Treating People with Behavioral Health Disorder

Second Regular Session
Seventy-fifth General Assembly
STATE OF COLORADO
INTRODUCED

LLS NO. 26-0121.01 Shelby Ross x4510 HOUSE BILL 26-1063
House Committees Senate Committees
Health & Human Services
A BILL FOR AN ACT
CONCERNING TREATING INDIVIDUAL S WITH A BEHAVIORAL HEALTH101
DISORDER, AND , IN CONNECTION THEREWITH , REIMBURSING102
LICENSED PROVIDERS WHO ADMINISTER MEDICATION-ASSISTED103
TREATMENT AND PROVIDING PROTECTIONS RELATED TO SECURE104
TRANSPORTATION FOR PERSONS EXPERIENCING A BEHAVIORAL105
HEALTH CRISIS.106
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov/.)
Legislative Oversight Committee Concerning the Treatment
HOUSE SPONSORSHIP
Bradfield and Rydin, Jackson
SENATE SPONSORSHIP
Amabile and Michaelson Jenet,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law.
of Persons with Behavioral Health Disorders in the Criminal and
Juvenile Justice Systems. Current law requires the department of health
care policy and financing to provide medicaid reimbursement to opioid
treatment programs for administering medication-assisted treatment
(MAT) in a jail setting. Section 1 of the bill expands medicaid
reimbursement to include licensed providers who administer MAT in a
jail setting.
Current law excludes personnel employed by or contracted with a
law enforcement agency from the definition of "secure transportation".
Section 2 removes this exclusion to allow entities that contract with law
enforcement agencies to provide secure transportation.
Sections 3 and 4 transfer the licensing authority for secure
transportation providers from the counties to the department of public
health and environment beginning January 1, 2027.
Sections 6 through 10 make changes to the secure transportation
requirements and petition filing requirements related to emergency mental
health holds and short-term and long-term certifications, including:
! Expanding the transportation provider types that may be
contacted for assistance in detaining and transporting a
person to a facility for an emergency mental health hold to
include a behavioral health crisis response team, a private
ambulance service provider, a private emergency medical
services provider, and a secure transportation provider;
! Requiring a certified peace officer to advise the person
being taken into protective custody that the person is not
under arrest and has not committed a crime;
! Requiring the petition for a court-ordered evaluation to
include any known history of the respondent's history of
assault or possession of weapons and whether the
respondent has a prior history of an emergency mental
health hold or short-term or long-term certification; and
! Creating a right for a person detained for an emergency
mental health hold to not be transported by a certified
peace officer if an alternative secure transportation option
is available.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 25.5-4-505.5, amend2
(5) as follows:3
25.5-4-505.5. Federal authorization related to persons involved4
in the criminal justice system - report - rules - legislative declaration.5
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(5) (a) The state department shall only reimburse an opioid1
treatment program, as defined in section 27-80-203, A PROVIDER2
LICENSED AND AUTHORIZED TO PRESCRIBE , DISPENSE , COMPOUND , OR3
ADMINISTER MEDICATION -ASSISTED TREATMENT for administering4
medication-assisted treatment in a jail setting. At a minimum, an opioid5
treatment program that administers medication-assisted treatment shall:6
(I) Employ a physician medical director;7
(II) Ensure the individual receiving medication-assisted treatment8
undergoes a minimum observa tion pe riod after receiving9
medication-assisted treatment as determined by behavioral health10
administration rule pursuant to section 27-80-204; and11
(III) Meet all critical incident reporting requirements as12
determined by behavioral health administration rule pursuant to section13
27-80-204.14
(b) The state department shall ensure as part of the state15
department's quality oversight that opioid treatment programs that16
LICENSED PROVIDERS WHO administer medication-assisted treatment in a17
jail setting maintain emergency policies and procedures that address18
adverse outcomes.19
SECTION 2. In Colorado Revised Statutes, 25-3.5-103, amend20
(11.4)(c) as follows:21
25-3.5-103. Definitions.22
As used in this article 3.5, unless the context otherwise requires:23
(11.4) (c) "Secure transportation" does not include urgent24
transportation services provided by law enforcement or personnel25
employed by or contracted with a law enforcement agency to individuals26
