Colorado § 25-3.5-103 - Definitions.

§ 25-3.5-103. Definitions.

As used in this article 3.5, unless the context otherwise requires:

(1) "Air ambulance" means a fixed-wing or rotor-wing aircraft that is equipped to provide air transportation and is specifically designed to accommodate the medical needs of individuals who are ill, injured, or otherwise mentally or physically incapacitated and who require in-flight medical supervision.

(1.3) "Air ambulance service" means a public or private entity that uses an air ambulance to transport patients to a medical facility and includes the provision of emergency ambulance service and nonemergency ambulance service.

(1.5) "Ambulance" means any privately or publicly owned ground vehicle:

(a) Especially constructed or modified and equipped, intended to be used, and maintained or operated by an ambulance service for the transportation, upon the streets and highways in this state, of individuals who are sick, injured, or otherwise incapacitated or helpless; and

(b) That is required to be licensed pursuant to part 3 of this article.

(2) (Deleted by amendment, L. 2005, p. 1330, § 1, effective July 1, 2005.)

(3) (a) "Ambulance service" means the furnishing, operating, conducting, maintaining, advertising, or otherwise engaging in or professing to be engaged in the transportation of patients by ambulance and includes the provision of emergency ambulance service and nonemergency ambulance service.

(b) Taken in context, "ambulance service" also means the person providing or professing to be providing ambulance service.

(c) The person providing and the vehicles used for the emergency transportation of individuals injured at a mine are excluded from this definition when the personnel utilized in the operation of the vehicles are subject to the mandatory safety standards of the federal mine safety and health administration, or its successor agency.

(3.1) "Authorization to operate" or "authorized to operate" means a local licensing authority's approval of or act of approving an ambulance service to operate within the jurisdiction of the local licensing authority.

(3.3) "Behavioral health" has the same meaning as set forth in section 27-50-101 (1).

(3.5) "Board" means the state board of health created pursuant to section 25-1-103.

(4) "Board of county commissioners" includes the governing body of any city and county.

(4.3) "Community integrated health-care service" means the provision of certain out-of-hospital medical services, as determined by rule, that a community paramedic may provide.

(4.5) "Community paramedic" means an emergency medical service provider who obtains an endorsement in community paramedicine pursuant to section 25-3.5-206.

(4.7) "Council" means the state emergency medical and trauma services advisory council created in section 25-3.5-104 (1)(a).

(5) "Department" means the department of public health and environment.

(6) "Director" means the executive director of the department of public health and environment.

(7) "Emergency" means any actual or self-perceived event which threatens life, limb, or well-being of an individual in such a manner that a need for immediate medical care is created.

(7.2) "Emergency ambulance service" means an immediate ambulance or air ambulance response at the time ambulance service or air ambulance service is requested that results in the assessment, treatment, or transport of a patient by an ambulance or air ambulance.

(7.5) "Emergency medical practice advisory council" or "advisory council" means the emergency medical practice advisory council created in section 25-3.5-206.

(8) "Emergency medical service provider" means an individual who holds a valid emergency medical service provider certificate or license issued by the department as provided in this article 3.5.

(8.1) "Emergency medical services facility" means a licensed or certified facility that provides emergency medical services, including but not limited to hospitals, hospital units as defined in section 25-3-101, freestanding emergency departments as defined in section 25-1.5-114, critical access hospitals as defined in section 25-1.5-114.5, psychiatric hospitals, community clinics, community mental health centers, and acute treatment units.

(8.3) "EMS agency patient care database" means the department's database containing records required to be submitted in accordance with section 25-3.5-501.

(8.4) "EMS system sustainability task force" or "task force" means the EMS system sustainability task force created in section 25-3.5-108 (1)(a).

(8.5) "First responder" means:

(a) A peace officer, as described in section 16-2.5-101;

(b) A firefighter, as defined in section 29-5-203 (10);

(c) A volunteer firefighter, as defined in section 31-30-1102 (9)(a);

(d) An emergency medical service provider; and

(e) A mental health professional who responds in a professional capacity to a justifiable medical emergency.

(8.6) "Health information organization network" means an organization that oversees and governs the exchange of health-related information among organizations according to nationally recognized standards.

