Administration

C.R.S. tit. 25, art. 1

in effect

C.R.S. § 25-1-101 Construction of terms

25-1-101. Construction of terms. (1) When any law of this state refers to the executive director of the state department of public health or of the department of health, said law shall be construed as referring to the executive director of the department of public health and environment. (2) Whenever any law of this state refers to the state department of public health or to the department of health, said law shall be construed as referring to the department of public health and environment.

C.R.S. § 25-1-101.5 Authority of revisor of statutes to amend references to department - affected statutory provisions

25-1-101.5. Authority of revisor of statutes to amend references to department - affected statutory provisions. The revisor of statutes is hereby authorized to change all references in the Colorado Revised Statutes to the department of health from said reference to the department of public health and environment, as appropriate. In connection with such authority, the revisor of statutes is hereby authorized to amend or delete provisions of the Colorado Revised Statutes so as to make the statutes consistent with the renaming of the department to the department of public health and environment.

C.R.S. § 25-1-102 Department created - executive director - divisions

25-1-102. Department created - executive director - divisions. (1) There is hereby created a department of public health and environment, referred to in this part 1 and article 1.5 of this title as the "department". The head of the department shall be the executive director of the department of public health and environment, which office is hereby created. The governor shall appoint said executive director, with the consent of the senate, and the executive director shall serve at the pleasure of the governor. The reappointment of an executive director after initial election of a governor shall be subject to the provisions of section 24-20-109, C.R.S. The executive director shall administer the department, subject to the authority of the state board of health, the air quality control commission, the state water quality control commission, and the solid and hazardous waste commission. (2) The department consists of the following divisions: (a) The division of administration, and such sections and units established as provided by law. The division is a type 2 entity, as defined in section 24-1-105. (b) (Deleted by amendment, L. 93, p. 1095, § 11, effective July 1, 1994.)

C.R.S. § 25-1-103 State board of health created

25-1-103. State board of health created. (1) (a) There is created the state board of health, referred to in this part 1 as the "board". The board is a type 1 entity, as defined in section 24-1-105. The board consists of the following members appointed by the governor, with the consent of the senate: (I) One member from each congressional district in the state; and (II) Two members from the state at large. (b) A vacancy on the board occurs whenever any member moves out of the congressional district from which the member was appointed. A member who moves out of such congressional district shall promptly notify the governor of the date of the member's move, but the notice is not required for the vacancy to occur. The governor shall fill any vacancy by appointment for the unexpired term. (c) No more than a minimum majority of the members of the board may be affiliated with the same political party. (d) The term of office for each appointed member is four years. In making appointments to the board, the governor shall ensure that no business or professional group constitutes a majority of the board. In making appointments to the board, the governor is encouraged to include representation by at least one member who is a person with a disability, as defined in section 24-34-301, a family member of a person with a disability, or a member of an advocacy group for persons with disabilities if the other requirements of this subsection (1) are met. (2) There shall always be one county commissioner member on the board. Whenever a county commissioner ceases to hold the office of county commissioner, the commissioner ceases to hold a position as a member of the board. A county commissioner shall not vote on any matter coming before the board that affects the commissioner's county in a manner significantly different from the manner in which it affects other counties.

C.R.S. § 25-1-104 State board - organization

25-1-104. State board - organization. The board shall elect from its members a president, a vice-president, and such other board officers as it shall determine. The executive director of the department, in the discretion of the board, may serve as secretary of the board but shall not be eligible to appointment as a member. All board officers shall hold their offices at the pleasure of the board. Regular meetings of the board shall be held not less than once every three months at such times as may be fixed by resolution of the board. Special meetings may be called by the president, by the executive director of the department, or by a majority of the members of the board at any time on three days' prior notice by mail or, in case of emergency, on twenty-four hours' notice by telephone or other telecommunications device. The board shall adopt, and at any time may amend, bylaws in relation to its meetings and the transaction of its business. A majority shall constitute a quorum of the board. Members shall receive the same per diem compensation and reimbursement of expenses as those provided for members of boards and commissions in the division of professions and occupations pursuant to section 12-20-103 (6). All meetings of the board, in every suit and proceeding, shall be taken to have been duly called and regularly held, and all orders and proceedings of the board to have been authorized, unless the contrary is proved.

C.R.S. § 25-1-105 Executive director - chief medical officer - qualifications - salary - office

25-1-105. Executive director - chief medical officer - qualifications - salary - office. (1) The executive director of the department shall: (a) Have a degree of doctor of medicine or doctor of osteopathy, be licensed to practice medicine in the state of Colorado, and have at least one of the following qualifications: (I) One year of graduate study in a school of public health; (II) Not less than two years' experience in an administrative capacity in a health-care organization; (III) Four years of said experience when one year of graduate study in a school of public health has not been completed; or (b) Have, at a minimum, experience or education in public administration and public or environmental health. (2) (a) If the governor appoints an executive director who does not have the qualifications specified in paragraph (a) of subsection (1) of this section, the executive director of the department shall, pursuant to the provisions of section 13 of article XII of the state constitution, upon consultation with the governor, and with the consent of a majority of the members of the senate, appoint a chief medical officer. The chief medical officer shall have the qualifications specified in paragraph (a) of subsection (1) of this section and shall serve at the pleasure of the governor. The executive director shall initially appoint the chief medical officer no later than three months after the executive director's appointment has been confirmed by the senate. (b) The chief medical officer shall provide independent medical judgment, guidance, and advice to the governor and to the executive director regarding medical and public health issues in all areas identified in article 1.5 of this title. (c) The chief medical officer shall be afforded direct access to the governor and the governor's staff. (3) The executive director shall receive such salary as may be fixed by the board subject to the state constitution and state laws and within the limits of funds made available to the department by appropriation of the general assembly or otherwise. The executive director shall be allowed traveling and subsistence expenses actually and necessarily incurred in the performance of the executive director's official duties when absent from his or her place of residence. The executive director shall be custodian of all property and records of the department.

C.R.S. § 25-1-106 Division personnel

25-1-106. Division personnel. The executive director of the department shall appoint the director of the division of administration, pursuant to the provisions of section 13 of article XII of the state constitution. Each subdivision (and section) of the division of administration shall be under the management of a head, and such heads and all other subordinate personnel of the division shall be appointed by the director of the division, subject to the constitution and state personnel system laws of the state, and shall possess qualifications approved by the board. All personnel shall receive such compensation as fixed by the executive director with the approval of the board, subject to the constitution and state personnel system laws of the state and within the limits of funds made available to the department by appropriation of the general assembly or otherwise. With the approval of the executive director, employees shall also be allowed traveling and subsistence expenses actually and necessarily incurred in the performance of their official duties when absent from their places of residence.