experiencing a behavioral health crisis; except that any member of a27
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co-responder team who is not law enforcement or personnel employed by1
or contracted with a law enforcement agency and who holds a valid2
license for secure transportation by the county in which the secure3
transportation originates, in a vehicle with a valid permit issued by the4
county in which the secure transportation originates, and which meets the5
minimum requirements for secure transportation established by rule6
pursuant to section 25-3.5-311 may provide urgent secure transportation7
services.8
SECTION 3. In Colorado Revised Statutes, 25-3.5-309, amend9
(1)(a) as follows:10
25-3.5-309. Secure transportation - license required - fees -11
exceptions.12
(1) (a) After January 1, 2023 JANUARY 1, 2027, an entity shall not13
provide public or private secure transportation services, as defined in14
section 25-3.5-103 (11.4), in this state unless that THE entity holds a valid15
license issued by the board of county commissioners of the county16
DEPARTMENT AND THE ENTITY HAS OBTAINED AUTHORIZATION TO17
OPERATE FROM THE LOCAL LICENSING AUTHORITY FOR THE COUNTY OR18
CITY AND COUNTY in which the secure transportation service is based;19
except that entities described in subsection (2) of this section may provide20
secure transportation services.21
SECTION 4. In Colorado Revised Statutes, 25-3.5-310, amend22
(1) and (2) as follows:23
25-3.5-310. Secure transportation - issuance of licenses and24
permits - term - requirements.25
(1) (a) After receipt of an original application for a license to26
provide public or private secure transportation services, the board of27
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county commissioners of the county in which the secure transportation1
service is based DEPARTMENT shall review the application, the applicant's2
record, and the applicant's equipment, as well as the applicant's training3
and operating procedures. In order to be approved for a license, the4
applicant must provide evidence that the applicant's equipment and5
training and operating procedures meet or exceed the minimum6
requirements established by the state board of health pursuant to section7
25-3.5-311. The board of county commissioners of any county may8
impose, by resolution, additional requirements for secure transportation9
that is based in that county.10
(b) If an applicant is approved pursuant to subsection (1)(a) of this11
section, the board of county commissioners of the county in which the12
secure transportation service is based DEPARTMENT shall issue a license,13
valid for three years, to the applicant to provide secure transportation14
services. The board of county commissioners of the county in which the15
secure transportation service is based shall also issue a permit, valid for16
twelve months after the date of issuance, for each vehicle used by the17
licensee if the vehicles and equipment meet or exceed the minimum18
requirements established by the state board of health pursuant to section19
25-3.5-311.20
(2) Any license or permit issued pursuant to this section, unless21
revoked by the DEPARTMENT OR board of county commissioners of the22
county in which the secure transportation service is based, may be23
renewed by filing an application, as applicable for an original license or24
permit. Applications for permit renewal must be filed annually, but not25
less than thirty days before the date the permit expires.26
SECTION 5. In Colorado Revised Statutes, 27-65-102, add27
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(30.5) as follows:1
27-65-102. Definitions.2
As used in this article 65, unless the context otherwise requires:3
(30.5) "SECURE TRANSPORT PERSONNEL" MEANS THE FOLLOWING4
PERSONNEL IN ORDER OF PRIORITY:5
(a) A SECURE TRANSPORTATION PROVIDER;6
(b) A BEHAVIORAL HEALTH CRISIS RESPONSE TEAM;7
(c) A PRIVATE AMBULANCE PROVIDER; OR8
(d) A PRIVATE EMERGENCY MEDICAL SERVICES PROVIDER.9
SECTION 6. In Colorado Revised Statutes, 27-65-106, amend10
(1)(a), (2), (4)(a)(III), (4)(a)(IV), (4)(a)(V), (4)(d), (10)(a)(XVI), and11
(10)(a)(XVII); and add (4)(a)(VI), (8)(f), and (10)(a)(XVIII) as follows:12
27-65-106. Emergency mental health hold - screening -13
court-ordered evaluation - discharge instructions - respondent's14
rights.15
(1) An emergency mental health hold may be invoked under one16
of the following conditions:17
(a) (I) When a certif ied peace officer ha s probable cause to18
believe a person has a mental health disorder and, as a result of the mental19
health disorder, is an imminent danger to the person's self or others or is20
