youth is at risk of out-of-home placement. The parent's or guardian's request for services described in this section may be done with assistance from a family advocate, family systems navigator, nonprofit advocacy organization, or county department; however, the state department is not obligated to pay for any services provided by entities with which they do not contract. In such circumstances, the mental health agency is responsible for evaluating the child or youth and clinically assessing the child's or youth's need for mental health services and, when warranted, to provide treatment services as necessary and in the best interests of the child or youth and the child's or youth's family. When evaluating a child or youth for eligibility, the mental health agency shall use a standardized risk stratification tool, in a manner determined by rule of the state department. Following the evaluation of the child or youth, the mental health agency shall provide a written notification to the child's or youth's parent or guardian that includes a comprehensive list of potential treatment providers, with a disclosure that the child's or youth's family may choose to seek services from the provider of their choice, including but not limited to the mental health agency. The written notification must also inform the child's or youth's family that they may request assistance from a family advocate, family systems navigator, nonprofit advocacy organization, or county department; however, the state department is not obligated to pay for any services provided by entities with which they do not contract. The state department shall maintain a list of available providers on a public website and shall update the website quarterly. The mental health agency is responsible for the provision of the treatment services and care management, including any residential treatment, community-based care, or any post-residential follow-up services that may be appropriate for the child's or youth's needs or his or her family's needs. A dependency or neglect action pursuant to article 3 of title 19 is not required in order to allow a family access to residential mental health treatment services for a child or youth.
- At the time of the assessment by the mental health agency, if requested services are denied, or at the time when the mental health agency has recommended that the child or youth be discharged from services, the mental health agency shall advise the family, both orally and in writing, of the appeal process available to them. The mental health agency shall have two working days within which to complete any internal appeal process. Within five working days after the mental health agency's final denial or recommendation for discharge, a parent or guardian may request an objective third party at the state department who is a professional person to review the action of the mental health agency. A family advocate, family systems navigator, nonprofit advocacy organization, or county department may assist a family in filing an appeal; however, the state department is not obligated to pay for any services provided by entities with which they do not contract. The review must occur within three working days of the parent's or guardian's request. The professional person shall determine if the requested services are appropriate.
- (1.5) (a) The parent or guardian of a medicaid child or youth who is at risk of out-of-home placement may request, within five days after all first-level medicaid appeals processes are exhausted, an objective third party at the state department who is a professional person to review the service request made to medicaid. A family advocate, family system navigator, or county department may assist a family in filing an appeal. The review must occur within three working days of the parent's or guardian's request.
- The administrative law judge considering the medicaid appeal for the medicaid child or youth who is at risk of out-of-home placement shall take into consideration the objective third-party review by the state department as part of his or her reconsideration and decision of the medicaid service request.
- If at any time the mental health agency determines pursuant to section 19-3-304 that there is reasonable cause to know or suspect that a child or youth has been subjected to abuse or neglect, then the mental health agency shall immediately make a referral to the statewide child abuse hotline established in section 26-5-111 or the appropriate county department. Within ten working days after the referral, if assigned for an assessment by the county department, a representative of the mental health agency shall meet with the county department and the family. Upon referral to the county department, if assigned for an assessment, the county department shall proceed with the assessment to determine whether there is a sufficient basis to believe that physical or sexual abuse or neglect or some other form of abuse or neglect of a child's or youth's physical well-being has occurred.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 709, § 2, effective April 29. L. 2018: Entire section amended, (HB 18-1094), ch. 343, p. 2039, § 4, effective June 30; (1)(a) amended, (HB 18-1431), ch. 313, p. 1892, § 11, effective August 8.
Editor's note:
- This section is similar to former § 27-10.3-104 as it existed prior to 2010.
- Amendments to subsection (1)(a) by HB 18-1094 and HB 18-1431 were harmonized.
27-67-105. Monitoring - reports.
-
On or before September 1, 2018, and by September 1 of each year thereafter, each mental health agency shall report to the state department the following information:
-
The number of children and youth who are at risk of out-of-home placement and whose parent or legal guardian requested residential or community-based care pursuant to section 27-67-104 to whom the following services were provided:
- An assessment pursuant to section 27-67-104 (1)(a);
- Community-based care;
- Residential treatment; or
- Post-residential follow-up services;
- The number of children and youth who are at risk of out-of-home placement and for whom a child abuse and neglect referral was made to the county department;
-
The number of children and youth for whom either:
- An assessment was requested but not performed, and the reasons that the assessment was not performed; or
- An assessment was performed but the mental health agency did not provide services pursuant to this article 67, and the reasons that services were not provided, including whether the family refused the services offered;
- The costs associated with the provision of the mental health treatment services described in subsection (1)(a) of this section;
- The demographic information of the children, youth, and families served, as outlined by the state department;
- The outcomes of treatment for the children and youth served, as determined by the state department in consultation with mental health agencies, service providers, and families;
- The length of stay and funding totals for residential services and community-based care; and
- The aggregate number of third-party reviews completed by the state department for children served pursuant to this article 67, delineated by children who are and are not categorically eligible for medicaid.
-
The number of children and youth who are at risk of out-of-home placement and whose parent or legal guardian requested residential or community-based care pursuant to section 27-67-104 to whom the following services were provided:
- On or after January 1, 2019, the state department shall make the information obtained pursuant to subsection (1) of this section available to the public by posting it to the state department's website. Any information so posted must not include any personal health information.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 710, § 2, effective April 29. L. 2018: Entire section R&RE, (HB 18-1094), ch. 343, p. 2041, § 5, effective June 30; IP(1)(a) and (1)(b) amended, (HB 18-1431), ch. 313, p. 1893, § 12, effective August 8.
Editor's note:
- This section is similar to former § 27-10.3-105 as it existed prior to 2010.
- Subsections IP(1)(a) and (1)(b) were amended in HB 18-1431, effective August 8, 2018. However, those amendments were superseded by the repeal and reenactment of this section in HB 18-1094, effective June 30, 2018.
27-67-106. Funding - rules.
- In order to make mental health treatment available, it is the intent of the general assembly that mental health treatment provided pursuant to this article to each child described in section 27-67-103 (2) be provided by mental health agencies.
-
- If neither the family's private insurance nor federal medicaid funding cover all of the costs associated with the services provided to a child at risk of out-of-home placement pursuant to this article, then the family is responsible for paying that portion that is not covered by private insurance or federal medicaid funding on a sliding scale basis as set forth in subsection (3) of this section. Any remaining portion of the services not covered by private insurance, federal medicaid funding, or the family's share, shall be paid for from any moneys appropriated by the general assembly for that purpose.
- Repealed.