C.R.S. § 25-1-107 Powers and duties of the department - repeal

25-1-107. Powers and duties of the department - repeal. (Repealed)

C.R.S. § 25-1-107.5 Additional authority of department - rules - remedies against nursing facilities - criteria for recommending assessments for civil penalties - cooperation with department of health care policy and financing - nursing home penalty cash fund - nursing home innovations grant board - reports - transfer of contracts to the department

25-1-107.5. Additional authority of department - rules - remedies against nursing facilities - criteria for recommending assessments for civil penalties - cooperation with department of health care policy and financing - nursing home penalty cash fund - nursing home innovations grant board - reports - transfer of contracts to the department. (1) For the purposes of this section, unless the context otherwise requires: (a) Repealed. (b) "Federal regulations for participation" means the regulations found in part 442 of title 42 of the code of federal regulations, as amended, for participation under Title XIX of the federal "Social Security Act", as amended. (b.5) "Benefit residents of nursing facilities" means that a grant has a direct impact on the residents of nursing facilities or has an indirect impact on the residents through education of nursing facility staff. (b.7) "Board" means the nursing home innovations grant board, authorized by subsection (6) of this section. (c) "Nursing facility" means any skilled or intermediate nursing care facility that receives federal and state funds under Title XIX of the federal "Social Security Act", as amended. (2) The department, as the state agency responsible for certifying nursing facilities, is authorized to adopt rules necessary to establish a series of remedies in accordance with this section and the federal "Omnibus Budget Reconciliation Act of 1987", Pub.L. 100-203, as amended, that may be imposed by the department of health care policy and financing when a nursing facility violates federal regulations for participation in the medicaid program. The remedies shall include any remedies required under federal law and the imposition of civil money penalties. (3) (a) In accordance with rules promulgated under this section, the department is authorized to recommend to the department of health care policy and financing an appropriate civil money penalty based on the nature of the violation. Any penalties recommended shall not be less than one hundred dollars nor more than ten thousand dollars for each day the facility is found to be in violation of the federal regulations. Penalties assessed shall include interest at the statutory rate. (b) The department shall adopt criteria for determining the amount of the penalty to be recommended for assessment. The criteria shall include, but need not be limited to, consideration of the following factors: (I) The period during which the violation occurred; (II) The frequency of the violation; (III) The nursing facility's history concerning the type of violation for which the penalty is assessed; (IV) The nursing facility's intent or reason for the violation; (V) The effect, if any, of the violation on the health, safety, security, or welfare of the residents of the nursing facility; (VI) The existence of other violations, in combination with the violation for which the penalty is assessed, that increase the threat to the health, safety, security, or welfare of the residents of the nursing facility; (VII) The accuracy, thoroughness, and availability of records regarding the violation that the nursing facility is required to maintain; and (VIII) The number of additional related violations occurring within the same period as the violation in question. r which the penalty is assessed, that increase the threat to the health, safety, security, or welfare of the residents of the nursing facility; (VII) The accuracy, thoroughness, and availability of records regarding the violation that the nursing facility is required to maintain; and (VIII) The number of additional related violations occurring within the same period as the violation in question. (c) (I) If the department finds that a violation is life threatening to one or more residents or creates a direct threat of serious adverse harm to the health, safety, security, rights, or welfare of one or more residents, the department of health care policy and financing shall impose a penalty for each day the deficiencies that constitute the violation are found to exist. (II) Except as provided in subsection (3)(c)(I) of this section, the department of health care policy and financing shall not assess a penalty prior to the date a nursing facility receives written notice from the department of its recommendation to assess civil money penalties. The department shall provide the notice to the facility no later than ten days after the last day of the inspection or survey during which the deficiencies that constitute the violation were found. The notice shall: (A) Set forth the deficiencies that are the basis for the recommendation to assess a penalty; (B) Provide instructions for responding to the notice; and (C) Require the nursing facility to submit a written plan of correction. The department shall adopt criteria for the submission of written plans of correction by nursing facilities and approval of the plans by the department. If the facility acts in a timely and diligent manner to correct the violation in accordance with an approved plan of correction, the department may recommend to the department of health care policy and financing that it suspend or reduce the penalty during the period of correction specified in the approved plan of correction. (d) Except as provided in sub-subparagraph (C) of subparagraph (II) of paragraph (c) of this subsection (3), the department of health care policy and financing shall continue to assess any penalty recommended under this section until the department verifies to the department of health care policy and financing that the violation is corrected or until the nursing facility notifies the department that correction has occurred, whichever is earlier. If the penalty has been suspended or reduced pursuant to sub-subparagraph (C) of subparagraph (II) of paragraph (c) of this subsection (3) and the nursing facility has not corrected the violation, the department of health care policy and financing shall reinstate the penalty at an increased amount and shall retroactively assess the penalty to the date the penalty was suspended. (4) (a) The department of health care policy and financing, after receiving a recommendation from the department, is authorized to assess, enforce, and collect the civil money penalty pursuant to section 25.5-6-205, C.R.S., for credit to the nursing home penalty cash fund, created pursuant to section 25.5-6-205 (3)(a), C.R.S. retroactively assess the penalty to the date the penalty was suspended. (4) (a) The department of health care policy and financing, after receiving a recommendation from the department, is authorized to assess, enforce, and collect the civil money penalty pursuant to section 25.5-6-205, C.R.S., for credit to the nursing home penalty cash fund, created pursuant to section 25.5-6-205 (3)(a), C.R.S. (b) (I) The department and the department of health care policy and financing have joint authority for administering the nursing home penalty cash fund; except that final authority regarding the administration of money in the fund is in the department. (II) (A) The authority of both departments includes establishing circumstances under which funds may be distributed in order to protect the health or property of individuals residing in nursing facilities that the department of health care policy and financing has found to be in violation of federal regulations for participation in the medicaid program. (B) The departments shall collaborate at least annually, and more often as needed, to assess and review emergency funding needs and response plans for potential nursing facility closures. The departments shall jointly administer emergency funding. (III) The state board of health may promulgate rules necessary to ensure proper administration of the nursing home penalty cash fund. (c) The departments shall consider, as a basis for distribution from the nursing home penalty cash fund, the following: (I) The need to pay costs to: (A) Relocate residents to other facilities when a nursing facility closes; (B) Maintain the operation of a nursing facility pending correction of violations; (C) Close a nursing facility; (D) Reimburse residents for personal funds lost; (II) Grants to be approved for measures that will benefit residents of nursing facilities by fostering innovation and improving the quality of life and care at the facilities, including, but not limited to: (A) Consumer education to promote resident-centered care in nursing facilities; (B) (Deleted by amendment, L. 2014.) (C) Initiatives in nursing facilities related to the quality measures promoted by the federal centers for medicare and medicaid services and other national quality initiatives; (D) Education and consultation for purposes of identifying and implementing resident-centered care initiatives in nursing facilities; and (E) Projects that support or compliment statewide quality and safety goals of the departments. (d) (I) Repealed. (II) The department, after receiving a recommendation from the board and approval from the federal centers for medicare and medicaid services, shall consider grants issued as sole source procurements that are not subject to the "Procurement Code", articles 101 to 112 of title 24. (II.5) (A) The board shall make recommendations for the approval of grants that benefit residents of nursing facilities for at least one year and not more than three-year cycles. The projects awarded via grants must be portable, sustainable, and replicable in other nursing facilities. (B) The department and the board shall develop processes for grant payments, which processes may allow grant payments to be made in advance of the delivery of goods and services to grantees. Grantees receiving advance payments shall report progress to the board. No state agency, nor any other governmental entity, with the exception of a facility that is owned or operated by a governmental agency and that is licensed as a nursing care facility under section 25-1.5-103 (1)(a)(I)(A), may apply for or receive a grant under this subsection (4). e delivery of goods and services to grantees. Grantees receiving advance payments shall report progress to the board. No state agency, nor any other governmental entity, with the exception of a facility that is owned or operated by a governmental agency and that is licensed as a nursing care facility under section 25-1.5-103 (1)(a)(I)(A), may apply for or receive a grant under this subsection (4). (C) Any moneys remaining in the fund at the end of a fiscal year may be held over and used by the board in the next fiscal year. Unexpended and unencumbered moneys from an appropriation in the annual general appropriation act to the departments for the purpose of carrying out the nursing home innovations grant program under this section remain available for expenditure by the departments in the next fiscal year without further appropriation. This sub-subparagraph (C) applies to appropriations made by the general assembly for fiscal years ending on and after June 30, 2014. On or before June 30, 2014, and on or before June 30 of each year thereafter, the departments shall notify the state controller of the amount of the appropriation from the annual general appropriation act for the current fiscal year the departments need to remain available for expenditure in the next fiscal year. The departments may not expend more than the amount stated in the notice under this sub-subparagraph (C). (D) Other policies of the board must conform with practices of other granting organizations. The work product from grants funded through the nursing home penalty cash fund is the intellectual property of the department and must be made available without charge to all nursing homes in the state. The state board of health may adopt rules as necessary to govern the procedure for awarding grants under this section. (II.7) The department shall adhere to all state and federal requirements for the encumbrance and payment of grants under this subsection (4)(d). In addition, the department shall: (A) Document necessary federal permissions for the use of moneys from the nursing home penalty cash fund, created under section 25.5-6-205, C.R.S., prior to making any payment or encumbrance; and (B) Adhere to the written determination of the board under subsection (6) of this section in releasing state moneys for payment to grantees under this section. The department's adherence to the written determination of the board is sufficient evidence to ensure that work was completed fully and adequately. (III) The state board of health shall establish a minimum reserve amount to be maintained in the nursing home penalty cash fund to ensure that there is sufficient money for the departments to distribute in accordance with subsection (4)(b)(II) of this section, if needed. The departments shall not expend money from the fund for the purposes described in subsection (4)(c)(II) of this section if the expenditure would cause the fund balance to fall below the minimum reserve amount. (IV) In determining how to allocate the money authorized to be distributed pursuant to this subsection (4)(d), the departments shall take into consideration the recommendations of the board made pursuant to subsection (6)(c) of this section. If the departments disagree with the recommendations of the board, they shall meet with the board to explain their rationale and shall seek to achieve a compromise with the board regarding the allocation of the money. If a compromise cannot be achieved with regard to all or a portion of the money to be distributed, the state board of health shall have the final authority regarding the distribution of money for which a compromise has not been reached. f the board, they shall meet with the board to explain their rationale and shall seek to achieve a compromise with the board regarding the allocation of the money. If a compromise cannot be achieved with regard to all or a portion of the money to be distributed, the state board of health shall have the final authority regarding the distribution of money for which a compromise has not been reached. (e) (I) The departments shall not utilize money from the nursing home penalty cash fund for costs of administration associated with any specific movement, association, or organization; except that the appropriation for administration of the grants authorized under this section shall not exceed ten percent of the appropriation for the disbursed grants. The department and the department of heath care policy and financing shall use any such appropriation for administration to administer the grant program described in this section and to improve nursing facility innovation and quality with the goal of reducing future penalties. (II) For purposes of this section, the departments shall jointly develop an annual administrative budget utilizing money from the nursing home penalty cash fund for the purposes of administering the fund and supporting the board. These purposes may include, but are not limited to: (A) All required state and federal reporting; (B) Public website maintenance; (C) Marketing the nursing home penalty cash fund and grantee recruitment; (D) Grant development, monitoring, and payment processing; (E) Outcome measurement utilizing state and federal data sources; (F) Coordination with quality programs already in place by the departments; (G) Grantee monitoring and support; (H) Costs associated with emergency closures and payment auditing; and (I) Maintenance of access to complete projects, including trainings, recordings, and project deliverables. (5) Repealed. (6) (a) The nursing home innovations grant board is created. On and after July 1, 2021, the board is transferred from the department of health care policy and financing to the department. The board is a type 2 entity, as defined in section 24-1-105, and exercises its powers and performs its duties and functions under the department. The department, in consultation with stakeholders, shall determine the appropriate entity to administer the board. The board consists of ten members as follows: (I) The state long-term care ombudsman or his or her designee; (II) The executive director of the department of health care policy and financing or the executive director's designee; (III) The executive director of the department of public health and environment or the executive director's designee; (IV) Seven members appointed by the governor as follows: (A) Four members currently employed in long-term care nursing facilities; (B) One member who is or represents a consumer of long-term care; (C) One member representing the disability community who is either a resident of a nursing facility or a family member of a nursing facility resident; and (D) One member representing the business community. (E) (Deleted by amendment, L. 2014.) (b) The members of the board shall serve without compensation. (c) The board shall review all grant projects, determine whether the grantees completed their grant projects and grant objectives, and shall provide written recommendations to the department to make or withhold payment to grantees. esident; and (D) One member representing the business community. (E) (Deleted by amendment, L. 2014.) (b) The members of the board shall serve without compensation. (c) The board shall review all grant projects, determine whether the grantees completed their grant projects and grant objectives, and shall provide written recommendations to the department to make or withhold payment to grantees. (d) By October 1 of each year, the departments, with the assistance of the board, shall jointly submit a report to the governor and the health and human services committee of the senate and the public health care and human services committee of the house of representatives of the general assembly, or their successor committees, regarding the expenditure of moneys in the nursing home penalty cash fund for the purposes described in subparagraph (II) of paragraph (c) of subsection (4) of this section. The report must detail the amount of moneys expended for such purposes, the recipients of the funds, the effectiveness of the use of the funds, and any other information deemed pertinent by the departments or requested by the governor or the committees. Notwithstanding the requirement in section 24-1-136 (11), C.R.S., the report required in this paragraph (d) continues indefinitely. (7) Repealed. (8) On and after July 1, 2021, whenever the department of health care policy and financing is referred to or designated by any contract or other document in connection with the duties and functions under this section, such reference or designation shall be deemed to apply to the department. All contracts entered into by the departments prior to July 1, 2021, in connection with the duties and functions under this section are hereby validated, with the department succeeding to all rights and obligations under such contracts.