gravely disabled, the certified peace officer may take the person into21
protective custody and transport the person to a facility designated by the22
commissioner for an emergency mental health hold. If such a facility is23
not available, the certified peace officer may transport the person to an24
emergency medical services facility. T O THE EXTENT POSSIBLE , THE25
CERTIFIED PEACE OFFICER SHALL ADVISE THE PERSON THAT THE PEACE26
OFFICER IS TAKING THE PERSON INTO PROTECTIVE CUSTODY AND27
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TRANSPORTING THE PERSON TO A FACILITY FOR AN EMERGENCY MENTAL1
HEALTH HOLD AND THAT THE PERSON IS NOT UNDER ARREST AND HAS NOT2
COMMITTED A CRIME. The certified peace officer may request assistance3
from a behavioral health crisis response team for assistance in detaining4
and transporting the person or an emergency medical services provider in5
transporting the person; or SECURE TRANSPORT PERSONNEL FOR6
ASSISTANCE IN TRANSPORTING THE PERSON.7
(II) When an intervening professional reasonably believes that a8
person appears to have a mental health disorder and, as a result of the9
mental health disorder, appears to be an imminent danger to the person's10
self or others or appears to be gravely disabled, the intervening11
professional may cause the person to be taken into protective custody and12
transported to a facility designated by the commissioner for an emergency13
mental health hold. If such a facility is not available, the certified peace14
officer may transport the person to an emergency medical services15
facility. IF REASONABLE, the intervening professional may SHALL request16
assistance from a certified peace officer, a secure transportation provider,17
or a behavioral health crisis response team SECURE TRANSPORT18
PERSONNEL for assistance in detaining and transporting the person. or19
assistance from an emergency medical services provider in transporting20
the person. I F THE INTERVENING PROFESSIONAL DETERMINES THAT21
TRANSPORTATION BY A CERTIFIED PEACE OFFICER IS REQUIRED , THE22
INTERVENING PROFESSIONAL SHALL REQUEST TRANSPORTATION23
ASSISTANCE FROM A PEACE OFFICER AND DOCUMENT AND ARTICULATE24
THE REASONING FOR THE DETERMINATION . IF SUCH A FACILITY IS NOT25
AVAILABLE, THE CERTIFIED PEACE OFFICER MAY TRANSPORT THE PERSON26
TO AN EMERGENCY MEDICAL SERVICES FACILITY.27
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(2) When a person is taken into custody pursuant to subsection (1)1
of this section, the person must not be detained in a jail, lockup, or other2
place used for the confinement of persons charged with or convicted of3
penal offenses. Unless otherwise required by law, a certified peace officer4
may transport the person to an emergency medical services facility or5
facility designated by the commissioner even if a warrant has been issued6
for the person's arrest if the certified peace officer believes it is in the best7
interest of the person. The person must not be held on an emergency8
mental health hold for longer than seventy-two hours after the hold is9
placed or ordered. Nothing in this section prohibits an emergency medical10
services facility OR AN AMBULANCE SERVICE PROVIDER from involuntarily11
holding the person in order to stabilize the person as required pursuant to12
the federal "Emergency Medical Treatment and Labor Act", 42 U.S.C.13
sec. 1395dd, or if the treating professional determines that the individual's14
physical or mental health disorder impairs the person's ability to make an15
informed decision to refuse care and the provider determines that further16
care is indicated.17
(4) (a) The petition for a court-ordered evaluation filed pursuant18
to subsection (1)(b) of this section must contain the following:19
(III) Allegations of fact indicating that the respondent may have20
a mental health disorder and, as a result of the mental health disorder, be21
a danger to the respondent's self or others or be gravely disabled and22
showing reasonable grounds to warrant an evaluation, INCLUDING ANY23
KNOWN HISTORY OF ASSAULT OR POSSESSION OF WEAPONS;24
(IV) The name and address of every person known or believed by25
the petitioner to be legally responsible for the care, support, and26
maintenance of the respondent, if available; and27
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(V) The name, address, and telephone number of the attorney, if1
any, who has most recently represented the respondent; AND2
(VI) T HE RESPONDENT 'S PRIOR HISTORY OF AN EMERGENCY3
MENTAL HEALTH HOLD OR SHORT-TERM OR LONG-TERM CERTIFICATION,4
IF KNOWN.5
(d) Whenever it appears, by petition and screening pursuant to this6
