First Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 23-0162.03 Jacob Baus x2173
HOUSE BILL 23-1013
House Committees Senate Committees
Judiciary
A BILL FOR AN ACT
C
ONCERNING MEASURES TO REGULA TE THE USE OF RESTRICTIVE101
PRACTICES ON INDIVIDUALS IN CORRECTIONAL FACILITIES .102
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
of Persons with Behavioral Health Disorders in the Criminal and
Juvenile Justice Systems. The bill prohibits the use of a clinical restraint
on an individual, unless:
! The use is to prevent the individual from committing
imminent and serious harm to the individual's self or
HOUSE SPONSORSHIP
Amabile,
SENATE SPONSORSHIP
Fields and Rodriguez,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing statute.
Dashes through the words indicate deletions from existing statute. another person, based on immediately present evidence and
circumstances;
! All less restrictive interventions have been exhausted; and
! The clinical restraint is ordered by a licensed mental health
provider.
The bill requires facilities that utilize clinical restraints to
implement procedures to ensure frequent and consistent monitoring for
the individual subjected to the clinical restraint and uniform
documentation procedures concerning the use of the clinical restraint.
The bill limits the amount of time an individual may be subjected
to a clinical restraint per each restraint episode and within a calendar year.
The bill prohibits the use of an involuntary medication on an
individual, unless:
! The individual is determined to be dangerous to the
individual's self or another person and the treatment is in
the individual's medical interest;
! All less restrictive alternative interventions have been
exhausted; and
! The involuntary medication is administered after
exhaustion of procedural requirements that ensure a
hearing, opportunity for review, and right to counsel.
The bill requires the department of corrections (department) to
submit an annual report to the judiciary committees of the senate and
house of representatives with data concerning the use of clinical restraints
and involuntary medication in the preceding calendar year.
The bill requires the department to include specific data
concerning the placement of individuals in settings with heightened
restrictions in its annual administrative segregation report.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, add 17-1-167 as2
follows:3
17-1-167. Use of restraints for state inmates - criteria -4
documentation - intake assessment - rules - report - definitions.5
(1) (a) S
UBJECT TO THE PROVISIONS OF THIS SECTION, A FACILITY SHALL6
NOT USE A CLINICAL RESTRAINT ON AN INDIVIDUAL , UNLESS:7
(I) T
HE USE IS TO PREVENT THE INDIVIDUAL FROM COMMITTING8
IMMINENT AND SERIOUS HARM TO THE INDIVIDUAL 'S SELF OR ANOTHER9
HB23-1013-2- PERSON, BASED ON IMMEDIATELY PRESENT EVIDENCE AND1
CIRCUMSTANCES;2
(II) T
HE FACILITY HAS EXHAUSTED ALL LESS RESTRICTIVE3
ALTERNATIVE INTERVENTIONS ; AND4
(III) T
HE RESTRAINT IS ORDERED BY A LICENSED MENTAL HEALTH5
PROVIDER.6
(b) A
FACILITY SHALL NOT USE A CLINICAL RESTRAINT ON AN7
INDIVIDUAL FOR LONGER THAN IS NECESSARY TO PREVENT THE8
INDIVIDUAL FROM COMMITTING IMMINENT AND SERIOUS HARM TO THE9
INDIVIDUAL'S SELF OR ANOTHER PERSON.10
(c) A
LICENSED MENTAL HEALTH PROVIDER , MENTAL HEALTH11