(8.7) "Justifiable medical emergency" means an underlying medical, traumatic, or psychiatric condition posing an immediate safety risk to the individual, emergency medical service provider, or public. Excited delirium, any subsequent term for excited delirium, or any acute psychiatric diagnosis not recognized in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders is not a justifiable medical emergency.

(8.8) "Local licensing authority" means the governing body of a city and county or the board of county commissioners in a county in the state.

(9) "Medical direction" includes, but is not limited to, the following:

(a) Approval of the medical components of treatment protocols and appropriate prearrival instructions;

(b) Routine review of program performance and maintenance of active involvement in quality improvement activities, including access to dispatch tapes as necessary for the evaluation of procedures;

(c) Authority to recommend appropriate changes to protocols for the improvement of patient care; and

(d) Provision of oversight for the ongoing education, training, and quality assurance for providers of emergency care.

(9.3) "Nonemergency ambulance service" means the transport of a patient by an ambulance or air ambulance and that includes the provision of medically necessary supplies and services and meets the medical necessity requirements under 42 CFR 410.40 (e), as that section existed on July 1, 2025.

(9.5) "Out-of-hospital services" means furnishing any necessary goods and services outside of a hospital setting for the purpose of preventing, alleviating, curing, or healing human illness, a physical disability, a physical injury, or a substance use disorder while responding to an emergency or other health-care condition. "Out-of-hospital services" does not include prehospital setting transports.

(9.8) "Patient" means an individual who is sick, injured, or otherwise incapacitated or helpless.

(10) "Permit" means the authorization issued by the department with respect to an ambulance used or to be used to provide ambulance service in the state.

(10.3) "Prehospital setting" means one of the following settings in which an emergency medical service provider performs patient care, which care is subject to medical direction by a medical director:

(a) At the site of an emergency;

(b) During emergency transport;

(c) During interfacility transport; or

(d) While providing out-of-hospital services.

(10.6) "Refresher course program" means a program establishing a course of instruction designed to keep emergency medical service providers abreast of developments or new techniques in their profession, which course includes an examination administered at any time during or following the course to facilitate continuing evaluation of emergency medical service providers.

(10.8) "Registered emergency medical responder" means an individual who has successfully completed the training and examination requirements for emergency medical responders, who provides assistance to the injured or ill until more highly trained and qualified personnel arrive, and who is registered with the department pursuant to part 11 of this article.

(11) "Rescue unit" means any organized group chartered by this state as a corporation not for profit or otherwise existing as a nonprofit organization whose purpose is the search for and the rescue of lost or injured persons and includes, but is not limited to, such groups as search and rescue, mountain rescue, ski patrols (either volunteer or professional), law enforcement posses, civil defense units, or other organizations of governmental designation responsible for search and rescue.

(11.4) (a) "Secure transportation" or "secure transportation services" means urgent transportation services provided to individuals experiencing a behavioral health crisis.

(b) Secure transportation includes:

(I) For an individual being transported pursuant to section 27-65-104 or 27-65-106 (1), transportation from the community to a facility designated by the commissioner of the behavioral health administration in the department of human services for treatment and evaluation pursuant to article 65 of title 27;

(II) For an individual in need of services pursuant to articles 81 and 82 of title 27, transportation from any location to an approved treatment facility, as described in section 27-81-106, or a walk-in crisis center that is operating as part of the behavioral health crisis response system;

(III) For an individual who is receiving transportation across levels of care or to a higher level of care, transportation between any of the following types of facilities:

(A) An emergency medical services facility;

(B) A facility designated by the commissioner of the behavioral health administration in the department of human services for treatment and evaluation pursuant to article 65 of title 27;

(C) An approved treatment facility, as described in section 27-81-106;

(D) A walk-in crisis center that is operating as part of the behavioral health crisis response system; or

(E) A behavioral health entity licensed pursuant to section 25-27.6-106 with a current twenty-four-hour endorsement.

(c) "Secure transportation" does not include urgent transportation services provided by law enforcement or personnel employed by or contracted with a law enforcement agency to individuals experiencing a behavioral health crisis; except that any member of a co-responder team who is not law enforcement or personnel employed by or contracted with a law enforcement agency and who holds a valid license for secure transportation by the county in which the secure transportation originates, in a vehicle with a valid permit issued by the county in which the secure transportation originates, and which meets the minimum requirements for secure transportation established by rule pursuant to section 25-3.5-311 may provide urgent secure transportation services.