section, to the satisfaction of the court that probable cause exists to7
believe that the respondent has a mental health disorder and, as a result8
of the mental health disorder, is a danger to the respondent's self or others9
or is gravely disabled and that efforts have been made to secure the10
cooperation of the respondent but the respondent has refused or failed to11
accept evaluation voluntarily, the court shall issue an order for evaluation12
authorizing a certified peace officer or secure transportation provider to13
take the respondent into custody and SECURE TRANSPORT PERSONNEL TO14
transport the respondent to a facility designated by the commissioner for15
an emergency mental health hold. I F THE COURT DETERMINES THAT16
SECURE TRANSPORT PERSONNEL ARE NOT AVAILABLE TO TRANSPORT THE17
RESPONDENT TO A DESIGNATED FACILITY , THE COURT MAY ORDER A18
CERTIFIED PEACE OFFICER TO TAKE THE RESPONDENT INTO CUSTODY AND19
TRANSPORT THE RESPONDENT TO THE DESIGNATED FACILITY. A COPY OF20
THE PETITION AND ORDER FOR EVALUATION MUST BE GIVEN TO THE21
SECURE TRANSPORT PERSONNEL OR CERTIFIED PEACE OFFICER AS SOON AS22
POSSIBLE BUT NO LATER THAN TWENTY-FOUR HOURS AFTER THE ORDER IS23
ISSUED. At the time the respondent is taken into custody, a copy of the24
petition and the order for evaluation must be given to the respondent and25
promptly thereafter to the one lay person designated by the respondent26
and to the person in charge of the facility named in the order or the27
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respondent's designee. If the respondent refuses to accept a copy of the1
petition and the order for evaluation, such refusal must be documented in2
the petition and the order for evaluation.3
(8) (f) T HE FACILITY MAY DISCLOSE THE DISPOSITION OF THE4
PERSON DETAINED FOR AN EMERGENCY MENTAL HEALTH HOLD TO LAW5
ENFORCEMENT.6
(10) (a) A person detained for an emergency mental health hold7
pursuant to this section has the following rights:8
(XVI) To have personal privacy to the extent possible during the9
course of treatment; and10
(XVII) To have the ability to meet with visitors in accordance11
with the facility's current visitor guidelines; AND12
(XVIII) TO NOT BE TRANSPORTED BY A CERTIFIED PEACE OFFICER13
IF AN ALTERNATIVE SECURE TRANSPORTATION OPTION IS AVAILABLE.14
SECTION 7. In Colorado Revised Statutes, 27-65-107, amend15
(2) as follows:16
27-65-107. Emergency transportation - application - screening17
- respondent's rights.18
(2) When a person is transported against the person's will pursuant19
to subsection (1) of this section, the facility shall require an application,20
in writing, stating the circumstances under which the person's condition21
was called to the attention of the certified peace officer or emergency22
medical services provider and further stating sufficient facts, obtained23
from personal observations or obtained from others whom the certified24
peace officer or emergency medical services provider reasonably believes25
to be reliable, to establish that the person is experiencing a behavioral26
health crisis or is gravely disabled and, as a result, it is believed that27
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without professional intervention the person may be a danger to the1
person's self or others. The application must indicate the name of the2
person, and the time the person was transported, AND, IF APPLICABLE, THE3
REASON WHY AN ALTERNATIVE TO A CERTIFIED PEACE OFFICER WAS NOT4
USED WHEN TRANSPORTING THE PERSON. A copy of the application must5
be furnished to the person being transported.6
SECTION 8. In Colorado Revised Statutes, 27-65-109, amend7
(8) as follows:8
27-65-109. Certification for short-term treatment - procedure.9
(8) Whenever it appears to the court, by reason of a report by the10
treating professional person or the BHA or any other report satisfactory11
to the court, that a respondent detained for evaluation and treatment or12
certified for short-term treatment should be transferred to another facility13
for treatment and the safety of the respondent or the public requires that14
the respondent be transported by a secure transportation provider, or a law15
enforcement agency, the court may issue an order directing the law16
enforcement agency where the respondent resides or A secure17
transportation provider to deliver the respondent to the designated facility.18
IF THE COURT DETERMINES THAT A SECURE TRANSPORTATION PROVIDER19
IS NOT AVAILABLE TO TRANSPORT THE RESPONDENT TO THE DESIGNATED20
FACILITY, THE COURT MAY ISSUE AN ORDER DIRECTING THE LAW21
ENFORCEMENT AGENCY WHERE THE RESPONDENT RESIDES TO TRANSPORT22