CLINICIAN AS DEFINED BY DEPARTMENT RULE OR DESIGNATED BY THE12
DEPARTMENT, QUALIFIED HEALTH-CARE PROVIDER, OR ANY PERSON13
EMPLOYED BY THE FACILITY SHALL TERMINATE THE ORDER WHEN THE14
BEHAVIORS NECESSITATING THE CLINICAL RESTRAINT ARE NO LONGER15
EVIDENT AND THE CRITERIA OUTLINED BY THE CLINICAL RESTRAINT ORDER16
ARE SATISFIED OR, IF THE TIME LIMITATIONS PURSUANT TO SUBSECTION17
(2)(c)
OR (3)(f) OF THIS SECTION ARE REACHED , WHICHEVER OCCURS18
FIRST.19
(2) (a) A
CORRECTIONAL FACILITY OR PRIVATE CONTRACT PRISON20
MAY USE A CLINICAL AMBULATORY RESTRAINT ON AN INDIVIDUAL ; EXCEPT21
THAT THE RESTRAINT MUST NOT BE CONSTRUCTED OF METAL OR HARD22
PLASTIC OR HAVE A BELLY CHAIN OR PADLOCK .23
(b) (I) A
CORRECTIONAL FACILITY OR PRIVATE CONTRACT PRISON24
SHALL NOT USE A CLINICAL AMBULATORY RESTRAINT ON AN INDIVIDUAL25
FOR MORE THAN:26
(A) T
WELVE HOURS PER EPISODE; AND27
HB23-1013
-3- (B) TWO HUNDRED FORTY HOURS TOTAL ACROSS ALL EPISODES IN1
ONE YEAR.2
(II) T
HE CORRECTIONAL FACILITY OR PRIVATE CONTRACT PRISON3
SHALL NOT RESTART THE TIME CALCULATION TO START A NEW EPISODE IF4
THE INDIVIDUAL IS TEMPORARILY RELEASED FROM A CLINICAL5
AMBULATORY RESTRAINT NOT FOR THE PURPOSE OF TERMINATING THE6
CLINICAL AMBULATORY RESTRAINT ORDER . THE TIME AN INDIVIDUAL IS7
TEMPORARILY RELEASED FROM A CLINICAL AMBULATORY RESTRAINT NOT8
FOR A PURPOSE OF TERMINATING THE CLINICAL AMBULATORY RESTRAINT9
ORDER SUSPENDS THE CALCULATION OF TIME PURSUANT TO SUBSECTION10
(2)(c)(I)
OF THIS SECTION.11
(c) (I) A
N INITIAL CLINICAL AMBULATORY RESTRAINT ORDER MUST12
NOT EXCEED TWO HOURS . A LICENSED MENTAL HEALTH PROVIDER , OR13
MENTAL HEALTH CLINICIAN AS DEFINED BY DEPARTMENT RULE OR14
DESIGNATED BY THE DEPARTMENT , SHALL ASSESS THE INDIVIDUAL15
SUBJECTED TO THE RESTRAINT TO DETERMINE WHETHER TO TERMINATE OR16
CONTINUE THE ORDER AT LEAST ONCE EVERY HOUR .17
(II) I
F THE LICENSED MENTAL HEALTH PROVIDER , OR MENTAL18
HEALTH CLINICIAN AS DEFINED BY DEPARTMENT RULE OR DESIGNATED BY19
THE DEPARTMENT, CONTINUES THE INITIAL CLINICAL AMBULATORY20
RESTRAINT ORDER, THE LICENSED MENTAL HEALTH PROVIDER , OR MENTAL21
HEALTH CLINICIAN AS DEFINED BY DEPARTMENT RULE OR DESIGNATED BY22
THE DEPARTMENT, SHALL ASSESS THE INDIVIDUAL SUBJECT TO THE23
RESTRAINT TO DETERMINE WHETHER TO TERMINATE OR CONTINUE THE24
ORDER AT LEAST ONCE EVERY HOUR .25
(III) A
T EACH ASSESSMENT PURSUANT TO SUBSECTIONS (2)(c)(I)26
AND (2)(c)(II) OF THIS SECTION, THE LICENSED MENTAL HEALTH27
HB23-1013
-4- PROVIDER, OR MENTAL HEALTH CLINICIAN AS DEFINED BY DEPARTMENT1
RULE OR DESIGNATED BY THE DEPARTMENT , SHALL:2
(A) M
AKE A NEW DETERMINATION WHETHER THE ORDER TO3
CONTINUE RESTRAINT IS NECESSARY TO PREVENT THE INDIVIDUAL FROM4
COMMITTING IMMINENT AND SERIOUS HARM TO THE INDIVIDUAL 'S SELF OR5
ANOTHER PERSON, BASED ON THE IMMEDIATELY PRESENT EVIDENCE AND6
CIRCUMSTANCES;7
(B) D
ETERMINE WHETHER A LESS RESTRICTIVE ALTERNATIVE8
INTERVENTION IS MORE APPROPRIATE THAN THE USE OF A CLINICAL9
AMBULATORY RESTRAINT ; AND10
(C) M
ODIFY THE ORDER TO REFLECT SPECIFIC BEHAVIORAL11
CRITERIA THE INDIVIDUAL MUST EXHIBIT IN ORDER FOR THE RESTRAINT TO12
BE REMOVED, AS APPROPRIATE.13
(IV) A
N ASSESSMENT PURSUANT TO SUBSECTIONS (2)(c)(I) OR14
(2)(c)(II)
OF THIS SECTION MAY BE PERFORMED USING AUDIO -VIDEO15
COMMUNICATION TECHNOLOGY .16
(3) (a) A
CORRECTIONAL FACILITY OR PRIVATE CONTRACT PRISON17
