HOUSE BILL 23-1013
BY REPRESENTATIVE(S) Amabile, Bacon, Bird, Boesenecker, Brown,
deGruy Kennedy, Dickson, Froelich, Gonzales-Gutierrez, Herod, Jodeh,
Lindsay, Lindstedt, Mabrey, Michaelson Jenet, Ortiz, Parenti, Sharbini,
Sirota, Snyder, Story, Velasco, Weissman, Willford, Woodrow, Young,
Joseph, Marshall, McCormick, McCluskie;
also SENATOR(S) Fields and Rodriguez, Buckner, Gonzales, Hansen,
Jaquez Lewis, Kolker, Marchman, Moreno, Priola.
C
ONCERNING MEASURES TO REGULATE THE USE OF RESTRICTIVE PRACTICES
ON INDIVIDUALS IN CORRECTIONAL FACILITIES
, AND, IN CONNECTION
THEREWITH
, MAKING AN APPROPRIATION.
Be it enacted by the General Assembly of the State of Colorado:
SECTION 1. In Colorado Revised Statutes, add 17-1-167 as
follows:
17-1-167. Use of restraints for state inmates - criteria -
documentation - intake assessment - report - rules - definitions. (1) B
Y
JULY 1, 2027, THE DEPARTMENT SHALL IMPLEMENT POLICIES AND PRACTICES
THAT CONFORM TO THE MINIMUM STANDARDS PRESCRIBED BY THE MOST
UPDATED RESTRAINT AND SECLUSION STANDARDS OF THE NATIONAL
NOTE: This bill has been prepared for the signatures of the appropriate legislative
officers and the Governor. To determine whether the Governor has signed the bill
or taken other action on it, please consult the legislative status sheet, the legislative
history, or the Session Laws.
________
Capital letters or bold & italic numbers indicate new material added to existing law; dashes
through words or numbers indicate deletions from existing law and such material is not part of
the act. COMMISSION ON CORRECTIONAL HEALTH CARE . THE DEPARTMENT SHALL
CONTINUOUSLY AMEND ITS PRACTICES AND POLICIES TO COMPLY
, AT A
MINIMUM
, WITH THE THOSE MINIMUM STANDARDS .
(2) (a) A
FACILITY OR QUALIFIED FACILITY SHALL ENSURE THAT THE
USE OF RESTRAINT IS DOCUMENTED AND MAINTAINED IN THE ELECTRONIC
HEALTH RECORD OF THE INDIVIDUAL WHO WAS RESTRAINED
. AT A MINIMUM,
THE FACILITY OR QUALIFIED FACILITY SHALL DOCUMENT :
(I)
THE ORDER FOR CLINICAL RESTRAINT, THE DATE AND TIME OF THE
ORDER
, AND THE SIGNATURE OF THE LICENSED OR LICENSE-ELIGIBLE MENTAL
HEALTH PROVIDER WHO ISSUED THE CLINICAL RESTRAINT ORDER
. IF THE
ORDER IS AUTHORIZED BY TELEPHONE
, THE ORDER MUST BE TRANSCRIBED
AND SIGNED AT THE TIME OF ISSUANCE BY A PERSON WITH AUTHORITY TO
ACCEPT ORDERS
. THE ORDERING LICENSED OR LICENSE- ELIGIBLE MENTAL
HEALTH PROVIDER SHALL SIGN THE ORDER AS SOON AS PRACTICABLE
.
