Colorado § 27-65-102 - Definitions.

§ 27-65-102. Definitions.

As used in this article 65, unless the context otherwise requires:

(1) "Acute treatment unit" means a facility or a distinct part of a facility for short-term psychiatric care, which may include treatment for substance use disorders, that provides a total, twenty-four-hour, therapeutically planned and professionally staffed environment for persons who do not require inpatient hospitalization but need more intense and individual services than are available on an outpatient basis, such as crisis management and stabilization services.

(2) "Behavioral health administration" or "BHA" means the behavioral health administration established in section 27-60-203.

(3) "Behavioral health crisis" means a significant disruption in a person's mental or emotional stability or functioning resulting in an urgent need for immediate assessment and treatment to prevent a serious deterioration in the person's mental or physical health.

(4) "Behavioral health crisis response team" means a mobile team that responds to people in the community who are in a behavioral health crisis and includes at least one licensed or bachelor-degree-level behavioral health worker. A "behavioral health crisis response team" includes, but is not limited to, a co-responder model, mobile crisis response unit, or a community response team.

(5) "Behavioral health entity" has the same meaning as set forth in section 27-50-101.

(6) "Certified peace officer" means any certified peace officer as described in section 16-2.5-102.

(7) "Commissioner" means the commissioner of the behavioral health administration established in section 27-60-203.

(8) "Court" means any district court of the state of Colorado and the probate court in the city and county of Denver.

(9) "Court-ordered evaluation" means an evaluation ordered by a court pursuant to section 27-65-106.

(10) "Danger to others" means a person poses a substantial risk of physical harm to another person or persons, as manifested by evidence of recent homicidal or other violent behavior by the person in question, or by evidence that others are placed in reasonable fear of violent behavior and serious physical harm to them, as evidenced by a recent overt act, attempt, or threat to do serious physical harm by the person in question.

(10.2) "Danger to the person's self", or similar terminology, means a person poses a substantial risk of physical harm to the person's self as manifested by evidence of recent threats or attempts at suicide or serious bodily harm to the person's self.

(11) "Department" or "CDHS" means the department of human services.

(12) "Emergency medical services facility" means a general hospital with an emergency department or a freestanding emergency department, as defined in section 25-1.5-114 (5). An emergency medical services facility is not required to be, but may elect to become, a facility designated or approved by the commissioner.

(13) "Emergency medical services provider" has the same meaning as set forth in section 25-3.5-103 (8).

(14) Repealed.

(15) "Facility" means a public hospital or a licensed private hospital, behavioral health entity, institution, or residential child care facility that provides treatment for persons with mental health disorders.

(16) "Family member" means a spouse, partner in a civil union, as defined in section 14-15-103 (5), parent, adult child, or adult sibling of a person with a mental health disorder.

(17) "Gravely disabled" means a condition in which a person, as a result of a mental health disorder, is incapable of making informed decisions about or providing for the person's essential needs without significant supervision and assistance from other people. As a result of being incapable of making these informed decisions, a person who is gravely disabled is at risk of substantial bodily harm, dangerous worsening of any concomitant serious physical illness, significant psychiatric deterioration, or mismanagement of the person's essential needs that could result in substantial bodily harm. A person of any age may be "gravely disabled", but the term does not include a person whose decision-making capabilities are limited solely by the person's developmental disability.

(18) "Hospitalization" means twenty-four-hour out-of-home placement for treatment in a facility for a person with a mental health disorder.

(19) "Independent professional person" means a professional person who evaluates a minor's condition as an independent decision-maker and whose recommendations are based on the standard of what is in the best interest of the minor. The professional person may be associated with the admitting facility if the professional person is free to independently evaluate the minor's condition and need for treatment and has the authority to refuse admission to any minor who does not satisfy the statutory standards specified in section 27-65-104 (2).

(20) "Intervening professional" means a person who is one of the following:

(a) A professional person;

(b) A physician assistant licensed pursuant to section 12-240-113;

(c) An advanced practice registered nurse, as defined in section 12-255-104 (1);

(d) A registered professional nurse, as defined in section 12-255-104 (11), who has specific mental health training as identified by the BHA;

(e) A clinical social worker licensed pursuant to part 4 of article 245 of title 12;

(f) A marriage and family therapist licensed pursuant to part 5 of article 245 of title 12;

(g) A professional counselor licensed pursuant to part 6 of article 245 of title 12; or

(h) An addiction counselor licensed pursuant to part 8 of article 245 of title 12.

