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

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

(1) An emergency mental health hold may be initiated under one of the following conditions:

(a) (I) When a certified peace officer has probable cause to believe a person has a mental health disorder and, as a result of the mental health disorder, is an imminent danger to the person's self, an imminent danger to others, or gravely disabled, the certified peace officer may take the person into protective custody and transport the person to a facility designated by the commissioner for an emergency mental health hold. If a facility is not available, the certified peace officer may transport the person to an emergency medical services facility. The certified peace officer may request assistance from a behavioral health crisis response team for assistance in detaining and transporting the person or an emergency medical services provider in transporting the person; or

(II) When an intervening professional reasonably believes that a person appears to have a mental health disorder and, as a result of the mental health disorder, appears to be an imminent danger to the person's self, an imminent danger to others, or gravely disabled, the intervening professional may cause the person to be taken into protective custody and transported to a facility designated by the commissioner for an emergency mental health hold. If a facility is not available, the certified peace officer may transport the person to an emergency medical services facility. The intervening professional may request assistance from a certified peace officer, a secure transportation provider, or a behavioral health crisis response team for assistance in detaining and transporting the person, or assistance from an emergency medical services provider in transporting the person.

(b) (I) When a person petitions the court in the county in which the respondent resides or is physically present requesting an evaluation of the respondent's condition and alleging that the respondent appears to have a mental health disorder and, as a result of the mental health disorder, appears to be a danger to the respondent's self, a danger to others, or gravely disabled.

(II) Any person who files a malicious or false petition for an evaluation of a respondent pursuant to this section is subject to criminal prosecution.

(2) (a) When a person is taken into custody pursuant to subsection (1) of this section, the person must not be detained in a jail, lockup, or other place used for the confinement of persons charged with or convicted of penal offenses. Unless otherwise required by law, a certified peace officer may transport the person to an emergency medical services facility or facility designated by the commissioner for an emergency mental health hold even if a warrant has been issued for the person's arrest if the certified peace officer believes it is in the best interest of the person. The person must not be held on an emergency mental health hold for longer than seventy-two hours after the hold is placed or ordered. Nothing in this section prohibits an emergency medical services facility from involuntarily holding the person in order to stabilize the person as required pursuant to the federal "Emergency Medical Treatment and Labor Act", 42 U.S.C. sec. 1395dd, or if the treating professional determines that the person's physical or mental health disorder impairs the person's ability to make an informed decision to refuse care and the provider determines that further care is indicated.

(b) This section does not preclude:

(I) A court from ordering an evaluation at the jail when the person is lawfully confined in jail because the person is charged with or convicted of a penal offense; or

(II) A person or entity that has care and custody of a detained person from transporting the detained person to an emergency medical services facility or facility designated by the commissioner for an emergency mental health hold.

(3) When a person is placed on an emergency mental health hold pursuant to subsection (1) of this section and is presented to an emergency medical services facility or a facility designated by the commissioner for an emergency mental health hold, the facility shall require a BHA-approved application in writing, stating the circumstances under which the person's condition was called to the attention of the intervening professional or certified peace officer and further stating sufficient facts, obtained from the intervening professional's or certified peace officer's personal observations or obtained from others whom the intervening professional or certified peace officer reasonably believes to be reliable, to establish that the person has a mental health disorder and, as a result of the mental health disorder, is an imminent danger to the person's self, a danger to others, or gravely disabled. The application must indicate when the person was taken into custody and who brought the person's condition to the attention of the intervening professional or certified peace officer. A copy of the application must be furnished to the person being evaluated, and the application must be retained in accordance with section 27-65-123 (4).

(4) (a) The petition for a court-ordered evaluation filed pursuant to subsection (1)(b) of this section must contain the following:

(I) The name and address of the petitioner and the petitioner's interest in the case;

(II) The name of the respondent for whom evaluation is sought, and, if known to the petitioner, the address, age, gender, marital status, occupation, and any animals or dependent children in the respondent's care;

(III) Allegations of fact indicating that the respondent may have a mental health disorder and, as a result of the mental health disorder, may be a danger to the respondent's self, a danger to others, or gravely disabled and showing reasonable grounds to warrant an evaluation;

(IV) The name and address of every person known or believed by the petitioner to be legally responsible for the care, support, and maintenance of the respondent, if available; and

(V) The name, address, and telephone number of the attorney, if any, who has most recently represented the respondent.