(II) A
CLEAR EXPLANATION OF THE CLINICAL BASIS FOR USE OF THE
CLINICAL RESTRAINT
, INCLUDING THE LESS INTRUSIVE INTERVENTIONS THAT
WERE EMPLOYED AND FAILED
, AND EVIDENCE OF THE IMMEDIATE
CIRCUMSTANCES JUSTIFYING THE BELIEF THAT THE USE OF RESTRAINT WAS
TO PREVENT THE INDIVIDUAL FROM COMMITTING IMMINENT AND SERIOUS
HARM TO THE INDIVIDUAL
'S SELF OR ANOTHER PERSON;
(III) T
HE SPECIFIC BEHAVIORAL CRITERIA THE INDIVIDUAL MUST
EXHIBIT FOR THE CLINICAL RESTRAINT EPISODE TO BE TERMINATED
;
(IV) A
NY MODIFICATIONS TO THE ORDER, AND THE TIME AND DATE,
AND THE SIGNATURE OF THE LICENSED OR LICENSE -ELIGIBLE MENTAL
HEALTH PROVIDER
, OR MENTAL HEALTH CLINICIAN AS DEFINED BY
DEPARTMENT RULE OR DESIGNATED BY THE DEPARTMENT
, WHO MODIFIES
THE ORDER
;
(V) T
HE DATE AND TIME OF AN ORDER MODIFICATION, THE DATE AND
TIME OF THE MODIFICATION
, AND THE SIGNATURE OF THE LICENSED OR
LICENSE
-ELIGIBLE MENTAL HEALTH PROVIDER , OR MENTAL HEALTH
CLINICIAN AS DEFINED BY DEPARTMENT RULE OR DESIGNATED BY THE
DEPARTMENT
, WHO ISSUED THE CLINICAL RESTRAINT ORDER . IF THE ORDER
IS MODIFIED BY TELEPHONE
, THE MODIFICATION MUST BE TRANSCRIBED AND
SIGNED AT THE TIME OF ISSUANCE BY A PERSON WITH AUTHORITY TO ACCEPT
PAGE 2-HOUSE BILL 23-1013 THE MODIFICATION. THE ORDERING LICENSED OR LICENSE-ELIGIBLE MENTAL
HEALTH PROVIDER
, OR MENTAL HEALTH CLINICIAN AS DEFINED BY
DEPARTMENT RULE OR DESIGNATED BY THE DEPARTMENT
, SHALL SIGN THE
ORDER AS SOON AS PRACTICABLE
; AND
(VI) THE DATE AND TIME OF THE TERMINATION OF THE ORDER , THE
SIGNATURE OF THE PERSON WHO TERMINATED THE ORDER
, THE
OBSERVATIONS
, AND EVIDENCE THAT THE INDIVIDUAL EXHIBITED BEHAVIOR
JUSTIFYING THE TERMINATION OF THE ORDER
.
(b) T
HE FACILITY OR QUALIFIED FACILITY SHALL ENSURE THE
DOCUMENTATION AND RETENTION REQUIRED PURSUANT TO THIS SECTION
ARE CONDUCTED PURSUANT TO ALL APPLICABLE STATE AND FEDERAL LAWS
REGARDING THE CONFIDENTIALITY OF THE INDIVIDUAL
'S INFORMATION AND
SHALL ENSURE AN INDIVIDUAL MAY ACCESS THE INFORMATION OR DEMAND
RELEASE OF THE INFORMATION TO A THIRD PARTY
.
(3) A
QUALIFIED FACILITY SHALL PERFORM AN EVALUATION UPON
EVERY INDIVIDUAL
'S INTAKE TO THE RESPECTIVE FACILITY FOR THE PURPOSE
OF ASSESSING THE INDIVIDUAL
'S RISK OF SELF-HARM BEHAVIORS AND
WHETHER THE INDIVIDUAL HAS BEEN PREVIOUSLY SUBJECTED TO CLINICAL
FOUR
-POINT RESTRAINTS. A LICENSED OR LICENSE-ELIGIBLE MENTAL HEALTH
PROVIDER
, MENTAL HEALTH CLINICIAN AS DEFINED BY DEPARTMENT RULE
OR DESIGNATED BY THE DEPARTMENT
, QUALIFIED HEALTH-CARE PROVIDER,
OR MENTAL HEALTH ADMINISTRATOR SHALL INITIATE APPROPRIATE SAFETY
PLANNING TO ADDRESS CONCERNS AND ATTEMPT TO AVOID THE USE OF
CLINICAL RESTRAINTS
, IF POSSIBLE.