C.R.S. § 25-1-108 Powers and duties of state board of health - rules

25-1-108. Powers and duties of state board of health - rules. (1) In addition to all other powers and duties conferred and imposed upon the state board of health by this part 1, the board has the following specific powers and duties: (a) To determine general policies to be followed by the division of administration in administering and enforcing the public health laws and the orders, standards, rules, and regulations of the board; (b) To act in an advisory capacity to the executive director of the department on all matters pertaining to public health; (c) (I) To issue from time to time such orders, to adopt such rules and regulations, and to establish such standards as the board may deem necessary or proper to carry out the provisions and purposes of this part 1 and to administer and enforce the public health laws of this state; (II) To adopt rules and standards concerning building regulations for skilled and intermediate health-care facilities. The enforcement of these rules may be waived by the board for periods of time as recommended by the department if the rigid application of the rules would result in demonstrated financial hardship to a skilled or intermediate facility, but only if the waiver will not adversely affect the health and safety of patients. (III) to (V) Repealed. (VI) To adopt rules and to establish such standards as the board may deem necessary or proper to assure that hospitals; other acute care facilities; county, district, and municipal public health agencies; and trauma centers are prepared for an emergency epidemic, as defined in section 24-33.5-703 (4), that is declared to be a disaster emergency, including the immediate investigation of any case of a suspected emergency epidemic, the maintenance of an adequate stockpile of personal protective equipment for infection control, and staff proficiency in using the personal protective equipment; (d) To hold hearings, administer oaths, subpoena witnesses, and take testimony in all matters relating to the exercise and performance of the powers and duties vested in or imposed upon the board. The board may designate an administrative law judge appointed pursuant to part 10 of article 30 of title 24, C.R.S., to conduct hearings for the board, pursuant to section 24-4-105, C.R.S., and to carry out such administrative and other duties of the board as the board may require in the conduct of its hearings. (e) To establish and appoint, as the board may deem necessary or advisable, special advisory committees to advise and confer with the board concerning the public health aspects of any business, profession, or industry within the state of Colorado. Any committee established and appointed under the provisions of this section shall act only in an advisory capacity to the board and shall meet with the board at least once each year at such regular meeting of the board as may be designated by the board and at such other times as such committee may be called into meeting by the president of the board. Members of any special advisory committee shall serve without compensation but may, in the discretion of the board, be allowed actual and necessary traveling and subsistence expenses when in attendance at meetings away from their places of residence. ng of the board as may be designated by the board and at such other times as such committee may be called into meeting by the president of the board. Members of any special advisory committee shall serve without compensation but may, in the discretion of the board, be allowed actual and necessary traveling and subsistence expenses when in attendance at meetings away from their places of residence. (f) to (h) Repealed. (2) The board shall act only by resolution adopted at a duly called meeting of the board, and no individual member of the board shall exercise individually any administrative authority with respect to the department. (3) In the exercise of its powers, the department shall not promulgate any rule or standard that limits or interferes with the ability of an individual to enter into a contract with a private pay facility concerning the programs or services provided at the private pay facility. For the purposes of this subsection (3), "private pay facility" means a skilled nursing facility or intermediate care facility subject to the requirements of section 25-1-120 or an assisted living residence licensed pursuant to section 25-27-105 that is not publicly funded or is not certified to provide services that are reimbursed from state or federal assistance funds. (4) and (5) Repealed.