(a.5) The petition for a court-ordered evaluation filed pursuant to subsection (1)(b) of this section may contain the respondent's history of emergency mental health holds invoked pursuant to this section, certifications for short-term treatment or long-term care and treatment, findings of incompetency to proceed pursuant to article 8 or 8.5 of title 16, and inpatient psychiatric hospitalizations, and a statement whether the petitioner believes the respondent has a persistent mental health disorder. In determining whether probable cause exists to order an evaluation, the court shall consider any history of emergency mental health holds invoked pursuant to this section, certifications for short-term treatment or long-term care and treatment, findings of incompetency to proceed pursuant to article 8 or 8.5 of title 16, and inpatient psychiatric hospitalizations, and whether the respondent may qualify as having a persistent mental health disorder.

(b) Upon receipt of a petition satisfying the requirements of subsection (4)(a) of this section, if the court is not satisfied that probable cause exists to issue an order for an evaluation, the court shall identify a facility designated by the commissioner, an intervening professional, or a certified peace officer to provide screening of the respondent to determine whether probable cause exists to believe the allegations.

(c) Following the screening described in subsection (4)(b) of this section, the facility, intervening professional, or certified peace officer designated by the court shall file a report with the court and may initiate an emergency mental health hold at the time of screening. The report must include a recommendation as to whether probable cause exists to believe that the respondent has a mental health disorder and, as a result of the mental health disorder, is a danger to the respondent's self, a danger to others, or gravely disabled, and whether the respondent will voluntarily receive evaluation or treatment. The screening report submitted to the court pursuant to this subsection (4)(c) is confidential in accordance with section 27-65-123 and must be furnished to the respondent or the respondent's attorney or personal representative.

(d) Whenever it appears, by petition and screening pursuant to this section, to the satisfaction of the court that probable cause exists to believe that the respondent has a mental health disorder and, as a result of the mental health disorder, is a danger to the respondent's self, a danger to others, or gravely disabled, and that efforts have been made to secure the cooperation of the respondent but the respondent has refused or failed to accept an evaluation voluntarily, the court shall issue an order for an evaluation authorizing a certified peace officer or secure transportation provider to take the respondent into custody and transport the respondent to a facility designated by the commissioner for an emergency mental health hold. At the time the respondent is taken into custody, a copy of the petition and the order for an evaluation must be given to the respondent and promptly thereafter to the one lay person designated by the respondent and to the person in charge of the facility named in the order or the respondent's designee. If the respondent refuses to accept a copy of the petition and the order for an evaluation, the refusal must be documented in the petition and the order for the evaluation.

(5) When a person is transported to an emergency medical services facility or a facility designated by the commissioner, the facility may detain the person under an emergency mental health hold for evaluation for a period not to exceed seventy-two hours from the time the emergency mental health hold was placed or ordered. Nothing in this section prohibits an emergency medical services facility from involuntarily holding the person in order to stabilize the person as required pursuant to the federal "Emergency Medical Treatment and Labor Act", 42 U.S.C. sec. 1395dd, or if the treating professional determines that the individual's physical or mental health disorder impairs the person's ability to make an informed decision to refuse care and the provider determines that further care is indicated. If, in the opinion of the person in charge of the evaluation, the person can be properly cared for without being detained, the person shall be provided services on a voluntary basis. If the person in charge of the evaluation determines the person should be released, the person in charge of the evaluation may terminate the emergency mental health hold.

(6) (a) Each person detained for an emergency mental health hold pursuant to this section shall receive an evaluation as soon as possible after the person presents to the facility, or as soon as possible where the person is confined for a criminal charge if the person is already lawfully confined in jail, and shall receive such treatment and care as the person's condition requires for the full period that the person is held. The evaluation must include an assessment to determine if the person continues to meet the criteria for an emergency mental health hold and requires further mental health care in a facility designated by the commissioner. The evaluation must state whether the person should be released, referred for further care and treatment on a voluntary basis, or certified for short-term treatment pursuant to section 27-65-109.

(b) Each evaluation must be completed using a standardized form approved by the commissioner and may be completed by a professional person; a licensed advanced practice registered nurse with training in psychiatric nursing; or a licensed physician assistant, a licensed clinical social worker, a licensed professional counselor, or a licensed marriage and family therapist who has two years of experience in behavioral health safety and risk assessment working in a health-care setting.