(4) (a) S
UBJECT TO THE PROVISIONS OF THIS SECTION, A QUALIFIED
FACILITY SHALL NOT USE AN INVOLUNTARY MEDICATION ON AN INDIVIDUAL
UNLESS
:
(I) T
HE INDIVIDUAL IS DETERMINED TO BE DANGEROUS TO THE
INDIVIDUAL
'S SELF OR ANOTHER PERSON, AND THE TREATMENT IS IN THE
INDIVIDUAL
'S MEDICAL INTEREST;
(II) T
HE QUALIFIED FACILITY HAS EXHAUSTED ALL LESS RESTRICTIVE
ALTERNATIVE INTERVENTIONS
;
(III) T
HE INVOLUNTARY MEDICATION IS ADMINISTERED AFTER
PAGE 3-HOUSE BILL 23-1013 EXHAUSTION OF PROCEDURAL REQUIREMENTS ESTABLISHED PURSUANT TO
THIS SECTION
; AND
(IV) THE MAJORITY OF THE INVOLUNTARY MEDICATION COMMITTEE
DESCRIBED IN SUBSECTION
(4)(b) OF THIS SECTION APPROVES OF THE
INVOLUNTARY MEDICATION
.
(b) T
HE QUALIFIED FACILITY SHALL CONVENE AN INVOLUNTARY
MEDICATION COMMITTEE
, COMPRISED OF A LICENSED PSYCHIATRIST , A
LICENSED PSYCHOLOGIST
, A LICENSED OR LICENSE-ELIGIBLE MENTAL HEALTH
PROVIDER
, AND THE SUPERINTENDENT OF THE QUALIFIED FACILITY OR THE
SUPERINTENDENT
'S DESIGNEE.
(c) A
N ORDER FOR AN INVOLUNTARY MEDICATION MUST NOT :
(I) E
XCEED ONE HUNDRED EIGHTY DAYS FROM THE DATE OF THE
ORDER
; AND
(II) PERMIT THE USE OF MORE THAN TEN DIFFERENT PSYCHOTROPIC
MEDICATIONS DURING THE ONE HUNDRED EIGHTY
-DAY PERIOD. THIS DOES
NOT LIMIT THE AMOUNT OF DOSES OF THE MEDICATIONS TO BE
ADMINISTERED
, AS MEDICALLY APPROPRIATE.
(d) A
QUALIFIED FACILITY SHALL ENSURE THAT THE USE OF
INVOLUNTARY MEDICATION IS DOCUMENTED AND MAINTAINED IN THE
INDIVIDUAL
'S ELECTRONIC HEALTH RECORD. AT A MINIMUM, THE QUALIFIED
FACILITY SHALL DOCUMENT
:
(I) T
HE ORDER FOR INVOLUNTARY MEDICATION ;
(II) T
HE DATE AND TIME OF THE ORDER; AND
(III) A CLEAR EXPLANATION OF THE CLINICAL BASIS FOR USE OF THE
INVOLUNTARY MEDICATION
, INCLUDING THE LESS INTRUSIVE INTERVENTIONS
THAT WERE EMPLOYED AND FAILED AND EVIDENCE OF THE IMMEDIATE
CIRCUMSTANCES JUSTIFYING THE DETER MINATION THAT THE INDIVIDUAL IS
DANGEROUS TO THE INDIVIDUAL
'S SELF OR ANOTHER PERSON AND THAT THE
TREATMENT IS IN THE INDIVIDUAL
'S MEDICAL INTEREST.
(e) T
HE FACILITY OR QUALIFIED FACILITY SHALL ENSURE THE
PAGE 4-HOUSE BILL 23-1013 DOCUMENTATION AND MAINTE NANCE REQUIRED PURSUANT TO THIS SECTION
ARE CONDUCTED PURSUANT TO ALL APPLICABLE STATE AND FEDERAL LAWS
REGARDING THE CONFIDENTIALITY OF THE INFORMATION
.
(f) T
HIS SUBSECTION (4) DOES NOT APPLY TO EMERGENCY MEDICINE
ADMINISTERED PURSUANT TO DEPARTMENT POLICY
.