C.R.S. § 25-1-108.5 Additional powers and duties of state board of health and department - programs that receive tobacco settlement moneys - definitions - monitoring - annual report

25-1-108.5. Additional powers and duties of state board of health and department - programs that receive tobacco settlement moneys - definitions - monitoring - annual report. (Repealed)

C.R.S. § 25-1-108.7 Health care credentials uniform application act - legislative declaration - definitions - state board of health rules

25-1-108.7. Health care credentials uniform application act - legislative declaration - definitions - state board of health rules. (Repealed)

C.R.S. § 25-1-109 Powers and duties of division of administration

25-1-109. Powers and duties of division of administration. (1) In addition to the other powers and duties conferred and imposed in this part 1 upon the division of administration, the division, through the director or, upon the director's direction and under the director's supervision, through the other officers and employees of the division, has the following powers and duties: (a) To administer and enforce the public health laws of the state of Colorado and the standards, orders, rules, and regulations established, issued, or adopted by the board; (b) To exercise all powers and duties conferred and imposed upon the department not expressly delegated to the board by the provisions of this part 1; (c) To hold hearings, administer oaths, subpoena witnesses, and take testimony in all matters relating to the exercise and performance of the powers and duties vested in or imposed upon the division of administration. The director may designate an administrative law judge appointed pursuant to part 10 of article 30 of title 24, C.R.S., to conduct hearings pursuant to section 24-4-105, C.R.S. (d) Repealed. (e) To supervise all subdivisions and boards of the department to determine that publications of the department and of any subdivisions thereof circulated in quantity outside the executive branch are issued in accordance with the provisions of section 24-1-136, C.R.S.; (f) To appoint, pursuant to section 13 of article XII of the state constitution, a chief health inspector and such deputy inspectors as may be authorized. Such inspectors have the power to enter any workplace as provided in section 8-1-116, C.R.S. All expenses incurred by the division and its employees, pursuant to the provisions of this section, shall be paid from the funds appropriated for its use, upon approval of the director. (g) Repealed. (h) To administer and enforce the minimum general sanitary standards and regulations adopted pursuant to section 25-1.5-202.

C.R.S. § 25-1-110 Higher standards permissible

25-1-110. Higher standards permissible. Nothing in this part 1 shall prevent any incorporated city, city and county, town, county, or other political subdivision of the state from imposing and enforcing higher standards than are imposed under this part 1.

C.R.S. § 25-1-111 Revenues of department

25-1-111. Revenues of department. (Repealed)

C.R.S. § 25-1-112 Legal adviser - attorney general - actions

25-1-112. Legal adviser - attorney general - actions. The attorney general is the legal adviser for the department and shall defend it in all actions and proceedings brought against it. The district attorney of the judicial district in which a cause of action arises shall bring any civil or criminal action requested by the executive director of the department to abate a condition that exists in violation of, or to restrain or enjoin any action that is in violation of, or to prosecute for the violation of or for the enforcement of, the public health laws and the standards, orders, and rules of the department established by or issued under the provisions of this part 1. If the district attorney fails to act, the executive director may bring any such action and shall be represented by the attorney general or by special counsel.

C.R.S. § 25-1-113 Judicial review of decisions

25-1-113. Judicial review of decisions. (1) Any person aggrieved and affected by a decision of the board or the executive director of the department is entitled to judicial review by filing in the district court of the county of his residence, or of the city and county of Denver, within ninety days after the public announcement of the decision, an appropriate action requesting such review. The court may make any interested person a party to the action. The review shall be conducted by the court without a jury and shall be confined to the record, if a complete record is presented; except that, in cases of alleged irregularities in the record or in the procedure before the board or the division of administration, testimony may be taken in the court. The court may affirm the decision or may reverse or modify it if the substantial rights of the appellant have been prejudiced as a result of the findings and decisions of the board being: Contrary to constitutional rights or privileges; or in excess of the statutory authority or jurisdiction of the board or the executive director of the department; or affected by any error of law; or made or promulgated upon unlawful procedure; or unsupported by substantial evidence in view of the entire record as submitted; or arbitrary or capricious. (2) Any party may have a review of the final judgment or decision of the district court by appellate review in accordance with law and the Colorado appellate rules.

C.R.S. § 25-1-114 Unlawful acts - penalties

25-1-114. Unlawful acts - penalties. (1) It is unlawful for any person, association, or corporation, and the officers thereof: (a) To willfully violate, disobey, or disregard the provisions of the public health laws or the terms of any lawful notice, order, standard, rule, or regulation issued pursuant thereto; or (b) To fail to make or file reports required by law or rule of the board relating to the existence of disease or other facts and statistics relating to the public health; or (c) To conduct any business or activity over which the department possesses the power to license and regulate without such license or permit as required by the department; or (d) To willfully and falsely make or alter any certificate or license or certified copy thereof issued pursuant to the public health laws; or (e) To knowingly transport or accept for transportation, interment, or other disposition a dead body without an accompanying permit issued in accordance with the public health laws or the rules of the board; or (f) To willfully fail to remove from private property under his control at his own expense, within forty-eight hours after being ordered so to do by the health authorities, any nuisance, source of filth, or cause of sickness within the jurisdiction and control of the department, whether such person, association, or corporation is the owner, tenant, or occupant of such private property; except that, if such condition is due to an act of God, it shall be removed at public expense; or (g) To pay, give, present, or otherwise convey to any officer or employee of the department any gift, remuneration, or other consideration, directly or indirectly, which such officer or employee is forbidden to receive by the provisions of this part 1; or (h) To make, install, maintain, or permit any cross-connection between any water system supplying drinking water to the public and any pipe, plumbing fixture, or water system which contains water of a quality below the minimum general sanitary standards as to the quality of drinking water supplied to the public or to fail to remove such connection within ten days after being ordered in writing by the department to remove the same. For the purposes of this paragraph (h), "cross-connection" means any connection which would allow water to flow from any pipe, plumbing fixture, or water system into a water system supplying drinking water to the public. (i) To sell or offer for sale any raw milk, milk product, or unsanitary dairy product, as defined in section 25-5.5-104, for other than human consumption unless it has first been treated with a dye approved by the department; or (j) To violate section 25-3-122. (2) It is unlawful for any officer or employee of the department or member of the board to accept any gift, remuneration, or other consideration, directly or indirectly, for an incorrect or improper performance of the duties imposed upon him by or on behalf of the department. (3) It is unlawful: (a) For any officer or employee of the department to perform any work, labor, or services other than the duties assigned to him by or on behalf of the department during the hours such officer or employee is regularly employed by the department, or to perform his duties as an officer or employee of the department under any condition or arrangement that involves a violation of this or any other law of the state of Colorado; ployee of the department to perform any work, labor, or services other than the duties assigned to him by or on behalf of the department during the hours such officer or employee is regularly employed by the department, or to perform his duties as an officer or employee of the department under any condition or arrangement that involves a violation of this or any other law of the state of Colorado; (b) For any officer or employee of the department other than members of the board to perform any work, labor, or services which consist of the private practice of medicine, veterinary surgery, sanitary engineering, nursing, or any other profession which is or may be of special benefit to any private person, association, or corporation as distinguished from the department or the public generally, and which is performed by such officer or employee, directly or indirectly, for remuneration, whether done in an active, advisory, or consultative capacity or performed within or without the hours such officer or employee is regularly employed by the department. (4) Except as provided in subsection (5) of this section, any person, association, or corporation, or the officers thereof, who violates any provision of this section commits a class 2 misdemeanor and is also liable for any expense incurred by health authorities in removing any nuisance, source of filth, or cause of sickness. Conviction under the penalty provisions of this part 1 or any other public health law shall not relieve any person from any civil action in damages that may exist for an injury resulting from any violation of the public health laws. (5) (a) It is unlawful for any person, association, or corporation, or the officers thereof, to tamper, attempt to tamper, or threaten to tamper with a public water system or with drinking water after its withdrawal for or treatment by a public water system. For purposes of this subsection (5), "tamper" means to introduce a contaminant into a public water system or into drinking water or to otherwise interfere with drinking water or the operation of a public water system with the intention of harming persons or the public water system. "Tamper" does not include the standardized and accepted treatment procedures performed by a supplier of water in preparing water for human consumption. (b) (I) Any person, association, or corporation, or the officers thereof, who tampers with a public water system or with drinking water after its withdrawal for or treatment by a public water system commits a class 3 felony and shall be punished as provided in section 18-1.3-401, C.R.S. (II) Any person, association, or corporation, or the officers thereof, who attempts to tamper or threatens to tamper with a public water system or with drinking water after its withdrawal for or treatment by a public water system commits a class 5 felony and shall be punished as provided in section 18-1.3-401, C.R.S. (III) Conviction under this subsection (5) shall not relieve any person from a civil action initiated pursuant to section 25-1-114.1.