(21) "Lay person" means a person identified by another person who is detained on an involuntary emergency mental health hold pursuant to section 27-65-106, certified for short-term treatment pursuant to section 27-65-108.5, 27-65-109, or 27-65-109.5, or certified for long-term care and treatment pursuant to section 27-65-110 who is authorized to participate in activities related to the person's involuntary emergency mental health hold, short-term treatment, or long-term treatment, including court appearances, discharge planning, and grievances. The person may rescind the lay person's authorization at any time.

(22) "Mental health disorder" means 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 and includes a mental disability or developmental disability, as those terms are defined in section 16-8.5-101, which has led a court to find the person with the disability incompetent to proceed pursuant to article 8.5 of title 16.

(23) "Minor" means a person under eighteen years of age; except that the term does not include a person who is fifteen years of age or older who is living separately and apart from the person's parent or legal guardian and is managing the person's own financial affairs, regardless of the person's source of income, or who is married and living separately and apart from the person's parent or legal guardian.

(24) "Patient representative" means a person designated by a mental health facility to process patient complaints or grievances or to represent patients who are minors pursuant to section 27-65-104 (4).

(24.5) "Persistent mental health disorder" means:

(a) A mental health disorder that has resulted in the person having three or more of the following within the preceding three years:

(I) An emergency mental health hold pursuant to section 27-65-106;

(II) A certification for short-term treatment pursuant to section 27-65-109 or 27-65-109.5;

(III) A finding of incompetency to proceed pursuant to article 8 or 8.5 of title 16; or

(IV) An inpatient psychiatric hospitalization; and

(b) A professional person with an established treatment relationship with the person, as described in section 27-65-109.5 (1)(a), has evaluated the person within the preceding ninety days or a professional person conducting an evaluation or treatment pursuant to this article 65 has given consideration to the person's history of psychiatric deterioration and cycling through interventions and determined that:

(I) The person currently has a mental health disorder that substantially impairs the person's ability to make informed decisions about treatment;

(II) Voluntary treatment is unlikely to be sufficient to prevent further psychiatric deterioration or crisis episodes based on the person's treatment history and current presentation;

(III) Involuntary treatment is clinically indicated and appropriate given the person's current condition, level of functioning, and treatment history, including any failures to maintain voluntary treatment despite any prior assurances the person would; and

(IV) The person has not had a continuous period of twelve or more months of immediately preceding stability, unless the professional person documents specific clinical findings that current psychiatric deterioration is occurring notwithstanding the period of stability.

(25) "Petitioner" means any person who files any petition in any proceeding in the interest of any person who allegedly has a mental health disorder or is allegedly gravely disabled.

(26) "Physician" means a person licensed to practice medicine in this state.

(27) "Professional person" means a person licensed to practice medicine in this state, a psychologist licensed to practice in this state, or a person licensed and in good standing to practice medicine in another state or a psychologist licensed to practice and in good standing in another state who is providing medical or clinical services at a treatment facility in this state that is operated by the armed forces of the United States, the United States public health service, or the United States department of veterans affairs.

(27.5) "Psychiatric deterioration" means a measurable decline in overall functioning due to the person's mental health disorder. Psychiatric deterioration may be evidenced by, but not limited to, a person's increased severity or frequency of symptoms; diminished ability to perform activities of daily living resulting in mental, emotional, or physical harm; or inability to recognize the need for intervention, which has a substantial probability of resulting in harm or further decompensation to the person.

(28) "Residential child care facility" has the same meaning as set forth in section 26-6-903 (29). A residential child care facility may be eligible for designation by the commissioner pursuant to this article 65.

(29) "Respondent" means either a person alleged in a petition filed pursuant to this article 65 to have a mental health disorder or be gravely disabled or a person certified pursuant to the provisions of this article 65.