SHALL NOT USE A CLINICAL FOUR-POINT RESTRAINT ON AN INDIVIDUAL;18
EXCEPT THAT A QUALIFIED FACILITY MAY USE A CLINICAL FOUR -POINT19
RESTRAINT ON AN INDIVIDUAL.20
(b) A
QUALIFIED FACILITY SHALL NOT USE A CLINICAL FOUR-POINT21
RESTRAINT CONSTRUCTED OF METAL OR HARD PLASTIC , OR HAS A BELLY22
CHAIN OR PADLOCK. A QUALIFIED FACILITY SHALL USE A CLINICAL23
FOUR-POINT RESTRAINT ON A BED WITH A MATTRESS .24
(c) A
QUALIFIED FACILITY SHALL NOT USE A HELMET OR DIAPER ON25
AN INDIVIDUAL SUBJECTED TO A CLINICAL FOUR -POINT RESTRAINT.26
(d) A
QUALIFIED FACILITY SHALL NOT RESTRAIN AN INDIVIDUAL27
HB23-1013
-5- SUBJECT TO A CLINICAL FOUR-POINT RESTRAINT IN A PRONE POSITION. A1
QUALIFIED FACILITY SHALL CONSIDER THE INDIVIDUAL 'S PREEXISTING2
MEDICAL CONDITIONS OR PHYSICAL DISABILITIES OR LIMITATIONS THAT3
MAY INCREASE THE RISK OF INJURY TO THE INDIVIDUAL DURING A4
CLINICAL RESTRAINT EPISODE AND RESTRAIN THE INDIVIDUAL IN A5
MANNER THAT MINIMIZES THE INDIVIDUAL 'S DISCOMFORT AND RISK OF6
INJURY OR COMPLICATION. THE QUALIFIED FACILITY SHALL NOTIFY THE7
INDIVIDUAL SUBJECTED TO THE CLINICAL FOUR -POINT RESTRAINT THAT8
THE INDIVIDUAL MAY REQUEST REPOSITIONING AT ANY TIME TO MINIMIZE9
DISCOMFORT; EXCEPT THAT PRONE POSITIONING MUST NEVER BE10
PERMITTED.11
(e) A
T LEAST EVERY TWO HOURS, A QUALIFIED FACILITY SHALL12
RELEASE AN INDIVIDUAL SUBJECTED TO A CLINICAL FOUR -POINT13
RESTRAINT TO PROVIDE NOT LESS THAN TEN MINUTES FOR THE PERSON TO14
MOVE FREELY.15
(f) (I) A
QUALIFIED FACILITY SHALL NOT USE A CLINICAL16
FOUR-POINT RESTRAINT ON AN INDIVIDUAL FOR MORE THAN :17
(A) F
OUR HOURS PER EPISODE; AND18
(B) T
WO HUNDRED FORTY HOURS IN ONE YEAR .19
(II) T
HE QUALIFIED FACILITY SHALL NOT RESTART THE TIME20
CALCULATION TO START A NEW EPISODE IF THE INDIVIDUAL IS21
TEMPORARILY RELEASED FROM A CLINICAL FOUR -POINT RESTRAINT NOT22
FOR THE PURPOSE OF TERMINATING THE CLINICAL FOUR -POINT RESTRAINT23
ORDER. THE TIME AN INDIVIDUAL IS TEMPORARILY RELEASED FROM A24
CLINICAL RESTRAINT FOR THE PURPOSE OF TERMINATING THE CLINICAL25
FOUR-POINT RESTRAINT ORDER SUSPENDS THE CALCULATION OF TIME26
PURSUANT TO SUBSECTION (3)(f)(I) OF THIS SECTION.27
HB23-1013
-6- (g) (I) AN INITIAL ORDER FOR CLINICAL FOUR-POINT RESTRAINT1
MUST NOT EXCEED THIRTY MINUTES . A LICENSED MENTAL HEALTH2
PROVIDER, OR MENTAL HEALTH CLINICIAN AS DEFINED BY DEPARTMENT3
RULE OR DESIGNATED BY THE DEPARTMENT , SHALL ASSESS THE4
INDIVIDUAL SUBJECT TO THE CLINICAL FOUR -POINT RESTRAINT TO5
DETERMINE WHETHER TO TERMINATE OR CONTINUE THE ORDER AT LEAST6
ONCE DURING THE INITIAL THIRTY-MINUTE PERIOD.7
(II) I
F THE LICENSED MENTAL HEALTH PROVIDER , OR MENTAL8
HEALTH CLINICIAN AS DEFINED BY DEPARTMENT RULE OR DESIGNATED BY9
THE DEPARTMENT, CONTINUES THE INITIAL ORDER, A LICENSED MENTAL10
HEALTH PROVIDER, OR MENTAL HEALTH CLINICIAN AS DEFINED BY11
DEPARTMENT RULE OR DESIGNATED BY THE DEPARTMENT , SHALL ASSESS12
THE INDIVIDUAL SUBJECT TO THE CLINICAL FOUR -POINT RESTRAINT TO13
DETERMINE WHETHER TO TERMINATE OR CONTINUE THE ORDER AT LEAST14
ONCE EVERY HOUR.15
(III) A
T EACH ASSESSMENT PURSUANT TO SUBSECTIONS (3)(g)(I)16
AND (3)(g)(II) OF THIS SECTION, THE LICENSED MENTAL HEALTH17
PROVIDER, OR MENTAL HEALTH CLINICIAN AS DEFINED BY DEPARTMENT18
RULE OR DESIGNATED BY THE DEPARTMENT , SHALL:19
(A) M
AKE A NEW DETERMINATION WHETHER THE ORDER TO20