C.R.S. § 25-1-114.1 Civil remedies and penalties

25-1-114.1. Civil remedies and penalties. (1) The division of administration of the department may institute a civil action or administrative action, as described in subsection (2.5) of this section, against any person who violates a final enforcement order of the department issued for a violation of any minimum general sanitary standard or regulation adopted pursuant to section 25-1.5-202. Such civil action shall be brought in the district court of the county in which the violation of the standard or regulation is alleged to have occurred. (2) Upon finding that a final enforcement order of the department has been violated and that the violation of the standard or regulation described in the order in fact occurred, the court shall: (a) Impose a civil penalty on the violator of not more than one thousand dollars per day for each day the violation of the standard or regulation occurred if the court determines the violation was willful; or (b) Enter such order as the public health may require, taking into consideration, where appropriate, the cost and time necessary to comply; or (c) Impose such civil penalty and enter such order. (2.5) (a) Any person who violates any minimum general sanitary standard and regulation promulgated pursuant to section 25-1.5-202 or 25-1-114 (1)(h), or any final enforcement order issued by the department, shall be subject to an administrative penalty as follows: (I) For systems that serve a population of more than ten thousand people, an amount not to exceed one thousand dollars per violation per day; or (II) For systems that serve a population of ten thousand people or less, an amount not to exceed one thousand dollars per violation per day, but only in an amount, as determined by the division, that is necessary to ensure compliance. (b) Penalties under this subsection (2.5) shall be determined by the executive director or the executive director's designee and may be collected by the division of administration by an action instituted in a court of competent jurisdiction for collection of such penalty. The final decision of the executive director or the executive director's designee may be appealed to the water quality control commission, created pursuant to section 25-8-201. A stay of any order of the division ending judicial review shall not relieve any person from any liability with respect to past or continuing violations of any minimum general sanitary standard or any regulation promulgated pursuant to section 25-1.5-202 or 25-1-114 (1)(h), but the reason for the request for judicial review shall be considered in the determination of the amount of the penalty. In the event that such an action is instituted for the collection of such penalty, the court may consider the appropriateness of the amount of the penalty, if such issue is raised by the party against whom the penalty was assessed. Any administrative penalty collected under this section shall be credited to the general fund. ew shall be considered in the determination of the amount of the penalty. In the event that such an action is instituted for the collection of such penalty, the court may consider the appropriateness of the amount of the penalty, if such issue is raised by the party against whom the penalty was assessed. Any administrative penalty collected under this section shall be credited to the general fund. (3) The department may request the attorney general to bring a suit for a temporary restraining order or a preliminary or permanent injunction to prevent or abate any violation of a minimum general sanitary standard or regulation adopted pursuant to section 25-1.5-202 or to prevent or abate any release or imminent release that causes or is likely to cause contamination resulting in liability under section 25-1.5-207, and the department, in such a suit, may collect, on behalf of political subdivisions or public water systems, the damages incurred by such political subdivisions or public water systems under section 25-1.5-207. The department shall pay to such political subdivisions or public water systems all damages collected on their behalf. The department is not required to issue an enforcement order prior to institution of such a suit. Upon a de novo finding by the court that such a violation has occurred, is occurring, or is about to occur or that such release or imminent release exists, the court may enjoin such violation, release, or imminent release and enter such order as the public health may require, taking into consideration, where appropriate, the cost and time necessary to comply. An enforcement settlement with the state under the provisions of this subsection (3) shall bar a separate action by a political subdivision or public water system under section 25-1.5-207 whenever notice and adequate opportunity to comment on the proposed settlement have been given to the political subdivision or public water system, damages have been collected on behalf of and paid to such political subdivision or public water system by the state, and the release or imminent release has been prevented or abated by means of the settlement. (4) Suits brought pursuant to subsection (3) of this section shall be brought in the district court of the county in which the violation is alleged to have occurred. The institution of such a suit by the division of administration shall confer upon such court exclusive jurisdiction to determine finally the subject matter of the proceeding; except that the exclusive jurisdiction of the court shall apply only to such proceeding and shall not preclude assessment of any civil penalties or any other enforcement action or sanction authorized by this section. (4.5) An action for civil penalties under this section may be joined with a civil action to recover the state's costs pursuant to subsection (3) of this section. (5) The powers of the department established by this section shall be in addition to, and not in derogation of, any powers of the department. of any civil penalties or any other enforcement action or sanction authorized by this section. (4.5) An action for civil penalties under this section may be joined with a civil action to recover the state's costs pursuant to subsection (3) of this section. (5) The powers of the department established by this section shall be in addition to, and not in derogation of, any powers of the department. (6) (a) The attorney general, at the request of the department, or the district attorney of the county in which an affected public water system is located or the attorney of the supplier of water may institute a civil action against any person, association, or corporation, or the officers thereof, who tampers, attempts to tamper, or threatens to tamper with a public water system or with drinking water after its withdrawal for or treatment by a public water system. Such action shall be brought in the district court of the county in which the violation is alleged to have occurred. As used in this subsection (6), "tamper" means to introduce a contaminant into a public water system or into drinking water or to otherwise interfere with drinking water or the operation of a public water system with the intention of harming persons or public water systems. "Tamper" does not include the standardized and accepted treatment procedures performed by a supplier of water in preparing water for human consumption. (b) Upon finding that tampering, attempting to tamper, or threatening to tamper has occurred, the court shall have the authority to: (I) Order appropriate injunctive relief; (II) Impose a civil penalty on the violator of not more than fifty thousand dollars for each act of tampering or of not more than twenty thousand dollars for each act of attempting to tamper or threatening to tamper; (III) Impose on the violator all costs incurred by the state and by the affected public water system in assessing and remedying all consequences of the tampering, attempting to tamper, or threatening to tamper; and (IV) Impose on the violator all court costs associated with remedying consequences of the tampering, attempting to tamper, or threatening to tamper. (7) Any person subject to an action brought pursuant to subsection (3) of this section or section 25-1.5-207 shall have an affirmative defense to such action if such person's potential liability results from a discharge of contaminants or substances authorized by and in substantial compliance with an existing federal or state permit which controls the quality of the release of the contaminant or substance.

