Provider resources for involuntary mental health services

Laws and rules

The 27-65 Program is a mental health services program outlined in Colorado law (C.R.S. 27-65 et seq.) which regulates the involuntary care and treatment of individuals with mental health disorders. These services include:

• Involuntary transportation
• Emergency mental health holds
• Emergency department assistance and subsequent 72-hour hold notifications
• Court-ordered evaluations
• Certifications
• Involuntary medications

The State of Colorado requires all facilities that perform 27-65 procedures submit data to the Colorado Behavioral Health Administration to ensure client safety and maintain standards of care. 

Learn more about laws and rules

Share feedback, questions, or concerns

27-65 annual reports

Calendar Year Reports

• Calendar Year 2021_27-65 Quick Facts
• Calendar Year 2020_27-65 Quick Facts
• Calendar Year 2019_27-65 Quick Facts

Fiscal Year Reports 

• Fiscal Year 2018_27-65 Annual Report
• Fiscal Year 2017_27-65 Annual Report
• Fiscal Year 2016_27-65 Annual Report
• Fiscal Year 2016_27-65 Annual Report Executive Summary 
• Fiscal Year 2015_27-65 Annual Report
• Fiscal Year 2014_27-65 Annual Report
• Fiscal Year 2013_27-65 Annual Report
• Fiscal Year 2012_27-65 Annual Report
• Fiscal Year 2011_27-65 Annual Report

Training resources

BHA is here to help with the ins and outs of involuntary behavioral health programs.

Upcoming training dates

Click calendar events to add them to your calendar and access Zoom call information.

Recorded trainings

• BHA Care Coordination Programs
• Provider Training for Care Coordination Civil Certifications Programs
• Intro to 27-65 C.R.S. and M Forms for Providers
• Emergency Mental Health Hold for Providers
• 27-65-107 C.R.S. Transportation Holds
• Emergency Department Assistance Program
• Patient Rights for Adults
• Patient Rights for Minors
• ED Assistance Survey Video Instructions

Training office hours

Our trainers hold office hours twice a month via Zoom. Providers are invited to ask the training team targeted questions. Join using the links below:

• First Monday of each month at 11 a.m.
• Fourth Monday of each month at 3 p.m.

Can't find what you need? You can also request training.

Contact a trainer

27-65 trainers:

• Taylor Linn, 27-65 Jurisprudence training specialist: taylor.linn@state.co.us; 720-877-2442
• Hailey Klingele, 27-65 provider training specialist: hailey.klingele@state.co.us; 720-775-9677

Request a training

To request a training for C.R.S. 27-65 or care coordination subjects, please fill out this form.

The PMH-BC Behavioral Health Administration Training as identified under C.R.S. 27-65-102(20) is now available for Registered Nurses who have their PMH-BC Certification. This training will take 4 hours, and can be conducted either in-person or virtually, although an in-person training is recommended. BHA staff will travel to your facility for any in-person training. To request this training, please fill out this form. Once you have completed the form, one of our 27-65 trainers will reach out to answer any questions you have and schedule the training.

More training resources

• Data Submission Training Resources
• 27-65 Data Questions
• C.R.S 27-65 Provider Training for Inpatient and Outpatient Services
• Questions and answers from 27-65 Q&A session 
• Incompetent to Proceed to Short term Civil Certification
• Terminated Certifications - Care Coordination

Designation process and facilities 

A designated facility is one that’s approved by BHA to treat people with mental health disorders. 
 

What does designation mean?

A designated facility is a facility approved by BHA pursuant to the provisions of the Care and Treatment of Persons with Mental Health Disorders. BHA is charged with ensuring that the procedures set forth in both statute and regulation are carried out in a manner that is in accordance with the law, and that all persons treated under this law in relation to a designation are afforded the rights given them by law. If those rights are restricted, all laws and procedures are followed in order to uphold the civil rights of those individuals. As part of the designation, facilities are able to provide specific services only afforded to individuals within designated facilities, these include:

• Certification: Court processes to enact involuntary care and treatment beyond 72 hours. Can be inpatient or outpatient treatment services.
• Psychiatric Medications: Involuntary psychiatric medications include medications administered for psychiatric emergency conditions and non- emergency conditions. Please see 2 CCR 502-1, Section 11.8.1.
  • Emergency Conditions (§§ 27-65-104, -106, -108, -108.5, -109, -110, C.R.S.)- when someone is in imminent danger of harming him or herself or someone else and refuses acceptance of a psychiatric medication. This is only allowed under involuntary services. Please see 2 CCR 502-1, Section 11.8.3.
  • Non-Emergency Involuntary Medications (§§ 27-65-104, -106, -108, -108.5, -109, -110), C.R.S.) when and individual who is detained under the involuntary statutes would benefit from the administration of a psychiatric medication but the individual does not consent, the facility petitions the court to obtain. Please see 2 CCR 502-1, Section 11.8.4.
• Seclusion and Restraint: Individuals being detained under §§ 27-65-104, -106, -108, -108.5, -109, -110), C.R.S. may be secluded or restrained over their objection under the conditions covered in 2 CCR 502-1, Section 11.9, otherwise there must be a signed consent for such an intervention as outlined in behavioral health rules and regulations.
• Therapy or Treatment Using Special Procedures: Therapies using stimuli such as electroconvulsive therapy (ECT) or feeding tubes require special procedures for consent and shall be governed by 2 CCR 502-1, Section 11.10. If the individual undergoing treatment using special procedures is a child age 16 to 18 years old, the clinical record shall reflect informed consent by both the child and the legal guardian(s).