(11.5) "Service agency" means a fixed-base or mobile prehospital provider of emergency medical services that employs emergency medical service providers to render medical care to patients.

(12) "Volunteer emergency medical service provider" means an emergency medical service provider who does not receive direct remuneration for the performance of emergency medical services.

Source: L. 77: Entire article added, p. 1279, § 2, effective January 1, 1978. L. 80: (1) and (3) amended, p. 633, § 1, effective April 8. L. 84: (10.6) added, p. 763, § 1, effective July 1. L. 87: (12) added, p. 1126, § 1, effective July 1. L. 94: (5) and (6) amended, p. 2757, § 418, effective July 1. L. 2000: (3.5) and (11.5) added, p. 526, § 3, effective July 1. L. 2005: (1) and (2) amended and (1.5) added, p. 1330, § 1, effective July 1. L. 2010: (7.5) added, (HB 10-1260), ch. 403, p. 1944, § 6, effective July 1. L. 2012: (8), (10.6), (11.5), and (12) amended, (HB 12-1059), ch. 271, p. 1437, § 20, effective July 1. L. 2016: (1.3) added, (HB 16-1280), ch. 206, p. 736, § 1, effective June 1; (4.3) and (4.5) added, (SB 16-069), ch. 260, p. 1062, § 1, effective June 8; (10.8) added, (HB 16-1034), ch. 324, p. 1310, § 1, effective August 10. L. 2018: IP amended and (8.3) and (8.5) added, (HB 18-1032), ch. 63, p. 612, § 1, effective August 8. L. 2019: (8) amended, (SB 19-242), ch. 396, p. 3518, § 1, effective May 31; (8.8) added, (SB 19-052), ch. 122, p. 527, § 1, effective August 2. L. 2021: (3.3), (8.1), and (11.4) added, (HB 21-1085), ch. 355, p. 2308, § 1, effective June 27; (8.6) and (10.3) added, (HB 21-1251), ch. 450, p. 2957, § 1, effective July 6. L. 2022: (3.1), (8.4), and (8.7) added and (10) amended, (SB 22-225), ch. 291, p. 2087, § 2, effective June 1; (3.3), (11.4)(b)(I), and (11.4)(b)(III)(B) amended, (HB 22-1278), ch. 222, p. 1508, § 57, effective July 1; (11.4)(b)(I) amended, (HB 22-1256), ch. 451, p. 3239, § 52, effective August 10; (11.4)(b)(I) amended, (HB 22-1278), ch. 222, p. 1600, § 249, effective August 10. L. 2024: (8.1) amended, (SB 24-121), ch. 439, p. 3066, § 4, effective July 1, 2026. L. 2025: (4.7) added, (SB 25-275), ch. 377, p. 2078, § 210, effective August 6. L. 2026: (8.5), (8.6), (8.7), (8.8), and (9) amended and (9.8) added, (HB 26-1069), ch. 303, p. 1734, § 2, effective June 2; (1.3), (3), (9), and (10.3) amended and (7.2), (8.9), and (9.2) added, (HB 26-1238), ch. 118, p. 501, § 3, effective August 12.

Editor's note: (1) Subsection (8.8) is similar to § 25-3.5-203 (5) as it existed prior to 2019.

(2) Subsection (9.3) was numbered as subsection (8.9) in HB 26-1238 but was renumbered on revision for ease of location.

(3) (a) Amendments to subsection (9) by HB 26-1238 and HB 26-1069 were harmonized and subsection (9) as amended by HB 26-1238 was renumbered as subsection (9.5).

(b) Amendments to subsection (9.2) by HB 26-1238 were harmonized with HB 26-1069 and subsection (9.2) as added by HB 26-1238 was renumbered as subsection (9.8).

Cross references: (1) For additional definitions applicable to this article 3.5, see § 25-3.5-703.

(2) For the legislative declaration contained in the 1994 act amending subsections (5) and (6), see section 1 of chapter 345, Session Laws of Colorado 1994. For the legislative declaration in HB 26-1238, see section 1 of chapter 118, Session Laws of Colorado 2026.