C.R.S. § 25-1-114.5 Voluntary disclosure arising from self-evaluation - presumption against imposition of administrative or civil penalties

25-1-114.5. Voluntary disclosure arising from self-evaluation - presumption against imposition of administrative or civil penalties. (1) For the purposes of this section, a disclosure of information by a person or entity to any division or agency within the department of public health and environment regarding any information related to an environmental law is voluntary if all of the following are true: (a) The disclosure is made promptly after knowledge of the information disclosed is obtained by the person or entity; (b) The disclosure arises out of a voluntary self-evaluation; (c) The person or entity making the disclosure initiates the appropriate effort to achieve compliance, pursues compliance with due diligence, and corrects the noncompliance within two years after the completion of the voluntary self-evaluation. Where such evidence shows the noncompliance is the failure to obtain a permit, appropriate efforts to correct the noncompliance may be demonstrated by the submittal of a complete permit application within a reasonable time. (d) The person or entity making the disclosure cooperates with the appropriate division or agency in the department of public health and environment regarding investigation of the issues identified in the disclosure. (2) For the purposes of paragraph (c) of subsection (1) of this section, upon application to and at the discretion of the department of public health and environment, the time period within which the noncompliance is required to be corrected may be extended if it is not practicable to correct the noncompliance within the two-year period. A request for a de novo review of the decision of the department of public health and environment may be made to the appropriate district court or administrative law judge. (3) If a person or entity is required to make a disclosure to a division or agency within the department of public health and environment under a specific permit condition or under an order issued by the division or agency, then the disclosure is not voluntary with respect to that division or agency. (4) If any person or entity makes a voluntary disclosure of an environmental violation to a division or agency within the department of public health and environment, then there is a rebuttable presumption that the disclosure is voluntary and therefore the person or entity is immune from any administrative and civil penalties associated with the issues disclosed and is immune from any criminal penalties for negligent acts associated with the issues disclosed. The person or entity shall provide information supporting its claim that the disclosure is voluntary at the time that the disclosure is made to the division or agency. (5) To rebut the presumption that a disclosure is voluntary, the appropriate division or agency shall show to the satisfaction of the respective commission in the department of public health and environment or the state board of health, if no respective commission exists, that the disclosure was not voluntary based upon the factors set forth in subsections (1), (2), and (3) of this section. A decision by the commission or the state board of health, whichever is appropriate, regarding the voluntary nature of a disclosure is final agency action. The division or agency may not include any administrative or civil penalty or fine or any criminal penalty or fine for negligent acts in a notice of violation or in a cease-and-desist order on any underlying environmental violation that is alleged absent a finding by the respective commission or the state board of health that the division or agency has rebutted the presumption of voluntariness of the disclosure. The burden to rebut the presumption of voluntariness is on the division or agency. penalty or fine for negligent acts in a notice of violation or in a cease-and-desist order on any underlying environmental violation that is alleged absent a finding by the respective commission or the state board of health that the division or agency has rebutted the presumption of voluntariness of the disclosure. The burden to rebut the presumption of voluntariness is on the division or agency. (6) The elimination of administrative, civil, or criminal penalties under this section does not apply if a person or entity has been found by a court or administrative law judge to have committed serious violations that constitute a pattern of continuous or repeated violations of environmental laws, rules, regulations, permit conditions, settlement agreements, or orders on consent and that were due to separate and distinct events giving rise to the violations, within the three-year period prior to the date of the disclosure. Such a pattern of continuous or repeated violations may also be demonstrated by multiple settlement agreements related to substantially the same alleged violations concerning serious instances of noncompliance with environmental laws that occurred within the three-year period immediately prior to the date of the voluntary disclosure. (7) Except as specifically provided in this section, this section does not affect any authority the department of public health and environment has to require any action associated with the information disclosed in any voluntary disclosure of an environmental violation. (8) Unless the context otherwise requires, the definitions contained in section 13-25-126.5 (2), C.R.S., apply to this section. (9) This section applies to voluntary disclosures that are made and voluntary self-evaluations that are performed on or after June 1, 1994.

C.R.S. § 25-1-114.6 Implementation of environmental self-audit law - pilot project - legislative declaration

25-1-114.6. Implementation of environmental self-audit law - pilot project - legislative declaration. (1) (a) The general assembly hereby finds and determines that, in order to encourage the regulated community to utilize the environmental self-audit provisions contained in this section and sections 25-1-114.5, 13-25-126.5, and 13-90-107 (1)(j), C.R.S., a pilot project is established. The general assembly hereby declares that the purpose of the environmental self-audit provisions contained in this section and sections 25-1-114.5, 13-25-126.5, and 13-90-107 (1)(j), C.R.S., is to encourage the regulated community to voluntarily identify environmental concerns and to address them expeditiously without fear of enforcement action by regulatory agencies. The general assembly recognizes that, due to concerns with the environmental self-audit provisions, the United States environmental protection agency has, in the past, taken direct action against entities in the regulated community that have made disclosures under the environmental self-audit provisions. The general assembly further declares that the pilot project enacted by this section is intended to allow entities to proceed under the environmental self-audit provisions with assurance that, if any such entity complies with such environmental self-audit provisions, the United States environmental protection agency will forego any enforcement action based on the disclosures made and addressed under the environmental self-audit pilot project. (b) The general assembly further recognizes that, under the pilot project enacted by this section, the department of public health and environment will have discretion to consider certain factors in assessing a regulated entity's eligibility for penalty immunity under the environmental laws. The general assembly intends that this additional flexibility to assess an entity's eligibility, along with the protection from federal overfiling that the pilot project provides, will encourage entities to participate in the project and allow the department of public health and environment to assess the effectiveness of the environmental self-audit provisions. (c) The provisions of this section shall only apply to disclosures made under this section and sections 25-1-114.5, 13-25-126.5, and 13-90-107 (1)(j), C.R.S., after the department of public health and environment and the United States environmental protection agency have entered into a memorandum of agreement binding Colorado and the federal government to enforce environmental laws in a manner consistent with the provisions of this section. (2) Notwithstanding the provisions of sections 25-1-114.5 (4) and (5), 13-25-126.5, and 13-90-107 (1)(j), C.R.S., on and after May 30, 2000, the department of public health and environment may assess penalties for criminal negligence when available under federal environmental law. (3) (a) In addition to the provisions of subsection (2) of this section, notwithstanding the provisions of sections 25-1-114.5 (4) and (5), 13-25-126.5, and 13-90-107 (1)(j), C.R.S., on and after May 30, 2000, in determining whether an entity is entitled to penalty immunity under the provisions of section 25-1-114.5, the department of public health and environment may consider: (I) Whether the activities disclosed may create imminent and substantial endangerment of, or result in serious harm to, public health and the environment; and (II) Whether the activities disclosed conferred an unfair or excessive economic benefit on the disclosing entity. to penalty immunity under the provisions of section 25-1-114.5, the department of public health and environment may consider: (I) Whether the activities disclosed may create imminent and substantial endangerment of, or result in serious harm to, public health and the environment; and (II) Whether the activities disclosed conferred an unfair or excessive economic benefit on the disclosing entity. (b) Notwithstanding any provision of sections 25-1-114.5 (4) and (5), 13-25-126.5, and 13-90-107 (1)(j), C.R.S., the department of public health and environment has discretion to determine whether and to what degree the factors in paragraph (a) of this subsection (3) apply given the particular circumstances of each situation. (4) The pilot project created by this section applies to voluntary disclosures made under this section and sections 25-1-114.5, 13-25-126.5, and 13-90-107 (1)(j), C.R.S., on and after the effective dates of both this section (May 30, 2000) and the memorandum of agreement entered into under paragraph (c) of subsection (1) of this section. (5) Pursuant to the procedures set forth in section 13-25-126.5, C.R.S., the department of public health and environment may obtain access to an environmental self-audit report where the department of public health and environment has independent evidence of any criminal violation of an environmental law. Evidence of a criminal violation constitutes "compelling circumstances" for purposes of section 13-25-126.5 (3)(c), C.R.S., where the department of public health and environment seeks access to an environmental self-audit report. When a self-audit report is obtained, reviewed, or used in a criminal proceeding under this subsection (5), the privilege provided in section 13-25-126.5, C.R.S., applicable to civil or administrative proceedings is not waived or eliminated. (6) Repealed.