- The state board of human services shall promulgate rules implementing a sliding scale for the payment of services, including mental health treatment and room and board, that are not covered by private insurance or federal medicaid funding. It is the intent of the general assembly that subsidies provided by the state through general fund money must be used to assist the lowest income families to ensure the maximum use of appropriate least restrictive treatment services and to provide access to the greatest number of children and youth.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 712, § 2, effective April 29. L. 2016: (2)(a) amended and (2)(b) repealed, (HB 16-1408), ch. 153, p. 472, §§ 24, 26, effective July 1. L. 2018: (3) amended, (HB 18-1094), ch. 343, p. 2042, § 6, effective June 30.
Editor's note: This section is similar to former § 27-10.3-106 as it existed prior to 2010.
27-67-107. Dispute resolution - rules.
- The state department shall utilize, when appropriate, established grievance and dispute resolution processes in order to assure that parents have access to mental health services on behalf of their children.
- The state board of human services shall promulgate rules to assure that a grievance process is available to parents concerning the provision of mental health services and to assure that a dispute resolution process is available for disputes between the county departments and mental health agencies.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 712, § 2, effective April 29.
Editor's note: This section is similar to former § 27-10.3-107 as it existed prior to 2010.
27-67-108. Repeal of article. (Repealed)
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 712, § 2, effective April 29. L. 2018: Entire section repealed, (HB 18-1094), ch. 343, p. 2043, § 7, effective June 30.
Editor's note: This section was similar to former § 27-10.3-108 as it existed prior to 2010.
27-67-109. Child and youth mental health services standards - advisory board.
- The advisory board established in subsection (2) of this section is responsible for recommending standards and rules relevant to the provision of mental health services to children and youth covered by this article 67.
-
An advisory board to the state department is established for the purpose of assisting and advising the executive director in accordance with this section in the development of service standards and rules. The advisory board consists of not less than eleven
nor more than fifteen members appointed by the state department as follows:
- One representative each from the office of behavioral health; the office of children, youth, and families; the department of health care policy and financing; and a leading professional association of psychiatrists in this state;
- One member representing nonprofit health-care facilities;
- One member representing children or youth consumers of services for persons with mental health disorders;
- One member representing families of persons with mental health disorders;
- One member representing children's health-care facilities;
- One member representing a community mental health center that performs evaluations pursuant to this article 67;
- One member representing a county human or social services agency;
- One member representing individuals with intellectual and developmental disabilities; and
- 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 advisory board's purpose and function.
- In making appointments to the advisory board, the state department must include representation by at least one member who is a person with a disability, 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 subsection (2) of this section are met.
Source: L. 2018: Entire section added, (HB 18-1094), ch. 343, p. 2043, § 8, effective June 30. L. 2019: (3) amended, (SB 19-241), ch. 390, p. 3474, § 42, effective August 2. L. 2020: (3) amended, (HB 20-1392), ch. 132, p. 575, § 4, effective June 26.
ARTICLE 68 MENTAL HEALTH SERVICES PILOT PROGRAM FOR FAMILIES OF DISCHARGED VETERANS OF OPERATION ENDURING FREEDOM AND OPERATION IRAQI FREEDOM
27-68-101 to 27-68-106. (Repealed)
Editor's note:
- This article was added with relocations in 2010 containing provisions of part 3 of article 1 of this title and was subsequently repealed in 2010. This article was not amended prior to its repeal in 2010. For a detailed comparison of this article, see the comparative tables located in the back of the index.
- Section 27-68-106 provided for the repeal of this article, effective July 1, 2010. (See L. 2010, p. 715 .)
ARTICLE 69 FAMILY ADVOCACY MENTAL HEALTH JUVENILE JUSTICE PROGRAMS
Editor's note: This article was added with relocations in 2010 containing provisions of article 22 of title 26. Former C.R.S. section numbers are shown in editor's notes following those sections that were relocated. For a detailed comparison of this article, see the comparative tables located in the back of the index.
27-69-101 to 27-69-106. (Repealed)
Editor's note:
- This article 69 was added in 2010. For amendments to this article 69 prior to its repeal in 2021, consult the 2020 Colorado Revised Statutes and the Colorado statutory research explanatory note beginning on page vii in the front of this volume.
- Section 27-69-106 provided for the repeal of this article 69, effective July 1, 2021. (See L. 2011, p. 198 .)
- Section 27-69-104 (3)(a) was amended in HB 21-1187, effective July 1, 2024. Those amendments were superseded by the repeal of this article 69, effective July 1, 2021.
ARTICLE 70 MEDICATION CONSISTENCY FOR INDIVIDUALS WITH BEHAVIORAL OR MENTAL HEALTH DISORDERS IN THE CRIMINAL AND JUVENILE JUSTICE SYSTEMS
Section
27-70-101. Legislative declaration.
-
The general assembly finds and declares that:
- The lack of medication consistency for individuals with behavioral or mental health disorders who are involved in the criminal and juvenile justice systems creates additional, often serious, problems for these individuals;
- It is critical that the state increase the likelihood that a broad spectrum of effective medications, including psychotropic medications, are available to these individuals, regardless of setting or service provider;
- By working cooperatively with the criminal and juvenile justice systems and mental health service providers, the state can help ensure medication consistency and also decrease overall state costs through the use of a common and agreed upon medication formulary and cooperative purchasing;
- Prior to its repeal in 2018, the medication consistency work group of the behavioral health transformation council identified mental health medications that are essential and preferred for a basic medication formulary that could be used across all public systems to increase medication continuity for individuals with behavioral or mental health disorders in the criminal and juvenile justice systems; and
- Increasing information sharing across systems and service providers about the importance of medication consistency and the use of a common and agreed upon medication formulary and cooperative purchasing will result in long-term benefits for the state and for individuals with behavioral or mental health disorders who are involved in the criminal and juvenile justice systems.
Source: L. 2017: Entire article added, (SB 17-019), ch. 405, p. 2113, § 1, effective August 9. L. 2018: (1)(d) amended, (SB 18-161), ch. 123, p. 831, § 5, effective September 1.
27-70-102. Definitions.
As used in this article 70, unless the context otherwise requires:
- "Department" means the department of human services created in section 26-1-105.
-
[ Editor's note: This version of subsection (2) is effective until July 1, 2022.] "Facility" means a federally qualified health-care center, clinic, community mental health center or clinic, institution, acute treatment unit, jail, facility operated by
the department of corrections, or a facility operated by the division of youth services.
(2) [ Editor's note: This version of subsection (2) is effective July 1, 2022. ] "Facility" means a federally qualified health-care center, clinic, community mental health center or clinic, behavioral health entity, institution, acute treatment unit, jail, facility operated by the department of corrections, or a facility operated by the division of youth services.
- "Medication formulary" means the medication formulary established pursuant to section 27-70-103 for use by providers.
- "Office" means the office of behavioral health in the department of human services.
- "Provider" means any person, facility, or government entity responsible for providing mental health services related to the care and treatment of an individual with behavioral or mental health disorders who is or was involved with the criminal or juvenile justice system.