(c) If the person conducting an evaluation pursuant to subsection (6)(a) of this section is not a professional person and the evaluating person recommends the detained person be certified for short-term treatment pursuant to section 27-65-109, the evaluating person shall notify the facility of the recommendation. A certification may only be initiated by a professional person.

(7) (a) If a person is evaluated at an emergency medical services facility and the evaluating professional determines that the person continues to meet the criteria for an emergency mental health hold pursuant to subsection (1) of this section, the emergency medical services facility shall immediately notify the BHA if the facility cannot locate appropriate placement. Once notified, the BHA shall support the emergency medical services facility in locating an appropriate placement option on an inpatient or outpatient basis, whichever is clinically appropriate.

(a.5) A person who is lawfully confined for a criminal charge in jail may be placed only in a secure placement or may be cared for in the person's place of confinement while the person is lawfully detained. If a person placed under an emergency mental health hold is released from confinement, the person or entity responsible for the person's confinement shall coordinate with the BHA to transfer the person to an emergency medical services facility or a facility designated by the commissioner for an emergency mental health hold.

(b) If an appropriate placement option cannot be located pursuant to subsection (7)(a) of this section and the person continues to meet the criteria for an emergency mental health hold pursuant to subsection (1) of this section and the person has been medically stabilized, the emergency medical services facility may place the person under a subsequent emergency mental health hold. If the facility places the person under a subsequent emergency mental health hold, the facility shall immediately notify the BHA, the person's lay person, and the court, and the court shall immediately appoint an attorney to represent the person. The facility may notify the court where the person resides by mail. Once the court is notified, the emergency medical services facility is not required to take any further action to provide the person with an attorney unless specified in subsection (10) of this section. The emergency medical services facility shall notify the BHA after each emergency mental health hold is placed. The BHA is responsible for actively assisting the facility in locating appropriate placement for the person. If the person has been recently transferred from an emergency medical services facility to a facility designated by the commissioner and the designated facility is able to demonstrate that the facility is unable to complete the evaluation before the initial emergency mental health hold is set to expire, the designated facility may place the person under a subsequent emergency mental health hold and shall immediately notify the BHA and lay person.

(c) The BHA shall maintain data on the characteristics of each person placed on a subsequent emergency mental health hold pursuant to subsection (7)(b) of this section. The BHA may contract with entities coordinating care or with providers serving within the safety net system developed pursuant to section 27-63-105 to meet the requirements of this subsection (7).

(d) A hospital that is subject to the federal "Emergency Medical Treatment and Labor Act", 42 U.S.C. sec. 1395dd, shall only discharge a person placed on an emergency mental health hold if the person no longer meets the criteria for an emergency mental health hold; except that a hospital may transfer the person to another hospital if the hospital is unable to provide the appropriate medical or behavioral health care to the person and the receiving hospital agrees to the transfer.

(8) (a) The facility shall provide each person detained for an emergency mental health hold discharge instructions. The discharge instructions must be completed for every person, regardless of the person's discharge status, before the person is released. If the detained person refuses to accept the discharge instructions, the refusal must be documented in the person's medical record. At a minimum, the discharge instructions must include:

(I) A summary of why the person was detained or evaluated for an emergency mental health hold; detailed information as to why the evaluating professional determined the person no longer meets the criteria for an emergency mental health hold or certification pursuant to section 27-65-109; and whether the person may receive services on a voluntary basis pursuant to subsection (6) of this section;

(II) If the person's medications were changed or the person was newly prescribed medications during the emergency mental health hold, a clinically appropriate supply of medications, as determined by the judgment of a licensed health-care provider, for the person until the person can access another provider or follow-up appointment;

(III) A safety plan for the person and, if applicable, the person's lay person where indicated by the person's mental health disorder or mental or emotional state;

(IV) Notification to the person's primary care provider, if applicable;

(V) A referral to appropriate services, if such services exist in the community, if the person is discharged without food, housing, or economic security. Any referrals and linkages must be documented in the person's medical record.