THE RESPONDENT TO THE DESIGNATED FACILITY.23
SECTION 9. In Colorado Revised Statutes, 27-65-110, amend24
(6) as follows:25
27-65-110. Long-term care and treatment of persons with26
mental health disorders - procedure.27
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(6) A respondent certified for long-term care and treatment may1
be discharged from the facility upon the signature of the treating2
professional person and medical director of the facility, and the facility3
shall notify the BHA prior to the respondent's discharge. The facility shall4
make the respondent's discharge instructions available to the respondent,5
the respondent's attorney, the respondent's lay person, and the6
respondent's legal guardian, if applicable, within one week after7
discharge, if requested. A facility that is transferring a respondent to a8
different facility or to an outpatient program shall provide all treatment9
records to the facility or provider accepting the respondent at least10
twenty-four hours prior to the transfer. IF THE TREATING PROFESSIONAL11
OR MEDICAL DIRECTOR OF THE FACILITY DETERMINES THE SAFETY OF THE12
RESPONDENT REQUIRES THAT THE RESPONDENT BE TRANSPORTED BY A13
SECURE TRANSPORTATION PROVIDER, THE FACILITY SHALL ATTEMPT TO14
UTILIZE ANY AVAILABLE TRANSPORTATION PROVIDER PRIOR TO15
REQUESTING TRANSPORTATION BY A LAW ENFORCEMENT AGENCY.16
SECTION 10. In Colorado Revised Statutes, 27-65-111, amend17
(3), (6)(i), and (6)(j); and add (6)(k) as follows:18
27-65-111. Certification on an outpatient basis - short-term19
and long-term care.20
(3) The facility responsible for providing services to a respondent21
on a certification on an outpatient basis shall proactively reach out to the22
respondent to engage the respondent in treatment. If the respondent23
refuses treatment or court-ordered medication and is decompensating24
psychiatrically AND THE COURT DETERMINES THAT AN ALTERNATIVE TO25
LAW ENFORCEMENT FOR SECURE TRANSPORTATION DOES NOT EXIST OR IS26
NOT AVAILABLE WITHIN A REASONABLE AMOUNT OF TIME, the court may27
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order a certified peace officer or secure transportation provider to1
transport the respondent to an appropriate, least restrictive designated2
facility in collaboration with the BHA and the provider holding the3
certification. The respondent does not need to be imminently dangerous4
to the respondent's self or others for the provider to request, and the court5
to order, transportation to a facility for the respondent to receive treatment6
and court-ordered medications. The facility responsible for providing7
services to a respondent on a certification on an outpatient basis shall8
provide the court information on the facility's proactive outreach to the9
respondent and the professional person's and psychiatric advanced10
practice registered nurse's basis for medical opinion, AND WHAT11
ALTERNATIVES TO LAW ENFORCEMENT FOR SECURE TRANSPORTATION12
EXIST. IF A CERTIFIED PEACE OFFICER IS ORDERED TO TAKE THE13
RESPONDENT INTO CUSTODY AND TRANSPORT THE RESPONDENT , THE14
COURT SHALL NOTIFY THE CERTIFIED PEACE OFFICER OF ANY KNOWN PRIOR15
HISTORY OF AN EMERGENCY MENTAL HEALTH HOLD OR SHORT -TERM OR16
LONG-TERM CERTIFICATION, OR ANY KNOWN PRIOR HISTORY RELATED TO17
ASSAULT OR POSSESSION OF A WEAPON.18
(6) A respondent subject to a short-term or long-term certification19
on an outpatient basis has the following rights, in addition to those20
enumerated in section 27-65-119:21
(i) To have access to a representative within the facility who22
provides assistance to file a grievance; and23
(j) To have the right to file a motion with the court at any time to24
contest the certification; AND25
(k) TO NOT BE TRANSPORTED BY A CERTIFIED PEACE OFFICER IF AN26
ALTERNATIVE SECURE TRANSPORTATION OPTION IS AVAILABLE.27
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SECTION 11. Act subject to petition - effective date. This act1
takes effect at 12:01 a.m. on the day following the expiration of the2
ninety-day period after final adjournment of the general assembly (August3
12, 2026, if adjournment sine die is on May 13, 2026); except that, if a4
referendum petition is filed pursuant to section 1 (3) of article V of the5
state constitution against this act or an item, section, or part of this act6
within such period, then the act, item, section, or part will not take effect7
unless approved by the people at the general election to be held in8
November 2026 and, in such case, will take effect on the date of the9
official declaration of the vote thereon by the governor.10
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