Source: L. 2017: Entire article added, (SB 17-019), ch. 405, p. 2114, § 1, effective August 9. L. 2019: (2) amended, (HB 19-1237), ch. 413, p. 3644, § 19, effective July 1, 2022.
27-70-103. Medication consistency for individuals with behavioral or mental health disorders in the criminal and juvenile justice systems - medication formulary - cooperative purchasing - reporting - rules.
-
- Beginning December 1, 2017, the department of human services in consultation with the department of corrections shall promulgate rules that require providers under each department's authority to use a medication formulary that has been developed collaboratively by departments, agencies, and providers. Public hospitals and licensed private hospitals may also, at their discretion, participate in the medication formulary. Using consulting services as necessary, the departments shall also develop processes for education and marketing related to information regarding the medication formulary and cooperative purchasing opportunities for facilities and providers. The processes for education and marketing required pursuant to this subsection (1) shall be completed on or before December 1, 2017.
- For the sole purpose of ensuring medication consistency for persons with mental health disorders in the criminal and juvenile justice systems, the department of corrections, counties, the division of youth services, community mental health centers, and other providers shall share patient-specific mental health and treatment information. All such information sharing must comply with confidentiality requirements, including any necessary memorandums of understanding between providers, set forth in the federal "Health Insurance Portability and Accountability Act of 1996", 45 CFR parts 2, 160, 162, and 164.
-
Beginning July 1, 2018, the office shall have the following duties and responsibilities, subject to available appropriations:
- On or before September 1, 2018, and every September 1 of every even-numbered year thereafter, the office shall conduct a review of the medication formulary to address any urgent concerns related to the formulary and to propose updates to the formulary. During this review, the office shall also create the appropriate notification process for updates to the formulary.
- On or before July 1, 2019, and every two years thereafter as necessary, the office shall conduct a review of the medication formulary to update the medication formulary and ensure compliance with the medicaid formulary used by the department of health care policy and financing.
- On or before September 1, 2018, the office, in collaboration with the office of information technology, the office of e-health innovation, the department of health care policy and financing, the department of public safety, the department of corrections, and other agencies as appropriate, shall develop a plan by which the patient-specific information required by subsection (1)(b) of this section can be shared electronically, while still in compliance with confidentiality requirements, including any necessary memorandums of understanding between providers, set forth in the federal "Health Insurance Portability and Accountability Act of 1996", 45 CFR parts 2, 160, 162, and 164.
-
- The office shall encourage providers that have been granted purchasing authority by the department of personnel pursuant to section 24-102-204 to utilize cooperative purchasing for the medication formulary, as authorized pursuant to section 24-110-201, unless the provider can obtain the medication elsewhere at a lower cost. The use of cooperative purchasing may, and is encouraged to, include external procurement activity, as defined in section 24-110-101 (2), if the external procurement activity aggregates purchasing volume to negotiate discounts with manufacturers, distributors, and other vendors.
- Any external procurement activity, as defined in section 24-110-101 (2), used by providers for purposes of this article 70 is encouraged to include an ongoing drug utilization review process. The purpose of the review process is to help ensure a structured, ongoing review of health-care provider prescribing, pharmacist dispensing, and patient use of medication. The review must include a comprehensive analysis of patients' prescription and medication data to help ensure appropriate medication decision-making and positive patient outcomes by providing educational feedback to providers on appropriate medication utilization.
- The office shall investigate and develop options for collaboration with local county jails to coordinate medication purchasing.
-
- Beginning in January 2019, and every January thereafter, the department of human services and the department of corrections shall report progress on the implementation and use of the medication formulary and cooperative purchasing as part of each department's "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" hearing required by section 2-7-203. Each department shall make such reports to the joint health and human services committee and the joint judiciary committee, or any successor committees.
- This section is exempt from the provisions of section 24-1-136 (11), and the periodic reporting requirement of that section shall remain in effect until changed by the general assembly acting by bill.
Source: L. 2017: Entire article added, (SB 17-019), ch. 405, p. 2114, § 1, effective August 9. L. 2018: (2)(e) amended, (SB 18-161), ch. 123, p. 831, § 6, effective September 1.
ALCOHOL AND SUBSTANCE USE - ALCOHOL AND SUBSTANCE USE DISORDERS
ARTICLE 80 ALCOHOL AND SUBSTANCE USE - ALCOHOL AND SUBSTANCE USE DISORDERS
Section
PART 1 PROGRAMS AND SERVICES
Editor's note: This part 1 was added with relocations in 2010 containing provisions of part 2 of article 1 of title 25. Former C.R.S. section numbers are shown in editor's notes following those sections that were relocated. For a detailed comparison of this part 1, see the comparative tables located in the back of the index.
27-80-101. Definitions.
As used in this article 80, unless the context otherwise requires:
- "Department" means the department of human services created in section 26-1-105, C.R.S.
- "Designated service area" means the geographical substate planning area specified by the director of the office of behavioral health to be served by a designated managed service organization, as described in section 27-80-107.
- "Executive director" means the executive director of the department of human services.
-
"Fetal alcohol spectrum disorder" or "FASD" means a continuum of permanent birth defects caused by maternal consumption of alcohol during pregnancy. "FASD" includes, but is not limited to, fetal alcohol syndrome.
(4.7) "Office of behavioral health" means the office of behavioral health in the department.
- "Public program" means a program concerning the problems of alcohol or drug abuse sponsored by a county, district, or municipal public health agency, county department of human or social services, court, probation department, law enforcement agency, school, school system, board of cooperative services, Indian tribal reservation, or state agency. "Public program" includes any alcohol or drug abuse treatment program required as a condition of probation under part 2 of article 11 of title 16, any alcohol or drug abuse program administered by the division of adult parole under article 2 of title 17, any community correctional facility or program administered under article 27 of title 17, and any alcohol or drug abuse treatment program administered by the division of youth services under title 19.
- and (7) Repealed.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 721, § 2, effective April 29; (5) amended, (HB 10-1422), ch. 419, p. 2091, § 85, effective August 11. L. 2011: (7) repealed, (HB 11-1144), ch. 65, p. 173, § 3, effective August 10. L. 2017: IP and (2) amended, (4.7) added, and (6) repealed, (SB 17-242), ch. 263, p. 1353, § 253, effective May 25; IP and (5) amended, (HB 17-1329), ch. 381, p. 1985, § 66, effective June 6. L. 2018: (5) amended, (SB 18-092), ch. 38, p. 453, § 140, effective August 8.
Editor's note:
- This section is similar to former § 25-1-201 as it existed prior to 2010.
- Subsection (5) was numbered as § 25-1-201 (4) in House Bill 10-1422 (see L. 2010, p. 2091 ) but was relocated due to its harmonization with this section as it was added by Senate Bill 10-175.