(VI) Information on the 988 crisis hotline operated pursuant to section 27-64-103 and information on the availability of peer support services;

(VII) Information on how to establish a psychiatric advance directive if one is not presented;

(VIII) Medications that were changed during the emergency mental health hold, including any medications that the person was taking or that were previously prescribed upon admission, and which medications, if any, were changed or discontinued at the time of discharge;

(IX) A list of any screening or diagnostic tests conducted during the emergency mental health hold, if requested;

(X) A summary of therapeutic treatments provided during the emergency mental health hold, if requested;

(XI) Any laboratory work, including blood samples or imaging that was completed or attempted, if requested;

(XII) The person's vital signs upon discharge from the emergency mental health hold, if requested;

(XIII) A copy of any psychiatric advance directive presented to the facility, if applicable; and

(XIV) How to contact the discharging facility if needed.

(b) The facility shall document in the person's medical record whether the person accepted the discharge instructions. The facility shall provide the discharge instructions to the person's parent or legal guardian if the person is under eighteen years of age, and to the person's lay person, when possible.

(c) Upon discharge, the facility shall discuss with the person, the person's parent or legal guardian, or the person's lay person the statewide care coordination infrastructure established in section 27-60-204 to facilitate a follow-up appointment for the person within seven calendar days after the discharge. Facilities shall comply with this subsection (8)(c) when the statewide care coordination infrastructure created in section 27-60-204 is fully operational, as determined by the BHA. The BHA shall immediately notify facilities when the statewide care coordination infrastructure is available to assist persons with discharge.

(d) (I) The facility shall, at a minimum, attempt to follow up with the person, the person's parent or legal guardian, or the person's lay person within seventy-two hours after discharge, excluding weekends and holidays. The facility is encouraged to utilize peer support professionals, as defined in section 27-60-108 (2)(b), when performing follow-up care with individuals and in developing a continuing care plan pursuant to subsection (8)(a)(I) of this section. The facility may facilitate follow-up care through contracts with community-based behavioral health providers or the 988 crisis hotline operated pursuant to section 27-64-103. If the facility facilitates follow-up care through a third-party contract, the facility shall obtain authorization from the person to provide follow-up care.

(II) If the person is enrolled in medicaid, the facility is not required to meet the requirements of this subsection (8)(d) and instead, the facility shall notify the person's relevant managed care entity, as defined in section 25.5-5-403, of the person's discharge and need for ongoing follow-up care prior to the person's discharge.

(III) If the facility contracts with a safety net provider, as defined in section 27-50-101, to provide behavioral health services to a person on or following an emergency mental health hold, the facility shall work with the safety net provider in order to meet the requirements of this subsection (8)(d).

(e) The facility shall encourage the person to designate a family member, friend, or other person as a lay person to participate in the person's discharge planning and shall notify the person that the person is able to rescind the authorization of a lay person at any time. If the person designates a lay person and has provided necessary authorization, the facility shall attempt to involve the lay person in the person's discharge planning. The facility shall notify the lay person that the person is being discharged or transferred.

(9) (a) On or before July 1, 2024, and each July 1 thereafter, each emergency medical services facility that has evaluated a person pursuant to this section shall provide an annual report to the BHA that includes only disaggregated and nonidentifying information concerning persons who were treated at an emergency medical services facility pursuant to this section. The report must comply with section 24-1-136 (9) and is exempt from section 24-1-136 (11)(a)(I). The report must contain the following:

(I) The names and counties of the facilities;

(II) The total number of persons treated pursuant to this section, including a summary of demographic information;

(III) A summary regarding the different reasons for which persons were treated pursuant to this section; and

(IV) A summary of the disposition of persons transferred to a designated facility.

(b) (I) Any information disaggregated and provided to the BHA pursuant to this subsection (9) is privileged and confidential. Such information must not be made available to the public except in an aggregate format that cannot be used to identify an individual facility. The information is not subject to civil subpoena and is not discoverable or admissible in any civil, criminal, or administrative proceeding against an emergency medical services facility or health-care professional. The information must be used only to assess statewide behavioral health services needs and to plan for sufficient levels of statewide behavioral health services. In collecting the data pursuant to the requirements of this subsection (9), the BHA shall protect the confidentiality of patient records, in accordance with state and federal laws, and shall not disclose any public identifying or proprietary information of any hospital, hospital administrator, health-care professional, or employee of a health-care facility.