CONTINUE RESTRAINT IS NECESSARY TO PREVENT THE INDIVIDUAL FROM21
COMMITTING IMMINENT AND SERIOUS HARM TO THE INDIVIDUAL 'S SELF OR22
ANOTHER PERSON, BASED ON THE IMMEDIATELY PRESENT EVIDENCE AND23
CIRCUMSTANCES;24
(B) D
ETERMINE WHETHER A LESS RESTRICTIVE ALTERNATIVE25
INTERVENTION IS MORE APPROPRIATE THAN THE USE OF A CLINICAL26
FOUR-POINT RESTRAINT; AND27
HB23-1013
-7- (C) MODIFY THE ORDER TO REFLECT SPECIFIC BEHAVIORAL1
CRITERIA THE INDIVIDUAL MUST EXHIBIT IN ORDER FOR THE RESTRAINT TO2
BE REMOVED, AS APPROPRIATE.3
(IV) A
N ASSESSMENT PURSUANT TO SUBSECTIONS (3)(g)(I) OR4
(3)(g)(II)
OF THIS SECTION MAY BE PERFORMED USING AUDIO -VIDEO5
COMMUNICATION TECHNOLOGY .6
(4) A
T LEAST EVERY FIFTEEN MINUTES, A QUALIFIED HEALTH-CARE7
PROVIDER SHALL EXAMINE THE INDIVIDUAL SUBJECTED TO A CLINICAL8
RESTRAINT, AT A MINIMUM:9
(a) T
O ENSURE THE INDIVIDUAL'S CIRCULATION IS UNRESTRICTED,10
BREATHING IS NOT COMPROMISED , AND OTHER PHYSICAL NEEDS ARE11
SATISFIED;12
(b) T
O ENSURE THE INDIVIDUAL IS PROPERLY POSITIONED IN THE13
RESTRAINT;14
(c) T
O OFFER THE INDIVIDUAL FLUIDS AND TOILET ACCESS, AND TO15
PROVIDE FLUIDS AND TOILET ACCESS IF REQUESTED BY THE INDIVIDUAL ;16
(d) T
O MONITOR THE EFFECT OF MEDICATION ON THE INDIVIDUAL ,17
IF APPLICABLE; AND18
(e) T
O MONITOR WHETHER THE INDIVIDUAL IS EXHIBITING19
BEHAVIORS REQUIRING THE CONTINUATION OR TERMINATION OF THE20
CLINICAL RESTRAINT ORDER.21
(5) A
T ALL TIMES AN INDIVIDUAL IS SUBJECTED TO A CLINICAL22
RESTRAINT, THE INDIVIDUAL MUST BE ABLE TO COMMUNICATE TO ANY23
EMPLOYEE, QUALIFIED HEALTH-CARE PROVIDER, LICENSED MENTAL24
HEALTH PROVIDER, OR MENTAL HEALTH CLINICIAN AS DEFINED BY25
DEPARTMENT RULE OR DESIGNATED BY THE DEPARTMENT , WHO IS26
RESPONSIBLE FOR MONITORING THE INDIVIDUAL DURING THE CLINICAL27
HB23-1013
-8- RESTRAINT EPISODE.1
(6) (a) A
FACILITY SHALL ENSURE THAT THE USE OF RESTRAINT IS2
DOCUMENTED AND MAINTAINED IN THE RECORD OF THE INDIVIDUAL WHO3
WAS RESTRAINED. AT A MINIMUM, THE FACILITY SHALL DOCUMENT:4
(I)
THE ORDER FOR CLINICAL RESTRAINT, THE DATE AND TIME OF5
THE ORDER, AND THE SIGNATURE OF THE LICENSED MENTAL HEALTH6
PROVIDER WHO ISSUED THE CLINICAL RESTRAINT ORDER . IF THE ORDER IS7
AUTHORIZED BY TELEPHONE , THE ORDER MUST BE TRANSCRIBED AND8
SIGNED AT THE TIME OF ISSUANCE BY A PERSON WITH AUTHORITY TO9
ACCEPT ORDERS, AND THE ORDERING LICENSED MENTAL HEALTH10
PROVIDER SHALL SIGN THE ORDER AS SOON AS PRACTICABLE .11
(II) A
CLEAR EXPLANATION OF THE CLINICAL BASIS FOR USE OF THE12
CLINICAL RESTRAINT, INCLUDING THE LESS INTRUSIVE INTERVENTIONS13
THAT WERE EMPLOYED AND FAILED , AND EVIDENCE OF THE IMMEDIATE14
CIRCUMSTANCES JUSTIFYING THE BELIEF THAT THE USE OF RESTRAINT WAS15
TO PREVENT THE INDIVIDUAL FROM COMMITTING IMMINENT AND SERIOUS16
HARM TO THE INDIVIDUAL'S SELF OR ANOTHER PERSON;17
(III) T
HE SPECIFIC BEHAVIORAL CRITERIA THE INDIVIDUAL MUST18
EXHIBIT IN ORDER FOR THE CLINICAL RESTRAINT EPISODE TO BE19
TERMINATED;20
(IV) A
NY MODIFICATIONS TO THE ORDER , AND THE TIME AND21
DATE, AND SIGNATURE OF THE LICENSED MENTAL HEALTH PROVIDER , OR22
MENTAL HEALTH CLINICIAN AS DEFINED BY DEPARTMENT RULE OR23
DESIGNATED BY THE DEPARTMENT , WHO MODIFIES THE ORDER;24
(V) T
HE DATE AND TIME OF AN ASSESSMENT PERFORMED25
PURSUANT TO SUBSECTIONS (2)(d) AND (3)(f) OF THIS SECTION, AND THE26
SIGNATURE OF THE QUALIFIED HEALTH -CARE PROFESSIONAL WHO27