(5) (a) O
N OR BEFORE JANUARY 1, 2024, AND ON OR BEFORE
JANUARY 1 EACH YEAR THEREAFTER , THE EXECUTIVE DIRECTOR OF THE
DEPARTMENT SHALL SUBMIT A REPORT TO THE JUDICIARY COMMITTEES OF
THE SENATE AND HOUSE OF REPRESENTATIVES
, OR ANY SUCCESSOR
COMMITTEES
, CONCERNING THE USE OF CLINICAL RESTRAINTS AND
INVOLUNTARY MEDICATION IN THE PRECEDING CALENDAR YEAR
. AT A
MINIMUM
, THE REPORT MUST INCLUDE:
(I) T
HE TOTAL NUMBER OF CLINICAL AMBULATORY RESTRAINT
EPISODES AND CLINICAL FOUR
-POINT RESTRAINT EPISODES;
(II) T
HE TOTAL NUMBER OF INVOLUNTARY MEDICATION ORDERS
ISSUED
;
(III) T
HE AVERAGE AMOUNT OF TIME OF A CLINICAL AMBULATORY
RESTRAINT EPISODE AND CLINICAL FOUR
-POINT RESTRAINT EPISODE;
(IV) T
HE AVERAGE DURATION OF INVOLUNTARY MEDICATION
ORDERS ISSUED
;
(V) T
HE LONGEST CLINICAL AMBULATORY RESTRAINT EPISODE AND
THE LONGEST CLINICAL FOUR
-POINT RESTRAINT EPISODE;
(VI) T
HE PERCENTAGE OF TOTAL CLINICAL AMBULATORY RESTRAINT
EPISODES THAT EXCEEDED TWO HOURS
, AND THE PERCENTAGE OF TOTAL
CLINICAL FOUR
-POINT RESTRAINT EPISODES THAT EXCEEDED TWO HOURS ;
(VII) T
HE PERCENTAGE OF TOTAL CLINICAL AMBULATORY
RESTRAINT EPISODES THAT INVOLVED AN INDIVIDUAL DIAGNOSED WITH A
BEHAVIORAL HEALTH DISORDER OR INTELLECTUAL OR DEVELOPMENTAL
DISABILITY
, AND THE PERCENTAGE OF TOTAL CLINICAL FOUR -POINT
RESTRAINT EPISODES THAT INVOLVED AN INDIVIDUAL DIAGNOSED WITH A
BEHAVIORAL HEALTH DISORDER OR INTELLECTUAL OR DEVELOPMENTAL
PAGE 5-HOUSE BILL 23-1013 DISABILITY;
(VIII) T
HE PERCENTAGE OF TOTAL INVOLUNTARY MEDICATION
ORDERS THAT INVOLVED AN INDIVIDUAL DIAGNOSED WITH A BEHAVIORAL
HEALTH DISORDER OR INTELLECTUAL OR DEVELOPMENTAL DISABILITY
, AND
THE PERCENTAGE OF TOTAL CLINICAL FOUR
-POINT RESTRAINT EPISODES
THAT INVOLVED AN INDIVIDUAL DIAGNOSED WITH A BEHAVIORAL HEALTH
DISORDER OR INTELLECTUAL OR DEVELOPMENTAL DISABILITY
;
(IX) T
HE PERCENTAGE OF TOTAL CLINICAL AMBULATORY RESTRAINT
EPISODES THAT INVOLVED AN INDIVI DUAL WHO WAS SUBJECTED TO THE
RESTRAINT FOR A SECOND OR SUBSEQUENT EPISODE WITHIN THE YEAR
, AND
THE PERCENTAGE OF TOTAL CLINICAL FOUR
-POINT RESTRAINT EPISODES
THAT INVOLVED AN INDIVIDUAL WHO WAS SUBJECTED TO THE RESTRAINT
FOR A SECOND OR SUBSEQUENT EPISODE WITHIN THE YEAR
;
(X) T
HE PERCENTAGE OF TOTAL INVOLUNTARY MEDICATION ORDERS
THAT INVOLVED AN INDIVIDUAL WHO WAS SUBJECTED TO A SECOND OR
SUBSEQUENT ORDER WITHIN THE YEAR
;
(XI) T
HE TOTAL NUMBER OF INVOLUNTARY MEDICATION ORDERS
THAT EXCEEDED ONE HUNDRED EIGHTY DAYS
; AND
(XII) AN IMPLEMENTATION PLAN TO CONFORM WITH THE
REQUIREMENTS PURSUANT TO SUBSECTION
(1) OF THIS SECTION, INCLUDING
TIMELINES
, A SUMMARY OF PROGRESS, AND A COMPLIANCE REPORT.