Cross references: For the legislative declaration in the 2011 act repealing subsection (7), see section 1 of chapter 65, Session Laws of Colorado 2011. For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017. For the legislative declaration in SB 18-092, see section 1 of chapter 38, Session Laws of Colorado 2018.
27-80-102. Duties of the office of behavioral health - repeal.
-
The office of behavioral health shall formulate a comprehensive state plan for substance use disorder treatment programs. The office of behavioral health shall submit the state plan to the governor and, upon his or her approval, submit it to the appropriate
United States agency for review and approval. The state plan must include, but not be limited to:
- A survey of the need for the prevention and treatment of alcohol and drug abuse, including a survey of the health facilities needed to provide services and a plan for the development and distribution of facilities and programs throughout the state;
- A plan for programs to educate the public in the problems of alcohol and drug abuse;
- A survey of the need for trained teachers, health professionals, and others involved in the prevention and treatment of alcohol and drug abuse and the rehabilitation of abusers, and a plan to provide the necessary training for such persons;
- Provisions for the periodic review and updating of the state plan, which shall take place at least annually.
- The department, acting by and through the office of behavioral health, is designated as the sole state agency for the supervision of the administration of the state plan.
-
-
The office of behavioral health shall:
- Contract with the Colorado 2-1-1 collaborative as set forth in section 29-11-203 to hire and train specialized personnel;
- Collaborate with the Colorado 2-1-1 collaborative to engage in targeted outreach and marketing to individuals who are unemployed, regardless of whether they receive benefits; and
- Report to the general assembly explaining the impact of the Colorado 2-1-1 collaborative statewide communication system on behavioral health referrals and access to behavioral health services and other resources.
- This subsection (3) is repealed, effective July 1, 2022.
-
The office of behavioral health shall:
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 722, § 2, effective April 29. L. 2017: IP(1) and (2) amended, (SB 17-242), ch. 263, p. 1353, § 254, effective May 25. L. 2021: (3) added, (SB 21-239), ch. 266, p. 1548, § 4, effective June 18.
Editor's note: This section is similar to former § 25-1-202 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-103. Grants for public programs.
- The office of behavioral health may make grants, from money appropriated by the general assembly for purposes of this section or available from any other governmental or private source, to approved public programs.
-
A public program may provide, but need not be limited to, any of the following:
- Acute medical services, including emergency services and detoxification;
- Case finding, diagnosis, treatment, counseling, individual or group psychotherapy, after-care treatment, and other rehabilitation services;
- Education and counseling regarding the use and abuse of alcohol and drugs;
- Programs for prevention of alcohol and drug abuse;
- Training of teachers, health professionals, and others in the field of alcohol and drug abuse and addiction counseling;
- Coordination of existing services and the development of other needed services through demonstration and evaluation projects; or
- Services to pregnant women who are alcohol and drug dependent through demonstration and evaluation projects.
-
In approving any public program, the office of behavioral health shall take into consideration the following:
- The community need for the public program;
- The range of services to be provided;
- The integration of the public program with, and the participation of, other public and nongovernmental agencies, organizations, institutions, and individuals, and their services and facilities, if any, that are available to assist the public program;
- The adequacy of the public program to accomplish its purposes; and
- Any other information the office of behavioral health deems necessary.
- Applications for grants made pursuant to subsection (1) of this section are made to the office of behavioral health, on forms furnished by the office of behavioral health, and must contain any information the office of behavioral health requires. Wherever possible, the office of behavioral health shall give priority to public programs that are community-based and include services to children and juveniles as well as adults, that provide a comprehensive range of services, and that evidence a high degree of community support, either financial or in the furnishing of services and facilities, or both.
- Whenever any department or agency of the state has money available from any source for public programs, the department or agency is authorized to distribute the money in accordance with the state plan and to make reasonable rules for the administration of the public programs.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 722, § 2, effective April 29. L. 2017: (1), IP(3), (3)(e), (4), and (5) amended, (SB 17-242), ch. 263, p. 1354, § 255, effective May 25.
Editor's note: This section is similar to former § 25-1-203 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-104. Cancellation of grants.
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The office of behavioral health may cancel a grant for any public program for any of the following reasons:
- There is no longer a need for the public program.
- Funds for the public program are not available.
- The public program does not meet the standards or requirements adopted by the department or does not conform to the comprehensive state plan for substance use disorder treatment programs.
- Before canceling a grant for the reasons set forth in subsection (1)(c) of this section, the office of behavioral health shall notify the person or agency in charge of the public program of the deficiency in the program, and the person or agency must be given a reasonable amount of time in which to correct the deficiency.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 723, § 2, effective April 29. L. 2017: IP(1), (1)(c), and (2) amended, (SB 17-242), ch. 263, p. 1354, § 256, effective May 25.
Editor's note: This section is similar to former § 25-1-204 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-105. Annual distribution of funds.
Funds for public programs shall be distributed annually, if available.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 724, § 2, effective April 29.
Editor's note: This section is similar to former § 25-1-205 as it existed prior to 2010.
27-80-106. Purchase of prevention and treatment services.
- Using money appropriated for purposes of this section or available from any other governmental or private source, the office of behavioral health may purchase services for prevention or for treatment of alcohol and drug abuse or substance use disorders or both types of services on a contract basis from any tribal nation or any public or private agency, organization, or institution approved by the office of behavioral health. The services purchased may be any of those provided through a public program, as set forth in section 27-80-103 (2). In contracting for services, the office of behavioral health shall attempt to obtain services that are in addition to, and not a duplication of, existing available services or services that are of a pilot or demonstration nature. An agency operating a public program may also purchase services on a contract basis.
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- In addition to the services purchased pursuant to subsection (1) of this section, using money appropriated for purposes of this section or available from any other governmental or private source, the office of behavioral health may purchase services for the treatment of alcohol and drug abuse or substance use disorders on a contract basis from a designated managed service organization for a designated service area as set forth in section 27-80-107. A public or private agency, organization, or institution approved by the office of behavioral health through the process set forth in section 27-80-107 may be designated as a designated managed service organization.
- Designated managed service organizations receiving money pursuant to this subsection (2) shall comply with all relevant provisions of and rules promulgated pursuant to this article 80.
- Repealed.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 724, § 2, effective April 29. L. 2017: Entire section amended, (SB 17-242), ch. 263, p. 1355, § 257, effective May 25. L. 2019: (3) added, (SB 19-228), ch. 276, p. 2605, § 9, effective May 23.
Editor's note:
- This section is similar to former § 25-1-206 as it existed prior to 2010.
- Subsection (3)(c) provided for the repeal of subsection (3), effective September 1, 2020. (See L. 2019, p. 2605 .)
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-107. Designation of managed service organizations - purchase of services - revocation of designation.
- The director of the office of behavioral health shall establish designated service areas to provide substance use disorder treatment and recovery services in a particular geographical region of the state.