HB23-1013
-9- PERFORMED THE ASSESSMENT , AND FINDINGS JUSTIFYING THE1
TERMINATION OR CONTINUATION OF THE ORDER MADE PURSUANT TO THE2
ASSESSMENT;3
(VI) T
HE DATE AND TIME OF AN ORDER MODIFICATION , THE DATE4
AND TIME OF THE MODIFICATION, AND THE SIGNATURE OF THE LICENSED5
MENTAL HEALTH PROVIDER, OR MENTAL HEALTH CLINICIAN AS DEFINED BY6
DEPARTMENT RULE OR DESIGNATED BY THE DEPARTMENT , WHO ISSUED7
THE CLINICAL RESTRAINT ORDER . IF THE ORDER IS MODIFIED BY8
TELEPHONE, THE MODIFICATION MUST BE TRANSCRIBED AND SIGNED AT9
THE TIME OF ISSUANCE BY A PERSON WITH AUTHORITY TO ACCEPT10
MODIFICATION, AND THE ORDERING LICENSED MENTAL HEALTH PROVIDER ,11
OR MENTAL HEALTH CLINICIAN AS DEFINED BY DEPARTMENT RULE OR12
DESIGNATED BY THE DEPARTMENT , SHALL SIGN THE ORDER AS SOON AS13
PRACTICABLE.14
(VII) T
HE DATE AND TIME OF EXAMINATIONS PURSUANT TO15
SUBSECTION (4) OF THIS SECTION, THE SIGNATURE OF THE QUALIFIED16
HEALTH-CARE PROVIDER WHO PERFORMED THE EXAMINATION , AND ANY17
RELEVANT OBSERVATIONS FROM THE EXAMINATION ; AND18
(VIII) T
HE DATE AND TIME OF THE TERMINATION OF THE ORDER ,19
THE SIGNATURE OF THE PERSON WHO TERMINATED THE ORDER , THE20
OBSERVATIONS, AND EVIDENCE THAT THE INDIVI DUAL EXHIBITED21
BEHAVIOR JUSTIFYING THE TERMINATION OF THE ORDER .22
(b) T
HE FACILITY SHALL ENSURE THE DOCUMENTATION AND23
RETENTION REQUIRED PURSUANT TO THIS SECTION IS CONDUCTED24
PURSUANT TO ALL APPLICABLE STATE AND FEDERAL LAWS REGARDING THE25
CONFIDENTIALITY OF THE INDIVIDUAL'S INFORMATION AND SHALL ENSURE26
AN INDIVIDUAL MAY ACCESS THE INFORMATION OR DEMAND RELEASE OF27
HB23-1013
-10- THE INFORMATION TO A THIRD PARTY .1
(7) (a) A
CORRECTIONAL FACILITY, PRIVATE CONTRACT PRISON, OR2
QUALIFIED FACILITY THAT IS AUTHORIZED TO USE A CLINICAL RESTRAINT3
PURSUANT TO THIS SECTION SHALL ENSURE THAT A QUALIFIED4
HEALTH-CARE PROVIDER, LICENSED MENTAL HEALTH PROVIDER , OR5
MENTAL HEALTH CLINICIAN AS DEFINED BY DEPARTMENT RULE OR6
DESIGNATED BY THE DEPARTMENT , PERFORMS A BEHAVIOR MANAGEMENT7
ASSESSMENT ON EVERY INDIVIDUAL 'S INTAKE TO THE FACILITY, FOR THE8
PURPOSE OF EXAMINING WHETHER THE INDIVIDUAL IS LIKELY TO EXHIBIT9
BEHAVIORS THAT MAY RESULT IN THE USE OF CLINICAL RESTRAINT . THE10
QUALIFIED HEALTH-CARE PROVIDER, LICENSED MENTAL HEALTH11
PROVIDER, OR MENTAL HEALTH CLINICIAN AS DEFINED BY DEPARTMENT12
RULE OR DESIGNATED BY THE DEPARTMENT , SHALL DOCUMENT AND13
MAINTAIN FINDINGS FROM THE ASSESSMENT IN THE INDIVIDUAL 'S MEDICAL14
RECORD. THE FACILITY SHALL NOT USE THE FINDINGS OF THE BEHAVIOR15
MANAGEMENT ASSESSMENT AS STANDING ORDERS FOR USING A CLINICAL16
RESTRAINT ON THE INDIVIDUAL.17
(b) I
F A BEHAVIORAL MANAGEMENT ASSESSMENT CONCLUDES18
THAT THE INDIVIDUAL IS AT INCREASED RISK FOR BEHAVIORS THAT MAY19
RESULT IN THE USE OF A CLINICAL RESTRAINT , A LICENSED MENTAL20
HEALTH PROVIDER, OR MENTAL HEALTH CLINICIAN AS DEFINED BY21
DEPARTMENT RULE OR DESIGNATED BY THE DEPARTMENT , SHALL DEVELOP22
AND IMPLEMENT, WITH INPUT FROM THE INDIVIDUAL , A BEHAVIORAL23
MANAGEMENT PLAN FOR THE PURPOSE OF UTILIZING INDIVIDUAL -SPECIFIC24
AND LESS RESTRICTIVE INTERVENTIONS TO PREVENT OR REDUCE USE OF25
CLINICAL RESTRAINTS.26
(8) (a) S
UBJECT TO THE PROVISIONS OF THIS SECTION , A27
HB23-1013
-11- CORRECTIONAL FACILITY OR PRIVATE CONTRACT PRISON SHALL NOT USE1
AN INVOLUNTARY MEDICATION ON AN INDIVIDUAL , UNLESS:2
(I) T