(b) B
EGINNING IN 2024 AND EACH YEAR THEREAFTER , THE
DEPARTMENT SHALL PRESENT FINDINGS FROM THE REPORT DESCRIBED BY
THIS SECTION TO THE HOUSE OF REPRESENTATIVES AND SENATE JUDICIARY
COMMITTEES
, OR ANY SUCCESSOR COMMITTEES , DURING THE HEARINGS
HELD PURSUANT TO THE
"SMART ACT", PART 2 OF ARTICLE 7 OF TITLE 2.
(c) N
OTWITHSTANDING THE REQUIREMENT IN SECTION 24-1-136
(11)(a)(I),
THE REQUIREMENT TO SUBMIT THE REPORT REQUIRED IN THIS
SUBSECTION
(5) CONTINUES INDEFINITELY.
(d) T
HE DEPARTMENT SHALL ENSURE THE REPORT REQUIRED IN THIS
SUBSECTION
(5) DOES NOT DISCLOSE ANY INFORMATION IN VIOLATION OF
APPLICABLE STATE AND FEDERAL LAWS REGARDING THE CONFIDENTIALITY
PAGE 6-HOUSE BILL 23-1013 OF INDIVIDUALS' INFORMATION.
(6) A
S USED IN THIS SECTION, UNLESS THE CONTEXT OTHERWISE
REQUIRES
:
(a) "C
LINICAL AMBULATORY RESTRAINT " MEANS A DEVICE USED TO
INVOLUNTARILY LIMIT AN INDIVIDUAL
'S FREEDOM OF MOVEMENT, BUT STILL
PERMITS THE ABILITY OF THE INDIVIDUAL TO WALK AND MOVE WHILE
SUBJECTED TO THE DEVICE
.
(b) "C
LINICAL FOUR-POINT RESTRAINT" MEANS A DEVICE USED TO
INVOLUNTARILY LIMIT AN INDIVIDUAL
'S FREEDOM OF MOVEMENT BY
SECURING THE INDIVIDUAL
'S ARMS AND LEGS.
(c) "C
LINICAL RESTRAINT" MEANS A DEVICE USED TO
INVOLUNTARILY LIMIT AN INDIVIDUAL
'S FREEDOM OF MOVEMENT. "CLINICAL
RESTRAINT
" INCLUDES CLINICAL AMBULATORY RESTRAINTS AND CLINICAL
FOUR
-POINT RESTRAINTS.
(d) "C
ORRECTIONAL FACILITY" HAS THE SAME MEANING AS SET
FORTH IN SECTION
17-1-102 (1.7).
(e) "D
EPARTMENT" MEANS THE DEPARTMENT OF CORRECTIONS ,
CREATED AND EXISTING PURSUANT TO SECTION 24-1-128.5.
(f) "F
ACILITY" MEANS A CORRECTIONAL FACILITY OR A PRIVATE
CONTRACT PRISON
.
(g) "I
NVOLUNTARY MEDICATION " MEANS GIVING AN INDIVIDUAL
MEDICATION INVOLUNTARILY
; EXCEPT THAT "INVOLUNTARY MEDICATION "
DOES NOT INCLUDE THE INVOLUNTARY ADMINISTRATION OF MEDICATION OR
ADMINISTRATION OF MEDICATION FOR VOLUNTARY LIFE
-SAVING MEDICAL
PROCEDURES
.
(h) "L
ICENSED OR LICENSE-ELIGIBLE MENTAL HEALTH PROVIDER "
HAS THE SAME MEANING AS DEFINED IN SECTION 27-60-108 (2)(a), OR
MEANS A PERSON WHO HAS COMPLETED THE EDUCATION REQUIREMENTS TO
BE A LICENSED MENTAL HEALTH PROVIDER AS DEFINED IN SECTION
27-60-108 (2)(a), BUT IS IN THE PROCESS OF COMPLETING THE EXPERIENCE
AND EXAMINATION REQUIREMENTS TO BECOMING LICENSED
.