(II) Subsection (9)(b)(I) of this section does not apply to information that is otherwise available from a source outside of the data collection activities required pursuant to subsection (9)(a) of this section.

(10) (a) A person detained for an emergency mental health hold pursuant to this section has the following rights:

(I) To be told the reason for the person's detainment and the limitations of the person's detainment, including a description of the person's right to refuse medication, unless the person requires emergency medications, and that the detainment does not mean all treatment during detainment is mandatory;

(II) To request a change to voluntary status;

(III) To be treated fairly, with respect and recognition of the person's dignity and individuality, by all employees of the facility with whom the person comes in contact;

(IV) To not be discriminated against on the basis of age, race, ethnicity, religion, culture, spoken language, physical or mental disability, socioeconomic status, sex, sexual orientation, gender identity, or gender expression;

(V) To retain and consult with an attorney at any time; except that, unless specified in subsection (7)(b) of this section, the facility is not required to retain an attorney on behalf of the person but must allow the person to contact an attorney;

(VI) To continue the practice of religion;

(VII) Within twenty-four hours after the person's request, to see and receive the services of a patient representative who has no direct or indirect clinical, administrative, or financial responsibility for the person;

(VIII) To have reasonable access to telephones or other communication devices and to make and to receive calls or communications in private. Facility staff shall not open, delay, intercept, read, or censor mail or other communications or use mail or other communications as a method to enforce compliance with facility staff.

(IX) To wear the person's own clothes, keep and use the person's own personal possessions, and keep and be allowed to spend a reasonable sum of the person's own money. A facility may temporarily restrict a person's access to personal clothing or personal possessions, until a safety assessment is completed. If the facility restricts a person's access to personal clothing or personal possessions, the facility shall have a discussion with the person about why the person's personal clothing or personal possessions are being restricted. A licensed medical professional or a licensed behavioral health professional shall conduct a safety assessment as soon as possible. The licensed professional shall document in the person's medical record the specific reasons why it is not safe for the person to possess the person's personal clothing or personal possessions. The facility shall periodically conduct additional safety assessments to determine whether the person may possess the person's personal clothing or personal possessions, with the goal of restoring the person's rights established pursuant to this section.

(X) To keep and use the person's cell phone, unless access to the cell phone causes the person to destabilize or creates a danger to the person's self or others, as determined by a provider, facility staff member, or security personnel involved in the person's care;

(XI) To have the person's information and records disclosed to family members and a lay person pursuant to section 27-65-123;

(XII) To have the person's treatment records remain confidential, except as required by law;

(XIII) To not be fingerprinted, unless required by law;

(XIV) To not be photographed, except upon admission for identification and administrative purposes. Any photographs must be confidential and must not be released by the facility except pursuant to a court order. Nonmedical photographs must not be taken or used without appropriate consent or authorization.

(XV) To have appropriate access to adequate water, hygiene products, and food and to have the person's nutritional needs met in a manner that is consistent with recognized dietary practices;

(XVI) To have personal privacy to the extent possible during the course of treatment; and

(XVII) To have the ability to meet with visitors in accordance with the facility's current visitor guidelines.

(b) A person's rights pursuant to this subsection (10) may only be denied if access to the item, program, or service causes the person to destabilize or creates a danger to the person's self or a danger to others, as determined by a licensed provider involved in the person's care. Denial of any right must be entered into the person's treatment record and must be made available, upon request, to the person, the person's legal guardian, or the person's attorney.

(c) A facility shall not intentionally retaliate or discriminate against a detained person or employee for contacting or providing information to any official or to an employee of any state protection and advocacy agency or for initiating, participating in, or testifying in a grievance procedure or in an action for any remedy authorized pursuant to this section. Any facility that violates this subsection (10) commits an unclassified misdemeanor and shall be fined not more than one thousand dollars.

(d) Any person whose rights are denied or violated pursuant to this section has the right to file a complaint against the facility with the behavioral health administration and the department of public health and environment.

(e) Notwithstanding subsection (10)(b) of this section, a person's rights pursuant to this subsection (10) may be restricted in any manner allowed by law if the person is lawfully confined for a criminal charge in jail.