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To be selected as a designated managed service organization to provide services in a particular designated service area, a private corporation; for profit or not for profit; or a public agency, organization, or institution shall apply to the office of
behavioral health for a designation in the form and manner specified by the executive director or the executive director's designee. The designation process is in lieu of a competitive bid process pursuant to the "Procurement Code",
articles 101 to 112 of title 24. The director of the office of behavioral health shall make the designation based on factors established by the executive director or the executive director's designee. The factors for designation
established by the executive director or the executive director's designee include the following:
- Whether the managed service organization has experience working with public treatment agencies and collaborating with other public agencies;
- Whether the managed service organization has experience working with publicly funded clients, including expertise in treating priority populations designated by the office of behavioral health;
- Whether the managed service organization has offices in and provides services in the substate planning area or is willing to relocate to the substate planning area;
- Whether the managed service organization has experience using the cost-share principles used by the office of behavioral health in its contracts with providers and is willing to cost-share;
- Whether the managed service organization has developed an effective, integrated information and fiscal reporting system and has experience working with and is able to comply with state and federal reporting requirements;
- Whether the managed service organization has experience engaging in a clinical quality improvement process; and
- Whether the managed service organization has experience with public funding requirements and state contracting requirements.
- The designation of a managed service organization by the director of the office of behavioral health, as described in subsection (2) of this section, is an initial decision of the department which may be reviewed by the executive director in accordance with the provisions of section 24-4-105. Review by the executive director in accordance with section 24-4-105 constitutes final agency action for purposes of judicial review.
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- The terms and conditions for providing substance use disorder treatment and recovery services must be specified in the contract entered into between the office of behavioral health and the designated managed service organization. Contracts entered into between the office of behavioral health and the designated managed service organization must include terms and conditions prohibiting a designated managed service organization contracted treatment provider from denying or prohibiting access to medication-assisted treatment, as defined in section 23-21-803, for a substance use disorder.
- Contracts entered into between the office of behavioral health and the designated managed service organization must include terms and conditions that outline the expectations for the designated managed service organization to invest in the state's recovery services infrastructure, which include peer-run recovery support services and specialized services for underserved populations. Investments are based on available appropriations.
- The contract may include a provisional designation for ninety days. At the conclusion of the ninety-day provisional period, the director of the office of behavioral health may choose to revoke the contract or, subject to meeting the terms and conditions specified in the contract, may choose to extend the contract for a stated time period.
- A managed service organization that is designated to serve a designated service area may subcontract with a network of service providers to provide treatment and recovery services for alcohol and drug abuse and substance use disorders within the particular designated service area.
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- The director of the office of behavioral health may revoke the designation of a designated managed service organization upon finding that the managed service organization is in violation of the performance of the provisions of or rules promulgated pursuant to this article 80. The revocation must conform to the provisions and procedures specified in article 4 of title 24, and occur only after notice and an opportunity for a hearing is provided as specified in article 4 of title 24. A hearing to revoke a designation as a designated managed service organization constitutes final agency action for purposes of judicial review.
- Once a designation has been revoked pursuant to subsection (7)(a) of this section, the director of the office of behavioral health may designate one or more service providers to provide the treatment services pending designation of a new designated managed service organization or may enter into contracts with subcontractors to provide the treatment services.
- From time to time, the director of the office of behavioral health may solicit applications from applicants for managed service organization designation to provide substance use disorder treatment and recovery services for a specified planning area or areas.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 724, § 2, effective April 29. L. 2017: (1), IP(2), (2)(b), (2)(d), (3), (4), (5), (6), and (7) amended, (SB 17-242), ch. 263, p. 1355, § 258, effective May 25. L. 2020: (4) amended, (SB 20-007), ch. 286, p. 1390, § 2, effective July 13. L. 2021: (1), (4), (6), and (7)(c) amended, (HB 21-1021), ch. 256, p. 1510, § 3, effective September 7.
Editor's note: This section is similar to former § 25-1-206.5 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-107.5. Increasing access to effective substance use disorder services act - managed service organizations - substance use disorder services - assessment - community action plan - allocations - reporting requirements - evaluation.
- The short title of this section is the "Increasing Access to Effective Substance Use Disorder Services Act".
- On or before February 1, 2017, each managed service organization designated pursuant to section 27-80-107 shall assess the sufficiency of substance use disorder services within its geographic region for adolescents ages seventeen and younger, young adults ages eighteen through twenty-five, pregnant women, women who are postpartum and parenting, and other adults who are in need of such services. During the community assessment process, each managed service organization shall seek input and information from appropriate entities, such as community mental health centers, behavioral health organizations, county departments of human or social services, local public health agencies, substance use disorder treatment providers, law enforcement agencies, probation departments, organizations that serve veterans or homeless individuals, and other relevant stakeholders. The community assessment must include an analysis of existing funding and resources within the community to provide a continuum of substance use disorder services, including prevention, intervention, treatment, and recovery support services, for adolescents ages seventeen and younger, young adults ages eighteen through twenty-five, pregnant women, women who are postpartum and parenting, and other adults who are in need of such services.
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- On or before March 1, 2017, each managed service organization that has completed a community assessment pursuant to subsection (2) of this section shall prepare and submit in electronic format to the department and the department of health care policy and financing a community action plan to increase access to effective substance use disorder services, referred to in this section as the "community action plan". The community action plan must summarize the results of the community assessment and include a description of how the managed service organization will utilize its allocation of funding from the marijuana tax cash fund created in section 39-28.8-501, C.R.S., to address the most critical service gaps in its geographic region and a timeline for implementation of the community action plan.
- A managed service organization may periodically update its community action plan to reflect changes in community needs and priorities. Any such updated plan must be submitted in electronic format to the department and the department of health care policy and financing.
- On or before May 1, 2017, the department shall post the community action plans from the managed service organizations developed pursuant to paragraph (a) of this subsection (3) on its website. On or before May 1, 2017, the department shall submit a report summarizing all of the community action plans received from the managed service organizations to the joint budget committee, the health and human services committee of the senate, and the public health care and human services committee of the house of representatives, or any successor committees. The department shall post on its website any updated community action plans received pursuant to paragraph (b) of this subsection (3).
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- On July 1, 2016, the department shall disburse to each designated managed service organization sixty percent of the designated managed service organization's allocation from the money appropriated from the marijuana tax cash fund. Each designated managed service organization that conducts a community assessment and prepares a community action plan pursuant to subsection (3) of this section may use up to fifteen percent of its state fiscal year 2016-17 allocation from the marijuana tax cash fund for such purposes and the remainder for substance use disorder services. The department shall disburse the remaining forty percent of the designated managed service organization's marijuana tax cash fund allocation to each designated managed service organization after the submission of its community action plan.
- On July 1, 2017, and on every July 1 thereafter, the department shall disburse to each designated managed service organization that has submitted a community action plan one hundred percent of the designated managed service organization's allocation from the money appropriated from the marijuana tax cash fund.