HE INDIVIDUAL IS DETERMINED TO BE DANGEROUS TO THE3
INDIVIDUAL'S SELF OR ANOTHER PERSON, AND THE TREATMENT IS IN THE4
INDIVIDUAL'S MEDICAL INTEREST;5
(II) T
HE FACILITY HAS EXHAUSTED ALL LESS RESTRICTIVE6
ALTERNATIVE INTERVENTIONS ; AND7
(III) T
HE INVOLUNTARY MEDICATION IS ADMINISTERED AFTER8
EXHAUSTION OF PROCEDURAL REQUIREMENTS ESTABLISHED PURSUANT TO9
THIS SECTION.10
(b) N
OTWITHSTANDING SECTION 17-1-111, THE DEPARTMENT11
SHALL PROMULGATE RULES ESTABLISHING A PROCESS FOR DETERMINING12
WHETHER TO USE, AND HOW TO USE, AN INVOLUNTARY MEDICATION ON AN13
INDIVIDUAL. THE PROCESS MUST BE CONSISTENT WITH SECTIONS 24-4-10514
AND 24-4-106.15
(c) T
HE CORRECTIONAL FACILITY OR PRIVATE CONTRACT FACILITY16
SHALL CONVENE AN INVOLUNTARY MEDICATION COMMITTEE , COMPRISED17
OF FOUR MEMBERS, TO SERVE AS THE AGENCY PRESIDING AT THE HEARING.18
T
HE FOUR MEMBERS ARE A LICENSED PSYCHIATRIST , A LICENSED19
PSYCHOLOGIST, A LICENSED MENTAL HEALTH PROVIDER , AND THE20
SUPERINTENDENT OF THE FACILITY OR THE SUPERINTENDENT 'S DESIGNEE.21
T
HE USE OF AN INVOLUNTARY MEDICATION ON AN INDIVIDUAL IS22
PROHIBITED, UNLESS A MAJORITY OF ALL COMMITTEE MEMBERS APPROVE23
THE USE.24
(d) T
HE CORRECTIONAL FACILITY OR PRIVATE CONTRACT FACILITY25
SHALL ASCERTAIN WHETHER THE INDIVIDUAL HAS RETAINED COUNSEL ,26
AND, IF THE INDIVIDUAL HAS NOT, SHALL REFER THE INDIVIDUAL TO AN27
HB23-1013
-12- OFFICE OF STATE PUBLIC DEFENDER LIAISON TO THE DEPARTMENT TO1
REPRESENT THE PERSON WITHOUT COST TO THE INDIVIDUAL WITHIN THREE2
DAYS AFTER THE NOTICE OF HEARING PROVIDED TO THE INDIVIDUAL3
UNLESS THE INDIVIDUAL WAIVES COUNSEL . AN INDIVIDUAL'S WAIVER OF4
COUNSEL MUST BE KNOWING , INTELLIGENT, AND VOLUNTARY.5
(e) A
N ORDER FOR AN INVOLUNTARY MEDICATION MUST NOT :6
(I) B
E FOR LONGER THAN NINETY DAYS FROM THE DATE OF THE7
ORDER; AND8
(II) P
ERMIT THE USE OF MORE THAN FIVE DIFFERENT MEDICATIONS9
DURING THE NINETY DAY PERIOD. THIS DOES NOT LIMIT THE AMOUNT OF10
DOSES OF THE MEDICATIONS TO BE ADMINISTERED , AS MEDICALLY11
APPROPRIATE.12
(f) A
FACILITY SHALL ENSURE THAT THE USE OF INVOLUNTARY13
MEDICATION IS DOCUMENTED AND MAINTAINED IN THE RECORD OF THE14
INDIVIDUAL. AT A MINIMUM, THE FACILITY SHALL DOCUMENT:15
(I) T
HE ORDER FOR INVOLUNTARY MEDICATION ;16
(II) T
HE DATE AND TIME OF THE ORDER; AND17
(III) A
CLEAR EXPLANATION OF THE CLINICAL BASIS FOR USE OF18
THE INVOLUNTARY MEDICATION , INCLUDING THE LESS INTRUSIVE19
INTERVENTIONS THAT WERE EMPLOYED AND FAILED AND EVIDENCE OF THE20
IMMEDIATE CIRCUMSTANCES JUSTIFYING THE BELIEF THAT THE21
INDIVIDUAL IS DETERMINED TO BE DANGEROUS TO THE INDIVIDUAL 'S SELF22
OR ANOTHER PERSON AND THAT THE TREATMENT IS IN THE INDIVIDUAL 'S23
MEDICAL INTEREST.24
(g) T
HE FACILITY SHALL ENSURE THE DOCUMENTATION AND25
MAINTENANCE REQUIRED PURSUANT TO THIS SECTION IS CONDUCTED26
PURSUANT TO ALL APPLICABLE STATE AND FEDERAL LAWS REGARDING THE27
HB23-1013
-13- CONFIDENTIALITY OF THE INFORMATION .1
(9) (a) O
N OR BEFORE MARCH 1, 2024, AND ON OR BEFORE MARCH2
1
EACH YEAR THEREAFTER , THE EXECUTIVE DIRECTOR OF THE3
DEPARTMENT SHALL SUBMIT A REPORT TO THE JUDICIARY COMMITTEES OF4
THE SENATE AND HOUSE AND REPRESENTATIVES , OR ANY SUCCESSOR5
COMMITTEES, CONCERNING THE USE OF CLINICAL RESTRAINTS AND6
INVOLUNTARY MEDICATION IN THE PRECEDING CALENDAR YEAR . AT A7
MINIMUM, THE REPORT MUST INCLUDE:8
(I) T