PAGE 7-HOUSE BILL 23-1013 (i) "PRIVATE CONTRACT PRISON" HAS THE SAME MEANING AS SET
FORTH IN SECTION
17-1-102 (7.3).
(j) "Q
UALIFIED FACILITY" MEANS:
(I) A
CORRECTIONAL FACILITY INFIRMARY ;
(II) T
HE SAN CARLOS CORRECTIONAL FACILITY; AND
(III) THE DENVER WOMEN'S CORRECTIONAL FACILITY.
(k) "Q
UALIFIED HEALTH-CARE PROVIDER" MEANS A LICENSED
PHYSICIAN
, A LICENSED ADVANCED PRACTICE REGISTERED NURSE , OR A
LICENSED REGISTERED NURSE
.
SECTION 2. In Colorado Revised Statutes, 17-1-113.9, amend (1)
as follows:
17-1-113.9. Use of administrative segregation for state inmates
- reporting. (1) Notwithstanding section 24-1-136 (11)(a)(I), on or before
January 1, 2012, and each January 1 thereafter, the executive director shall
provide a written report to the judiciary committees of the senate and house
of representatives, or any successor committees, concerning the status of
administrative segregation; reclassification efforts for offenders
INDIVIDUALS DIAGNOSED with mental BEHAVIORAL health disorders or
intellectual and developmental disabilities, including duration of stay,
reason for placement, and number and percentage discharged; and any
internal reform efforts since July 1, 2011. T
HE REPORT MUST INCLUDE DATA
CONCERNING THE PLACEMENT OF INDIVIDUALS IN ALL SETTINGS WITH
HEIGHTENED RESTRICTIONS
, INCLUDING THE TOTAL NUMBER OF PLACEMENTS
IN EACH SETTING
, THE TOTAL NUMBER OF PLACEMENTS IN EACH SETTING
INVOLVING AN INDIVIDUAL DIAGNOSED WITH A BEHAVIORAL HEALTH
DISORDER OR INTELLECTUAL OR DEVELOPMENTAL DISABILITY
, THE AVERAGE
DURATION OF STAY OF AN INDIVIDUAL IN EACH SETTING
, THE REASONS FOR
PLACEMENT IN EACH SETTING
, AND THE TOTAL NUMBER OF INDIVIDUALS
DISCHARGED FROM EACH SETTING
.
SECTION 3. Appropriation. (1) For the 2023-24 state fiscal year,
$18,872 is appropriated to the department of corrections. This appropriation
is from the general fund. To implement this act, the department may use this
PAGE 8-HOUSE BILL 23-1013 appropriation as follows:
(a) $12,000 for the purchase of information technology services; and
(b) $6,872 for use by institutions for operating expenses related to
the mental health subprogram.
(2) For the 2023-24 state fiscal year, $12,000 is appropriated to the
office of the governor for use by the office of information technology. This
appropriation is from reappropriated funds received from the department of
corrections under subsection (1)(a) of this section. To implement this act,
the office may use this appropriation to provide information technology
services for the department of corrections.
SECTION 4. Safety clause. The general assembly hereby finds,
PAGE 9-HOUSE BILL 23-1013 determines, and declares that this act is necessary for the immediate
preservation of the public peace, health, or safety.
____________________________ ____________________________
Julie McCluskie Steve Fenberg
SPEAKER OF THE HOUSE PRESIDENT OF
OF REPRESENTATIVES THE SENATE
____________________________ ____________________________
Robin Jones Cindi L. Markwell
CHIEF CLERK OF THE HOUSE SECRETARY OF
OF REPRESENTATIVES THE SENATE
APPROVED________________________________________
(Date and Time)
_________________________________________
Jared S. Polis
GOVERNOR OF THE STATE OF COLORADO
PAGE 10-HOUSE BILL 23-1013