- It is the intent of the general assembly that each designated managed service organization use money allocated to it from the marijuana tax cash fund to cover expenditures for substance use disorder services that are not otherwise covered by public or private insurance. Except as provided in subsection (4)(a) of this section, each managed service organization may use its allocation from the marijuana tax cash fund to implement its community action plan, including expenditures for substance use disorder services and for any start-up costs or other expenses necessary to increase capacity to provide such services. A designated managed service organization must spend its allocation in the state fiscal year in which it is received or in the next state fiscal year thereafter. If there is any money from the allocation remaining after the second state fiscal year, then the designated managed service organization shall return the money to the department. If an enhanced residential and inpatient substance use disorder treatment and medical detoxification services benefit becomes available under the Colorado medical assistance program, managed service organizations shall determine to what extent money allocated from the marijuana tax cash fund may be used to assist in providing substance use disorder treatment, including residential and inpatient substance use disorder treatment and medical detoxification services, if those services are not otherwise covered by public or private insurance.
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- For state fiscal year 2016-17, and each state fiscal year thereafter, the department shall allocate money that is annually appropriated to it from the marijuana tax cash fund to the designated managed service organizations based on the department's allocation of the federal substance abuse prevention and treatment block grant to geographical areas for the same state fiscal year. Any money from the marijuana tax cash fund that is allocated in accordance with this subsection (4)(d)(I) and that is not expended by a managed service organization in the state fiscal year in which it is disbursed remains available for expenditure by the department in the next state fiscal year without further appropriation.
- For state fiscal year 2017-18 and each fiscal year thereafter, the department shall modify the allocation methodology set forth in subparagraph (I) of this paragraph (d) if the designated managed service organizations recommend, by consensus, a change. Any such recommendation must be submitted to the department by February 28 prior to the state fiscal year in which the change would apply.
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- On or before September 1, 2017, and on or before each September 1 thereafter, each designated managed service organization shall submit an annual report to the department, the joint budget committee, the health and human services committee of the senate, and the public health care and human services committee of the house of representatives, or their successor committees, concerning the amount and purpose of actual expenditures made using money from the marijuana tax cash fund in the previous state fiscal year. The report must contain a description of the impact of the expenditures on addressing the needs that were identified in the initial and any subsequent community assessments and action plans developed pursuant to subsection (3) of this section, as well as any other requirements established for the contents of the report by the department.
- A designated managed service organization shall provide the department with information about actual expenditures as required by the department.
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On or before November 1, 2020, the department, in collaboration with the designated managed service organizations, shall submit a report to the joint budget committee and the joint health and human services committee, or any successor committees. The
report must:
- Summarize expenditures made by the designated managed service organizations using money made available pursuant to this section for state fiscal years 2016-17, 2017-18, 2018-19, and 2019-20;
- Describe the impact the expenditures have had on increasing statewide access to a continuum of effective substance use disorder services, including the availability of prevention, intervention, treatment, and recovery support services in each designated service area; and
- Include any recommendations to strengthen or improve the program.
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- On or before November 1, 2016, the department shall enter into a contract with an evaluation contractor to study the effectiveness of intensive residential treatment of substance use disorders provided through managed service organizations. The department and the department of health care policy and financing shall collaborate with the evaluation contractor on the design of the evaluation so that the data and analyses will be of maximum benefit for evaluating whether the medicaid behavioral health benefit should be expanded to include intensive residential treatment for substance use disorders.
- Prior to entering into a contract for the evaluation of intensive residential treatment of substance use disorders provided through managed service organizations, the department shall seek input from managed service organizations and residential substance use disorder treatment providers concerning relevant outcome measures to be used by the evaluation contractor in the study.
- On or before February 1, 2019, the department shall submit a copy of the evaluation contractor's final report to the joint budget committee, the health and human services committee of the senate, and the public health care and human services committee of the house of representatives, or any successor committees.
- Notwithstanding section 24-1-136 (11)(a)(I), the department shall report on outcomes related to the implementation of this section as part of its annual "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" hearing required by section 2-7-203, beginning with the hearing that precedes the 2019 legislative session.
Source: L. 2016: Entire section added, (SB 16-202), ch. 209, p. 748, § 1, effective June 1. L. 2017: IP(5)(c) amended, (SB 17-234), ch. 154, p. 524, § 17, effective August 9. L. 2018: (4)(c), (4)(d)(I), (5)(a), (5)(b), IP(5)(c), and (5)(c)(II) amended and (7) added, (HB 18-1172), ch. 110, p. 801, § 1, effective April 9; (4)(c) amended, (HB 18-1136), ch. 373, p. 2271, § 3, effective June 5.
Editor's note: Amendments to subsection (4)(c) by HB 18-1172 and HB 18-1136 were harmonized.
27-80-108. Rules.
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The state board of human services, created in section 26-1-107, has the power to promulgate rules governing the provisions of this article 80. The rules may include, but are not limited to:
- Requirements for the operation of a public program, including record keeping and data compilation;
- Conditions that may be imposed on a public program for the program to maintain grant eligibility;
- Requirements for public and private agencies, organizations, and institutions from which the office of behavioral health may purchase services pursuant to section 27-80-106 (1), which requirements must include prohibiting the purchase of services from entities that deny or prohibit access to medical services or substance use disorder treatment and services to persons who are participating in prescribed medication-assisted treatment, as defined in section 23-21-803, for a substance use disorder;
- Requirements for managed service organizations that are designated by the director of the office of behavioral health to provide services in a designated service area pursuant to section 27-80-106 (2);
- Standards that addiction counselors must meet to participate in public programs or to provide purchased services and certification requirements necessary to be certified by the director of the division of professions and occupations, pursuant to part 8 of article 245 of title 12;
- On or before March 1, 2022, standards that addiction counselors must meet to participate in public programs or to provide purchased services and education requirements necessary to be licensed by the director of the division of professions and occupations, pursuant to part 8 of article 245 of title 12;
- Any rules that are necessary to carry out the purposes of the treatment program for high-risk pregnant women created in section 27-80-112.
- In the rules promulgated pursuant to subsection (1)(e) of this section, the state board of human services shall include education requirements for certified addiction technicians, certified addiction specialists, and licensed addiction counselors.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 726, § 2, effective April 29. L. 2017: Entire section amended, (SB 17-242), ch. 263, p. 1357, § 259, effective May 25. L. 2019: (1)(e) amended, (HB 19-1172), ch. 136, p. 1714, § 200, effective October 1. L. 2020: (1)(c) amended, (SB 20-007), ch. 286, p. 1390, § 3, effective July 13; (2) added, (HB 20-1206), ch. 304, p. 1543, § 41, effective July 14. L. 2021: (1)(e.5) added and (2) amended, (HB 21-1305), ch. 399, p. 2649, § 6, effective July 1.