C.R.S. § 25-1-115 Treatment - religious belief

25-1-115. Treatment - religious belief. Nothing in this part 1 shall authorize the department to impose any mode of treatment inconsistent with the religious faith or belief of any person.

C.R.S. § 25-1-116 Licensed healing systems not affected

25-1-116. Licensed healing systems not affected. Nothing in this part 1 shall be construed or used to amend or restrict any statute in force pertaining to the scope of practice of any state licensed healing system.

C.R.S. § 25-1-117 Acquisition of federal surplus property

25-1-117. Acquisition of federal surplus property. The governor of the state of Colorado is authorized, for and on behalf of the state of Colorado, to make application for and secure the transfer to the state of Colorado of federal surplus property for the purpose of establishing state public health facilities in the state of Colorado; and to do and perform any acts and things which may be necessary to carry out the above, including the preparing, making, and filing of plans, applications, reports, and other documents, and the execution, acceptance, delivery, and recordation of agreements, deeds, and other instruments pertaining to the transfer of said property. The governor is further authorized to expend available general revenue funds, or such other funds as may be made available by the general assembly, for the purpose of making the above application and securing the transfer of said property in accordance with federal laws and with rules and regulations and requirements of the United States department of health, education, and welfare.

C.R.S. § 25-1-118 Rental properties - salvage - fund created - repeal

25-1-118. Rental properties - salvage - fund created - repeal. (Repealed)

C.R.S. § 25-1-119 Disposition and expenditures of moneys from fund

25-1-119. Disposition and expenditures of moneys from fund. (Repealed)

C.R.S. § 25-1-120 Nursing facilities - rights of patients

25-1-120. Nursing facilities - rights of patients. (1) The department shall require all skilled nursing facilities and intermediate care facilities to adopt and make public a statement of the rights and responsibilities of the patients who are receiving treatment in such facilities and to treat their patients in accordance with the provisions of said statement. The statement shall ensure each patient the following: (a) The right to civil and religious liberties, including knowledge of available choices and the right to independent personal decisions, which will not be infringed upon, and the right to encouragement and assistance from the staff of the facility in the fullest possible exercise of these rights; (b) The right to have private and unrestricted communications with any person of the patient's choice, except as specified in section 25-3-125 (2) and (3); (c) The right to present grievances on behalf of himself or others to the facility's staff or administrator, to governmental officials, or to any other person, without fear of reprisal, and to join with other patients or individuals within or outside of the facility to work for improvements in patient care; (d) The right to manage his own financial affairs or to have a quarterly accounting of any financial transactions made in his behalf, should he delegate such responsibility to the facility for any period of time; (e) The right to be fully informed, in writing, prior to or at the time of admission and during his stay, of services available in the facility and of related charges, including charges for services not covered under medicare or medicaid or not covered by the basic per diem rate; (f) The right to be adequately informed of his medical condition and proposed treatment, unless otherwise indicated by his physician, and to participate in the planning of all medical treatment, including the right to refuse medication and treatment, unless otherwise indicated by his physician, and to know the consequences of such actions; (g) The right to receive adequate and appropriate health care consistent with established and recognized practice standards within the community and with skilled and intermediate nursing care facility rules and regulations as promulgated by the department; (h) The right to have privacy in treatment and in caring for personal needs, confidentiality in the treatment of personal and medical records, and security in storing and using personal possessions; (i) The right to be treated courteously, fairly, and with the fullest measure of dignity and to receive a written statement of the services provided by the facility, including those required to be offered on an as-needed basis; (j) The right to be free from mental and physical abuse and from physical and chemical restraints, except those restraints initiated through the judgment of the professional staff for a specified and limited period of time or on the written authorization of a physician; (k) The right to be transferred or discharged only for medical reasons or his welfare, or that of other patients, or for nonpayment for his stay and the right to be given reasonable advance notice of any transfer or discharge, except in the case of an emergency as determined by the professional staff; (l) The right to devolution of his or her rights and responsibilities upon a sponsor, guardian, or person exercising rights contained in a designated beneficiary agreement executed pursuant to article 22 of title 15, C.R.S., who shall see that he or she is provided with adequate, appropriate, and respectful medical treatment and care and all rights which he or she is capable of exercising should he or she be determined to be incompetent pursuant to law and not be restored to legal capacity; (m) The right to freedom of choice in selecting a health-care facility; ent executed pursuant to article 22 of title 15, C.R.S., who shall see that he or she is provided with adequate, appropriate, and respectful medical treatment and care and all rights which he or she is capable of exercising should he or she be determined to be incompetent pursuant to law and not be restored to legal capacity; (m) The right to freedom of choice in selecting a health-care facility; (n) The right to copies of the facility's rules and regulations and an explanation of his responsibility to obey all reasonable rules and regulations of the facility and to respect the personal rights and private property of the other patients. (1.5) If a facility requires a lease agreement with a provision requiring in excess of a month-to-month tenancy and the lease agreement results in or requires forfeiture of more than thirty days of rent if a patient moves due to a medical condition or dies during the term of the lease agreement, then the lease agreement shall be deemed to be against public policy and shall be void; except that inclusion of such a provision shall not render the remainder of the contract or lease agreement void. A contract provision or lease agreement that requires forfeiture of rent for thirty days after the patient moves due to a medical condition or dies does not violate this section. The provisions regarding forfeiture of rent shall appear on the front page of the contract or lease agreement and shall be printed in no less than twelve-point bold-faced type. The provisions shall read as follows: This lease agreement is for a month-to-month tenancy. The lessor shall not require the forfeiture of rent beyond a thirty-day period if the lessee moves due to a medical condition or dies during the term of the lease. In circumstances in which the patient moves due to a medical condition or dies during the term of a contract or lease agreement, the facility shall return that part of the rent paid in excess of thirty days' rent after a patient moves or dies to the patient or the patient's estate. The facility may assess daily rental charges for any days in which the former or deceased patient's personal possessions remain in the patient's room after the period for which the patient has paid rent and for the usual time to clean the room after the patient's personal possessions have been removed. The facility shall have forty-five days after the date the patient's personal possessions have been removed from the patient's room to reconcile the patient's accounts and to return any moneys owed. This subsection (1.5) applies to any facility, or a distinct part of a facility, that meets the state nursing home licensing standards set forth in section 25-1.5-103 (1)(a)(I) and the licensing requirements specified in section 25-3-101. For purposes of this section, "daily rental charges" means an amount not to exceed one-thirtieth of thirty days' rental amount plus reasonable expenses. (2) Each skilled nursing facility or intermediate care facility shall provide a copy of the statement required by subsection (1) of this section to each patient or his guardian at or before the patient's admission to a facility and to each staff member of a facility. Each such facility shall prepare a written plan and provide appropriate staff training to implement the provisions of this section. (3) Each skilled nursing facility or intermediate care facility shall prepare a written plan and provide appropriate facilities to ensure that the rights guaranteed by subsection (1) of this section are enforced by a grievance procedure which contains the following procedures and rights: all prepare a written plan and provide appropriate staff training to implement the provisions of this section. (3) Each skilled nursing facility or intermediate care facility shall prepare a written plan and provide appropriate facilities to ensure that the rights guaranteed by subsection (1) of this section are enforced by a grievance procedure which contains the following procedures and rights: (a) A resident of any facility, the residents' advisory council, or the sibling, child, spouse, parent, or person exercising rights contained in a designated beneficiary agreement executed pursuant to article 22 of title 15, C.R.S., of any resident may formally complain in the manner described in this subsection (3) about any conditions, treatment, or violations of his or her rights by the facility or its staff or about any treatment, conditions, or violations of the rights of any other resident, regardless of the consent of the victim of the alleged improper treatment, condition, or violation of rights by the facility or its staff. (b) Each facility shall designate one full-time staff member, referred to in this subsection (3) as the "designee", to receive all grievances when they are first made. (c) Each facility shall establish a grievance committee consisting of the chief administrator of the facility or his designee, a resident selected by the resident population of the facility, and a third person to be agreed upon by the administrator and the resident representative. (d) If anyone designated in paragraph (a) of this subsection (3) wishes to complain about treatment, conditions, or violations of rights, he shall write or cause to be written his grievance or shall state it orally to the designee no later than fourteen days after the occurrence giving rise to the grievance. The designee shall confer with persons involved in the occurrence and with any other witnesses and, no later than three days after the grievance, give a written explanation of findings and proposed remedies, if any, to the complainant and to the aggrieved party, if someone other than the complainant. Where appropriate because of the mental or physical condition of the complainant or the aggrieved party, the written explanation shall be accompanied by an oral explanation. (e) If the complainant or aggrieved party is dissatisfied with the findings and remedies or the implementation thereof, he may then make the same grievance orally or in writing, with any additional comments or information, to the grievance committee no later than ten days after the receipt of the explanation from the designee. Said committee shall confer with persons involved in the occurrence and with any other witnesses and, no later than ten days after the appeal from the designee, give a written explanation of its findings and proposed remedies, if any, to the complainant and to the aggrieved party, if someone other than the complainant. Where appropriate because of the mental or physical condition of the complainant or the aggrieved party, the written explanation shall be accompanied by an oral explanation. (4) Each skilled nursing facility or intermediate care facility shall also establish a residents' advisory council which shall consist of not less than five members selected by and from the resident population of the facility. The council shall meet at least once a month with the administrator of the facility and a representative of the staff to make recommendations concerning policies of the facility. The council may also present grievances to the grievance committee on behalf of a resident. advisory council which shall consist of not less than five members selected by and from the resident population of the facility. The council shall meet at least once a month with the administrator of the facility and a representative of the staff to make recommendations concerning policies of the facility. The council may also present grievances to the grievance committee on behalf of a resident. (5) If a complainant or aggrieved party is dissatisfied with the findings and remedies of the grievance committee or implementation thereof, except for grievances against a physician or his prescribed treatment, he may file the same grievance in writing with the executive director of the department. The department shall investigate the facts and circumstances of the grievance and make findings of fact, conclusions, and recommendations, copies of which shall be transmitted to the complainant and the nursing home administrator. If the complainant or the nursing home administrator is aggrieved by the findings and the recommendations of the department, the aggrieved party may request a hearing to be conducted by the department pursuant to section 24-4-105, C.R.S. The board shall adopt rules and regulations to carry out the intent of this section. (6) Implementation of this section shall be pursuant to section 25.5-6-204, C.R.S. (7) Nothing in this section shall apply to any nursing institution conducted by or for the adherents of any well-recognized church or religious denomination for the purpose of providing facilities for the care and treatment of the sick who depend exclusively upon spiritual means through prayer for healing in the practice of the religion of such church or denomination. (8) (a) A patient who is eligible to receive medicaid benefits pursuant to articles 4, 5, and 6 of title 25.5, C.R.S., and who qualifies for nursing facility care shall have the right to select any nursing care facility recommended for certification by the department of public health and environment under Title XIX of the federal "Social Security Act", as amended, as a provider of medicaid services and licensed by the department pursuant to article 3 of this title where space is available, and the department of health care policy and financing shall reimburse the selected facility for services pursuant to section 25.5-6-204, C.R.S., unless such nursing care facility shall have been notified by the department of health care policy and financing that it may not qualify as a provider of medicaid services. (b) A patient who is residing in such nursing care facility shall be assured the resident rights which are provided by section 4211 of Title IV of the federal "Omnibus Budget Reconciliation Act of 1987", as amended, Pub.L. 100-203. Failure to protect and promote those rights shall subject the violating facility to sanctions imposed by the department. (9) A patient who is eligible to receive benefits from a skilled or intermediate nursing care facility certified by the department under Title XVIII of the federal "Social Security Act", as amended, as a provider of medicare services shall be assured the same rights as provided in paragraph (a) of subsection (8) of this section.