(30) "Screening" means a review of all petitions, to consist of an interview with the petitioner and, whenever possible, the respondent; an assessment of the problem; an explanation of the petition to the respondent; and a determination of whether the respondent needs and, if so, will accept on a voluntary basis, a comprehensive evaluation, treatment, referral, and other appropriate services, either on an inpatient or an outpatient basis.

(31) "Secure transportation provider" means a provider licensed pursuant to section 25-3.5-310 to provide public or private secure transportation services.

(32) "Substantial risk of serious harm to others" means an appreciable and considerable risk that the person will commit a criminal act against a person now or in the reasonably foreseeable future that causes serious bodily injury, as defined in section 18-1-901, to another person, or is likely to cause serious emotional distress to a reasonable person.

Source: L. 2022: (1.5)(a) and (28) amended, (HB 22-1295), ch. 123, p. 863, § 116, effective July 1; (2) and (7) added, (12) and (28) amended, and (14) repealed, (HB 22-1278), ch. 222, p. 1537, § 114, effective July 1; entire article amended with relocations, (HB 22-1256), ch. 451, p. 3171, § 1, effective August 10; (14) repealed, (HB 22-1256), ch. 451, p. 3240, § 56, effective August 10; (5) and (15) amended, (HB 22-1278), ch. 222, p. 1594, § 235, effective July 1, 2024. L. 2026: (10), (11), (21), and (22) amended and (10.2), (24.5), (27.5), and (32) added, (SB 26-149), ch. 142, p. 727, § 3, effective May 21.

Editor's note: (1) This section is similar to former § 27-65-102 as it existed prior to 2022.

(2) Subsection (2) was numbered as § 27-65-102 (1.3) in HB 22-1278 (see L. 2022, p. 1537). That provision was harmonized with subsection (2) of this section as it appears in HB 22-1256.

(3) Subsection (5) was numbered as § 27-65-102 (1.5) in HB 22-1278 (see L. 2022, p. 1594). That provision was harmonized with subsection (5) of this section as it appears in HB 22-1256, effective July 1, 2024.

(4) Subsection (1.5)(a) was amended in HB 22-1295. Those amendments were superseded by the amendments to this section in HB 22-1256, effective August 10, 2022, and HB 22-1278, effective July 1, 2024. For the amendments to section 27-65-102 (1.5)(a) in HB 22-1295 in effect from July 1, 2022, to August 10, 2022, see chapter 123, Session Laws of Colorado 2022 (L. 2022, p. 863).

(5) Subsection (7) was numbered as § 27-65-102 (2.5) in HB 22-1278 (see L. 2022, p. 1537). That provision was harmonized with subsection (7) of this section as it appears in HB 22-1256.

(6) Subsection (12) was numbered as § 27-65-102 (5.5) in HB 22-1278 (see L. 2022, p. 1537). That provision was harmonized with subsection (12) of this section as it appears in HB 22-1256.

(7) Subsection (14) was numbered as § 27-65-102 (6) in HB 22-1278 (see L. 2022, p. 1537). That provision was harmonized with subsection (14) of this section as it appears in HB 22-1256.

(8) Subsection (15) was numbered as § 27-65-102 (7) in HB 22-1278 (see L. 2022, p. 1594). That provision was harmonized with subsection (15) of this section as it appears in HB 22-1256, effective July 1, 2024.

(9) Subsection (28) was numbered as § 27-65-102 (18) in HB 22-1278 (see L. 2022, p. 1537). That provision was harmonized with HB 22-1295 and subsection (28) of this section as it appears in HB 22-1256.

(10) Subsection (14) was repealed in § 56 of HB 22-1256, effective August 10, 2022. However, those repeals were superseded by the amendment of this entire article by § 1 of HB 22-1256, effective August 10, 2022.

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).

Definition of "gravely disabled" takes precedence over a respondent's own testimony regarding the respondent's mental state. People in Interest of Ramsey, 2023 COA 95, 541 P.3d 1198.

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).

A court's determination regarding whether a respondent has a "mental health disorder" takes precedence over a respondent's own testimony regarding the respondent's mental state. People in Interest of Ramsey, 2023 COA 95, 541 P.3d 1198.

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).