Editor's note: This section is similar to former § 25-1-207 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-109. Coordination of state and federal funds and programs.
- Requests for state appropriations for substance use disorder treatment programs must be submitted to the office of behavioral health and the office of state planning and budgeting on dates specified by the office of behavioral health, consistent with requirements and procedures of the office of state planning and budgeting. After studying each request, the office of behavioral health shall make a report with its comments and recommendations, including priorities for appropriations and a statement as to whether the requested appropriation would be consistent with the comprehensive state plan for substance use disorder treatment programs. The office of behavioral health shall submit its reports to the governor, the office of state planning and budgeting, and the joint budget committee, together with all pertinent material on which the report's recommendations are based.
- The office of behavioral health shall also review applications for federal grants for substance use disorder treatment programs submitted by any department or agency of state government; political subdivision of the state; Indian tribal reservation; or other public or private agency, organization, or institution. The office of behavioral health shall transmit to the division of planning and to the appropriate United States agency its comments and recommendations, together with a statement as to whether the grant would be consistent with the comprehensive state plan for substance use disorder treatment programs.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 727, § 2, effective April 29. L. 2017: Entire section amended, (SB 17-242), ch. 263, p. 1357, § 260, effective May 25.
Editor's note: This section is similar to former § 25-1-209 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-110. Reports. (Repealed)
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 727, § 2, effective April 29. L. 2017: Entire section amended, (SB 17-242), ch. 263, p. 1358, § 261, effective May 25; entire section repealed, (SB 17-234), ch. 154, p. 524, § 18, effective August 9.
Editor's note:
- This section was similar to former § 25-1-210 as it existed prior to 2010.
- This section was amended in SB 17-242. Those amendments were superseded by the repeal of this section in SB 17-234, effective August 9, 2017.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-111. Counselor training - fund created.
- The executive director shall establish by rule fees to be charged for addiction counselor training. The amount assessed must be sufficient to cover a portion of the costs of administering the training, and the money collected must be deposited in the addiction counselor training fund. Additional funding may be obtained from general, cash, or federal funds otherwise appropriated to the office of behavioral health.
- There is created in the office of the state treasurer the addiction counselor training fund, referred to in this section as the "fund". Money collected pursuant to subsection (1) of this section shall be deposited in the fund. The money in the fund is subject to annual appropriation by the general assembly to the department for allocation to the office of behavioral health for the administration of addiction counselor training requirements established by rules of the state board of human services pursuant to section 27-80-108 (1)(e). Money in the fund at the end of the fiscal year must remain in the fund and not revert to the general fund.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 727, § 2, effective April 29. L. 2017: Entire section amended, (SB 17-242), ch. 263, p. 1358, § 262, effective May 25.
Editor's note: This section is similar to former § 25-1-211 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-112. Legislative declaration - treatment program for high-risk pregnant women - creation.
- The general assembly hereby finds and declares that the health and well-being of the women of Colorado is at risk; that such women are at risk of poor birth outcomes or physical and other disabilities due to substance abuse, which is the abuse of alcohol and drugs, during the prenatal period; that early identification of such high-risk pregnant women and substance abuse treatment greatly reduce the occurrence of poor birth outcomes; and that the citizens of Colorado will greatly benefit from a program to reduce poor birth outcomes and subsequent problems resulting from such poor birth outcomes in cases involving high-risk pregnant women through the cost savings envisioned by the prevention and early treatment of such problems.
- In recognition of such problems, there is hereby created a treatment program for high-risk pregnant women.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 728, § 2, effective April 29.
Editor's note: This section is similar to former § 25-1-212 as it existed prior to 2010.
27-80-113. Substance use and addiction counseling and treatment - necessary components.
Any entity that qualifies to provide services pursuant to section 25.5-5-202 (1)(r) in regard to the treatment program for high-risk pregnant women, shall make available, in addition to substance use and addiction counseling and treatment: Risk assessment services; care coordination; nutrition assessment; psychosocial counseling; intensive health education, including parenting education and education on risk factors and appropriate health behaviors; home visits; transportation services; and other services deemed necessary by the office of behavioral health and the department of health care policy and financing.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 728, § 2, effective April 29. L. 2017: Entire section amended, (SB 17-242), ch. 263, p. 1358, § 263, effective May 25.
Editor's note: This section is similar to former § 25-1-213 as it existed prior to 2010.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-114. Treatment program for high-risk pregnant and parenting women - cooperation with organizations.
The department of health care policy and financing shall cooperate with any organizations that desire to assist the department of health care policy and financing in the provision of services connected with the treatment program for high-risk pregnant and parenting women. Organizations may provide services that are not provided to persons pursuant to the treatment program for high-risk pregnant and parenting women, article 2 of title 26, and articles 4, 5, and 6 of title 25.5, which may include, but shall not be limited to, needs assessment services, preventive services, rehabilitative services, care coordination, nutrition assessment, psychosocial counseling, intensive health education, home visits, transportation, development of provider training, child care, and other necessary components of residential or outpatient treatment or care.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 728, § 2, effective April 29. L. 2019: Entire section amended, (HB 19-1193), ch. 272, p. 2570, § 6, effective May 23.
Editor's note: This section is similar to former § 25-1-214 as it existed prior to 2010.
Cross references: For the legislative declaration in HB 19-1193, see section 1 of chapter 272, Session Laws of Colorado 2019.
27-80-115. Treatment program for high-risk pregnant and parenting women - data collection.
The department of health care policy and financing shall create a data collection mechanism regarding persons receiving services pursuant to the treatment program for high-risk pregnant and parenting women that must include the collection of data on cost-effectiveness, success of the program, and other data the department of health care policy and financing deems appropriate.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 728, § 2, effective April 29. L. 2019: Entire section amended, (HB 19-1193), ch. 272, p. 2570, § 7, effective May 23.
Editor's note: This section is similar to former § 25-1-215 as it existed prior to 2010.
Cross references: For the legislative declaration in HB 19-1193, see section 1 of chapter 272, Session Laws of Colorado 2019.
27-80-116. Fetal alcohol spectrum disorders - legislative declaration - health warning signs.
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The general assembly finds and declares that:
- Fetal alcohol exposure is the leading known cause of preventable intellectual and developmental disabilities and birth defects in the children of this state;
- Individuals with undiagnosed fetal alcohol spectrum disorders suffer substantially from secondary issues such as child abuse and neglect, separation from families, multiple foster placements, depression, aggression, school failure, juvenile detention, and job instability;
- Compared to individuals diagnosed before age twelve, individuals with undiagnosed FASD are two to four times more likely to suffer from inappropriate sexual behavior; disrupted school experiences; trouble with the law; alcohol and substance problems or disorders; or confinement in a jail, a hospital or treatment facility for persons with behavioral or mental health disorders, or a substance use disorder treatment facility;
- These secondary disabilities come at a high cost to individuals, their families, and society;
- A survey performed in 2006 by the Colorado pregnancy risk assessment system estimated that eleven and two-tenths percent of women in Colorado said that they drank alcohol during the last three months of their pregnancy; and
- The commission should evaluate the current use and distribution of written and electronic informational materials designed to increase awareness of the consequences of drinking alcohol while pregnant and should investigate additional means by which such written and electronic materials might best be used.