What’s the process to apply or renew?

• Facilities applying for designation must submit an application through LADDERS, the State's online substance use disorder licensing and mental health designation application system and service directory.
• All designations are annual renewals and require on-site inspection

What are the reporting requirements?

Designated facilities must file an annual report with BHA pursuant to Rule Volume 2 CCR 502-1, Section 11.5.

Where can I find designated facilities?

You can use the Behavioral Health Administration Licensing and Designation Database and Electronic Records System (LADDERS) to find the most updated facilities and providers.

You may also find behavioral health providers licensed by the Behavioral Health Administration (BHA) through OwnPath.

27-65 Data Reporting

Find templates and information about reporting requirements.
 

Reporting templates

27-65 Reporting Templates

Report a terminating, expiring, or transferring civil certification

Effective July 1, 2024, facilities designated for involuntary care and treatment of individuals are required to notify the BHA whenever an involuntary civil certification is being terminated, allowed to expire, or transferred to another provider. For more information about required reporting or this form please consult the Care Coordination for People on Involuntary Civil Certification section of this page.

Please use the link below to submit one form for each individual who has an involuntary civil certification that is being terminated, allowed to expire, or transferred to another provider. This form submission is secure and meets HIPAA confidentiality requirements.

Report a Terminating, Expiring, or Transferring Civil Certification

Reporting form instructions

27-65 Data reporting resources

BHA’s data reporting templates can be used in either a Google Sheets or Microsoft Excel format. If a facility prefers to use an alternative method to collect and report data (e.g. pull data from an EHR), the alternative method must include all aspects as outlined in the BHA created template and must be submitted using excel. 27-65 designated facilities must send excel documents as ".xslm" files.

Each facility will submit one data report per agency, not per site. Data reports must be submitted to:

• cdhs_bha_data_services_sys@state.co.us 

In addition to resources provided, BHA is offering individualized agency training for data reporting. To request a training on these data requirements or utilizing BHA’s 2024 data reporting template, please contact us utilizing this Training Request Form.

• Data reporting fact sheet for designated providers
• Data reporting fact sheet for emergency medical service facilities
• Data reporting aids
• Data reporting for designated providers recording
• Dara reporting for emergency medical service facilities recording

M-Forms

M-Forms are required for involuntary services under Article 65 of Title 27 of Colorado Revised Statutes, which explains how mental health services should be given. BHA makes sure the rules and laws are followed properly. That way, everyone treated has their rights protected.

View and download M-forms

Emergency department assistance

The Emergency Department Assistance Program has been created to assist emergency departments with placement for subsequent mental health holds.

Resources

• Memo: External Protocols for Emergency Medical Services Facilities Emergency Mental Health Holds Related to 27-65-106
• Form: Emergency Department Assistance Request and Subsequent Hold Notification (Updated 09/03/2024)
  • ED Assistance Survey Video Instructions
  • Fillable PDF
  • Online form
• Presentation: Emergency Department Assistance Program Protocol

Contact info

To schedule a training or for questions regarding the Emergency Department Assistance Program, contact the BHA's Kalli Likness at kalli.likness@state.co.us or 720-594-0158.

Involuntary civil certification programs

Care Coordination for People on Involuntary Civil Certification 

As of July 1, 2024, the Behavioral Health Administration (BHA) Care Coordination Team is providing two essential Care Coordination programs to providers serving individuals on involuntary civil certifications.

• Care Coordination for Individuals Adjudicated Incompetent to Proceed (ITP) on Involuntary Civil Certifications: In accordance with HB23-1138 and CRS 27-65-108.5, the BHA has been entrusted with enhancing oversight, monitoring, and providing necessary care coordination support to individuals deemed ITP and meeting the criteria for involuntary civil certification. To gain deeper insights into this program, please refer to the official memo outlining its guidance or email bha_civilcertifications@state.co.us. 
• Care Coordination for Individuals with Terminating, Expiring, or Transferring Involuntary Civil Certifications: Per HB22-1256, CRS 27-65-110(6), and CRS 27-65-108, the BHA is mandated to monitor and track individuals with "terminated" involuntary civil certifications (including those expired, transferred, or discharged from care). Furthermore, the BHA, or its contracted agents, will extend care coordination services to such individuals. 
  • Click here to report a terminating, expiring or transferring involuntary civil certification.
  • For detailed information, please consult the official memo provided.

Involuntary Civil Certification Programs Memos: To view and download an individual form, scroll through the list below. For all forms, view the complete  Protocols folder.