HE TOTAL NUMBER OF CLINICAL AMBULATORY RESTRAINT9
EPISODES AND CLINICAL FOUR-POINT RESTRAINT EPISODES;10
(II) T
HE TOTAL NUMBER OF INVOLUNTARY MEDICATION ORDERS11
ISSUED;12
(III) T
HE AVERAGE AMOUNT OF TIME OF CLINICAL AMBULATORY13
RESTRAINT EPISODES AND CLINICAL FOUR -POINT RESTRAINT EPISODES;14
(IV) T
HE AVERAGE DURATION OF INVOLUNTARY MEDICATION15
ORDERS ISSUED;16
(V) T
HE LONGEST CLINICAL AMBULATORY RESTRAINT EPISODE17
AND THE LONGEST CLINICAL FOUR-POINT RESTRAINT EPISODE;18
(VI) T
HE PERCENTAGE OF TOTAL CLINICAL AMBULATORY19
RESTRAINT EPISODES THAT EXCEEDED TWO HOURS , AND THE PERCENTAGE20
OF TOTAL CLINICAL FOUR-POINT RESTRAINT EPISODES THAT EXCEEDED21
TWO HOURS;22
(VII) T
HE PERCENTAGE OF TOTAL CLINICAL AMBULATORY23
RESTRAINT EPISODES THAT INVOLVED AN INDIVIDUAL DIAGNOSED WITH A24
BEHAVIORAL HEALTH DISORDER OR INTELLECTUAL OR DEVELOPMENTAL25
DISABILITY AND THE PERCENTAGE OF TOTAL CLINICAL FOUR -POINT26
RESTRAINT EPISODES THAT INVOLVED AN INDIVIDUAL DIAGNOSED WITH A27
HB23-1013
-14- BEHAVIORAL HEALTH DISORDER OR INTELLECTUAL OR DEVELOPMENTAL1
DISABILITY;2
(VIII) T
HE PERCENTAGE OF TOTAL INVOLUNTARY MEDICATION3
ORDERS THAT INVOLVED AN INDIVIDUAL DIAGNOSED WITH A BEHAVIORAL4
HEALTH DISORDER OR INTELLECTUAL OR DEVELOPMENTAL DISABILITY5
AND THE PERCENTAGE OF TOTAL CLINICAL FOUR -POINT RESTRAINT6
EPISODES THAT INVOLVED AN INDIVIDUAL DIAGNOSED WITH A7
BEHAVIORAL HEALTH DISORDER OR INTELLECTUAL OR DEVELOPMENTAL8
DISABILITY;9
(IX) T
HE PERCENTAGE OF TOTAL CLINICAL AMBULATORY10
RESTRAINT EPISODES THAT INVOLVED AN INDIVIDUAL WHO WAS11
SUBJECTED TO THE RESTRAINT FOR A SECOND OR SUBSEQUENT EPISODE12
WITHIN THE YEAR AND THE PERCENTAGE OF TOTAL CLINICAL FOUR -POINT13
RESTRAINT EPISODES THAT INVOLVED AN INDIVIDUAL WHO WAS14
SUBJECTED TO THE RESTRAINT FOR A SECOND OR SUBSEQUENT EPISODE15
WITHIN THE YEAR;16
(X) T
HE PERCENTAGE OF TOTAL INVOLUNTARY MEDICATION17
ORDERS THAT INVOLVED AN INDIVIDUAL WHO WAS SUBJECTED TO A18
SECOND OR SUBSEQUENT ORDER WITHIN THE YEAR ; AND19
(XI) T
HE TOTAL NUMBER OF INVOLUNTARY MEDICATION THAT20
EXCEEDED NINETY DAYS IN VIOLATION OF SUBSECTION (8)(b)(III) OF THIS21
SECTION.22
(b) N
OTWITHSTANDING THE REQUIREMENT IN SECTION 24-1-13623
(11)(a)(I),
THE REQUIREMENT TO SUBMIT THE REPORT REQUIRED IN THIS24
SUBSECTION (9) CONTINUES INDEFINITELY.25
(c) T
HE DEPARTMENT SHALL ENSURE THE REPORT REQUIRED IN26
THIS SUBSECTION (9) DOES NOT DISCLOSE ANY INFORMATION IN VIOLATION27
HB23-1013
-15- OF APPLICABLE STATE AND FEDERAL LAWS REGARDING THE1
CONFIDENTIALITY OF INDIVIDUALS' INFORMATION.2
(10) A
S USED IN THIS SECTION, UNLESS THE CONTEXT OTHERWISE3
REQUIRES:4
(a) "C
LINICAL AMBULATORY RESTRAINT " MEANS A DEVICE USED5
TO INVOLUNTARILY LIMIT AN INDIVIDUAL'S FREEDOM OF MOVEMENT, BUT6
STILL PERMITS THE ABILITY OF THE INDIVIDUAL TO WALK AND MOVE7
WHILE SUBJECTED TO THE DEVICE.8
(b) "C
LINICAL FOUR-POINT RESTRAINT" MEANS A DEVICE USED TO9
INVOLUNTARILY LIMIT AN INDIVIDUAL 'S FREEDOM OF MOVEMENT BY10
SECURING THE INDIVIDUAL'S ARMS AND LEGS.11
(c) "C
LINICAL RESTRAINT" MEANS A DEVICE USED TO12
INVOLUNTARILY LIMIT AN INDIVIDUAL 'S FREEDOM OF MOVEMENT .13
"C
LINICAL RESTRAINT" INCLUDES CLINICAL AMBULATORY RESTRAINT AND14
CLINICAL FOUR-POINT RESTRAINT.15
(d) "C
ORRECTIONAL FACILITY" HAS THE SAME MEANING AS SET16
FORTH IN SECTION 17-1-102 (1.7).17
(e) "D
EPARTMENT" MEANS THE DEPARTMENT OF CORRECTIONS ,18