- The general assembly therefore declares that fetal alcohol exposure and its related problems can be reduced substantially by a greater awareness of the consequences of drinking alcohol while pregnant and by early diagnosis and receipt of appropriate and effective intervention.
- Each person licensed pursuant to section 44-3-401 (1)(h) to (1)(t) or 44-3-401 (1)(v) to sell malt, vinous, and spirituous liquors or licensed pursuant to section 44-4-104 (1)(c) to sell fermented malt beverages is hereby encouraged to post a health warning sign informing patrons that the consumption of alcohol during pregnancy may cause birth defects, including fetal alcohol spectrum disorders.
- Repealed.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 728, § 2, effective April 29. L. 2011: Entire section amended, (HB 11-1144), ch. 65, p. 170, § 2, effective August 10. L. 2015: (3) and (4)(c) amended, (HB 15-1204), ch. 121, p. 374, § 23, effective April 24. L. 2016: (3) amended, (SB 16-189), ch. 210, p. 783, § 80, effective June 6. L. 2017: IP(1) and (1)(b.5) amended, (SB 17-242), ch. 263, p. 1359, § 264, effective May 25. L. 2018: (3) amended, (HB 18-1025), ch. 152, p. 1080, § 16, effective October 1.
Editor's note:
- This section is similar to former § 25-1-216 as it existed prior to 2010.
- Subsection (4)(e) provided for the repeal of subsection (4), effective June 30, 2015. (See L. 2011, p. 170 .)
Cross references: For the legislative declaration in the 2011 act amending this section, see section 1 of chapter 65, Session Laws of Colorado 2011. For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-117. Rural alcohol and substance abuse prevention and treatment program - creation - administration - definitions - cash fund - repeal.
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As used in this section, unless the context otherwise requires:
- "Program" means the rural alcohol and substance abuse prevention and treatment program created pursuant to subsection (2) of this section that shall consist of the rural youth alcohol and substance abuse prevention and treatment project and the rural detoxification project.
- "Rural area" means a county with a population of less than thirty thousand people, according to the most recently available population statistics of the United States bureau of the census.
- "Youth" means an individual who is at least eight years of age but who is less than eighteen years of age.
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There is created the rural alcohol and substance abuse prevention and treatment program in the office of behavioral health to provide: (2) (a) (I) There is created the rural alcohol and substance abuse prevention and treatment program in the office of
behavioral health to provide:
- Prevention and treatment services to youth in rural areas. The services may include providing alternative activities for youth through the rural youth alcohol and substance abuse prevention and treatment project; and
- Treatment services through the rural detoxification project for persons with substance use disorders.
- The office of behavioral health shall administer the program pursuant to rules adopted by the state board of human services as of January 1, 2010, or as amended by the state board.
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There is created the rural alcohol and substance abuse prevention and treatment program in the office of behavioral health to provide: (2) (a) (I) There is created the rural alcohol and substance abuse prevention and treatment program in the office of
behavioral health to provide:
- The office of behavioral health shall incorporate provisions to implement the program into its regular contracting mechanism for the purchase of prevention and treatment services pursuant to section 27-80-106, including detoxification programs. The office of behavioral health shall develop a method to equitably distribute and provide additional money through contracts to provide for prevention services for and treatment of persons in rural areas.
- Notwithstanding any provision of this section to the contrary, the office of behavioral health shall implement the program on or after January 1, 2011, subject to the availability of sufficient money to operate an effective program, as determined by the office.
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- There is created in the state treasury the rural alcohol and substance abuse cash fund, referred to in this section as the "fund", that consists of the rural youth alcohol and substance abuse prevention and treatment account, referred to in this section as the "youth account", and the rural detoxification account, referred to in this section as the "detoxification account". The fund is comprised of money collected from surcharges assessed pursuant to sections 18-19-103.5, 42-4-1307 (10)(d)(I), and 42-4-1701 (4)(f). The money collected from the surcharges must be divided equally between the youth account and the detoxification account. The fund also includes any money credited to the fund pursuant to subsection (3)(b) of this section. Money in the fund credited pursuant to subsection (3)(b) of this section must be divided equally between the youth account and the detoxification account unless the grantee or donor specifies to which account the grant, gift, or donation is to be credited. The money in the fund is subject to annual appropriation by the general assembly to the office of behavioral health for the purpose of implementing the program. All interest derived from the deposit and investment of money in the fund remains in the fund. Any unexpended or unencumbered money remaining in the fund at the end of a fiscal year remains in the fund and shall not be transferred or credited to the general fund or another fund; except that any unexpended and unencumbered money remaining in the fund as of August 30, 2025, is credited to the general fund.
- The office of behavioral health is authorized to accept grants, gifts, or donations from any private or public source on behalf of the state for the purpose of the program. The office of behavioral health shall transmit all private and public money received through grants, gifts, or donations to the state treasurer, who shall credit the same to the fund.
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- This section is repealed, effective September 1, 2025.
- Prior to such repeal, the program shall be reviewed as provided in section 24-34-104, C.R.S.
Source: L. 2010: Entire article added with relocations, (SB 10-175), ch. 188, p. 730, § 2, effective April 29; (3)(a) amended, (HB 10-1347), ch. 258, p. 1159, § 6, effective July 1. L. 2016: (3)(a) and (4)(a) amended, (HB 16-1168), ch. 93, p. 261, § 1, effective April 14. L. 2017: (2) and (3) amended, (SB 17-242), ch. 263, p. 1359, § 265, effective May 25.
Editor's note:
- This section is similar to former § 25-1-217 as it existed prior to 2010.
- Subsection (3)(a) was numbered as § 25-1-217 (3)(a) in House Bill 10-1347 (see L. 2010, p. 1159 ) but was relocated due to its harmonization with this section as it was added by Senate Bill 10-175.
Cross references: For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
27-80-118. Center for research into substance use disorder prevention, treatment, and recovery support strategies - established - appropriation - legislative declaration.
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The general assembly finds that:
- Opioid addiction has emerged as a significant public health concern in Colorado, with more than ten thousand deaths attributed to drug overdoses since 2000, and the annual rate of death from drug overdose doubling from seven-point-eight deaths per one hundred thousand people in 2000 to fifteen-point-seven deaths per one hundred thousand people in 2015. This rate is significantly higher than the national rate.
- The abuse of prescription drugs is the fastest growing substance abuse problem in the United States, particularly among adolescents;
- Each year, the