Source: L. 2022: (4)(b) and (4)(d) amended, (HB 22-1278), ch. 222, p. 1539, § 116, effective July 1; (1)(a), (1)(b), (3), IP(9)(a), and (9)(b) amended, (HB 22-1278), ch. 222, p. 1537, § 115, effective July 1; Entire article amended with relocations, (HB 22-1256), ch. 451, p. 3179, § 1, effective August 10; (1), (7), (8), (9), and (10) repealed, (HB 22-1256), ch. 451, p. 3240, § 56, effective August 10; Entire section amended, (HB 22-1256), ch. 451, p. 3207, § 2, effective July 1, 2023. L. 2023: IP(9)(a) amended, (HB 23-1236), ch. 206, p. 1065, § 36, effective May 16. L. 2025: (8)(a)(VI) and (8)(d)(I) amended, (SB 25-236), ch. 140, p. 531, § 6, effective July 1; (6)(a) amended and (7)(d) added, (SB 25-042), ch. 28, p. 159, § 4, effective August 6. L. 2026: IP(1), (1)(a), (1)(b)(I), (2), (3), (4)(a)(III), (4)(c), (4)(d), (6)(a), (8)(d)(I), and (10)(b) amended and (4)(a.5), (7)(a.5), and (10)(e) added, (SB 26-149), ch. 142, p. 729, § 5, effective May 21; (8)(d)(I) amended, (HB 26-1116), ch. 377, p. 2344, § 1, effective August 12.

Editor's note: (1) The provisions of this section are similar to several former provisions of §§ 27-65-105 and 27-65-106 as they existed prior to 2022. For a detailed comparison, see the comparative tables located in the back of the index.

(2) Subsection (1)(a) was numbered as § 27-65-105 (1)(a)(I) in HB 22-1278 (see L. 2022, p. 1537). That provision was harmonized with subsection (1)(a) of this section as it appears in HB 22-1256.

(3) Subsection (1)(a)(I.5) was amended in HB 22-1278. Those amendments were superseded by the repeal of subsection (1)(a)(I.5) in HB 22-1256.

(4) Subsection (1)(b) was numbered as § 27-65-105 (1)(b) in HB 22-1278 (see L. 2022, p. 1538). That provision was harmonized with subsection (1)(b) of this section as it appears in HB 22-1256.

(5) Subsection (1)(c) was amended in HB 22-1278. Those amendments were superseded by the repeal of subsection (1)(c) in HB 22-1256.

(6) Subsection (3) was numbered as § 27-65-105 (3) in HB 22-1278 (see L. 2022, p. 1538). That provision was harmonized with subsection (3) of this section as it appears in HB 22-1256.

(7) Subsection (4)(b) was numbered as § 27-65-106 (4) in HB 22-1278 (see L. 2022, p. 1539). That provision was harmonized with subsection (4)(b) of this section as it appears in HB 22-1256.

(8) Subsection (4)(d) was numbered as § 27-65-106 (6) in HB 22-1278 (see L. 2022, p. 1539). That provision was harmonized with subsection (4)(d) of this section as it appears in HB 22-1256.

(9) Subsection IP(9)(a) was numbered as § 27-65-105 IP(7)(a) in HB 22-1278 (see L. 2022, p. 1539). That provision was harmonized with subsection IP(9)(a) of this section as it appears in HB 22-1256.

(10) Subsection (9)(b) was numbered as § 27-65-105 (7)(b)(I) in HB 22-1278 (see L. 2022, p. 1539). That provision was harmonized with subsection (9)(b) of this section as it appears in HB 22-1256.

(11) Subsections (1), (7), (8), (9), and (10) were 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.

(12) Amendments to subsection (8)(d)(I) by SB 26-149 and HB 26-1116 were harmonized.

Cross references: For rights of persons under arrest, see part 4 of article 3 of title 16.

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 § 27-65-106 is similar to § 27-65-105 and § 27-65-106 as they existed prior to the 2022 amendments to this article and to laws antecedent to those sections, relevant cases construing those provisions 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 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).

A proceeding under this article is not a criminal action. Kendall v. People, 126 Colo. 573, 252 P.2d 91 (1952).

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).

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 Colorado rules of civil procedure 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. Sw. Denver Mental Health Ctr., 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. 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 Schmidt, 720 P.2d 629 (Colo. App. 1986); Asten v. City of Boulder, 652 F. Supp. 2d 1188 (D. Colo. 2009).