CREATED AND EXISTING PURSUANT TO SECTION 24-1-128.5.19
(f) "F
ACILITY" MEANS A CORRECTIONAL FACILITY AND A PRIVATE20
CONTRACT PRISON.21
(g) "I
NVOLUNTARY MEDICATION " MEANS GIVING AN INDIVIDUAL22
MEDICATION INVOLUNTARILY FOR THE PURPOSE OF RESTRAINING THAT23
INDIVIDUAL; EXCEPT THAT "INVOLUNTARY MEDICATION " DOES NOT24
INCLUDE THE INVOLUNTARY ADMINISTRATION OF MEDICATION OR25
ADMINISTRATION OF MEDICATION FOR VOLUNTARY LIFE -SAVING MEDICAL26
PROCEDURES.27
HB23-1013
-16- (h) "LICENSED MENTAL HEALTH PROVIDER " HAS THE SAME1
MEANING AS DEFINED AT SECTION 27-60-108 (2)(a).2
(i) "P
RIVATE CONTRACT PRISON" HAS THE SAME MEANING AS SET3
FORTH IN SECTION 17-1-102 (7.3).4
(j) "P
RONE POSITION" MEANS A FACE-DOWN POSITION.5
(k) "Q
UALIFIED FACILITY" MEANS:6
(I) A
CORRECTIONAL FACILITY INFIRMARY ;7
(II) T
HE SAN CARLOS CORRECTIONAL FACILITY; AND8
(III) T
HE DENVER WOMEN'S CORRECTIONAL FACILITY.9
(l) "Q
UALIFIED HEALTH-CARE PROVIDER" MEANS A LICENSED10
PHYSICIAN, A LICENSED ADVANCED PRACTICE REGISTERED NURSE , OR11
LICENSED REGISTERED NURSE.12
SECTION 2. In Colorado Revised Statutes, 17-1-113.9, amend13
(1) as follows:14
17-1-113.9. Use of administrative segregation for state inmates15
- reporting. (1) Notwithstanding section 24-1-136 (11)(a)(I), on or16
before January 1, 2012, and each January 1 thereafter, the executive17
director shall provide a written report to the judiciary committees of the18
senate and house of representatives, or any successor committees,19
concerning the status of administrative segregation; reclassification20
efforts for offenders
INDIVIDUALS DIAGNOSED with mental BEHAVIORAL21
health disorders or intellectual and developmental disabilities, including22
duration of stay, reason for placement, and number and percentage23
discharged; and any internal reform efforts since July 1, 2011. T
HE24
REPORT MUST INCLUDE DATA CONCERNING THE PLACEMENT OF25
INDIVIDUALS IN ALL SETTINGS WITH HEIGHTENED RESTRICTIONS ,26
INCLUDING THE TOTAL NUMBER OF PLACEMENTS IN EACH SETTING , THE27
HB23-1013
-17- TOTAL NUMBER OF PLACEMENTS IN EACH SETTING INVOLVING AN1
INDIVIDUAL DIAGNOSED WITH A BEHAVIORAL HEALTH DISORDER OR2
INTELLECTUAL OR DEVELOPMENTAL DISABILITY , THE AVERAGE DURATION3
OF STAY OF AN INDIVI DUAL IN EACH SETTING , THE REASONS FOR4
PLACEMENT IN EACH SETTING, AND THE TOTAL NUMBER OF INDIVIDUALS5
DISCHARGED FROM EACH SETTING .6
SECTION 3. In Colorado Revised Statutes, 21-1-104, amend (6)7
as follows:8
21-1-104. Duties of public defender - report. (6) The office of9
state public defender shall provide one or more public defender liaisons10
to the department of corrections and the state board of parole to assist11
inmates or inmate liaisons with legal matters related to detainers, bonds,12
holds, warrants, competency, special needs parole applications,13
INVOLUNTARY MEDICATION PROCEEDINGS PURSUANT TO SECTION14
17-1-167
(8), and commutation applications. The office of state public15
defender, in consultation with the state board of parole and the16
department of corrections, shall develop any necessary policies and17
procedures for implementation of this subsection (6).18
SECTION 4. Safety clause. The general assembly hereby finds,19
determines, and declares that this act is necessary for the immediate20
preservation of the public peace, health, or safety.21
HB23-1013
-18-