C.R.S. § 25-1-121 Patient grievance mechanism - institution's obligations to patient

25-1-121. Patient grievance mechanism - institution's obligations to patient. (1) As used in this section, "institution" means every hospital or related facility or institution having in excess of fifty beds and required to be licensed under part 1 of article 3 of this title or required to be certified pursuant to section 25-1.5-103 (1)(a)(II), except skilled nursing facilities and intermediate care facilities which are subject to the provisions of section 25-1-120. (2) The department shall require every institution to submit to the department a plan for a patient grievance mechanism and a policy statement with respect to the obligations of the institution to patients using the facilities of such institution. The plan and policy statement must meet with the approval of the department prior to certification of compliance or issuance or renewal of a license. (3) A patient grievance mechanism plan shall include, but not be limited to: (a) A provision for a patient representative to serve as a liaison between the patient and the institution; (b) A description of the qualifications of the patient representative; (c) An outline of the job description of the patient representative; (d) A description of the amount of decision-making authority given to the patient representative; (e) A method by which each patient will be made aware of the patient representative program and how the representative of the program may be contacted. (4) The policy statement with respect to the obligations of the institution to patients using facilities of such an institution shall be posted conspicuously in a public place on its premises and made available to each patient upon admission. Such policy statement shall include, but need not be limited to, a clarification of a physician's duty to provide informed consent, admission procedures, staff identification, privacy, medical records, billing procedures, and the obligation of the physician to provide information regarding research, experimental, or educational projects relating to the patient's own case. Nothing in this section shall apply to any nursing institution conducted by or for the adherents of any well-recognized church or religious denomination for the purpose of providing facilities for the care and treatment of the sick who depend exclusively upon spiritual means through prayer for healing in the practice of the religion of such church or denomination.

C.R.S. § 25-1-122 Named reporting of certain diseases and conditions - access to medical records - confidentiality of reports and records

25-1-122. Named reporting of certain diseases and conditions - access to medical records - confidentiality of reports and records. (1) With respect to investigations of epidemic and communicable diseases, morbidity and mortality, cancer in connection with the statewide cancer registry, environmental and chronic diseases, sexually transmitted infections, tuberculosis, and rabies and mammal bites, the board has the authority to require reporting, without patient consent, of occurrences of those diseases and conditions by any person having knowledge of such to the state department of public health and environment and county, district, and municipal public health agencies, within their respective jurisdictions. Any required reports must contain the name, address, age, sex, and diagnosis and other relevant information as the board determines is necessary to protect the public health. The board shall set the manner, time period, and form in which the reports are to be made. The board may limit reporting for a specific disease or condition to a particular region or community or for a limited period of time. (2) When investigating diseases and conditions pursuant to subsection (1) of this section, authorized personnel of the state department of public health and environment and county, district, and municipal public health agencies, within their respective jurisdictions, may, without patient consent, inspect, have access to, and obtain information from pertinent patient medical, coroner, and laboratory records in the custody of all medical practitioners, veterinarians, coroners, institutions, hospitals, agencies, laboratories, and clinics, whether public or private, which are relevant and necessary to the investigation. Review and inspection of records shall be conducted at reasonable times and with such notice as is reasonable under the circumstances. Under no circumstances may personnel of the state department of public health and environment or county, district, or municipal public health agencies, within their local jurisdictions, have access pursuant to this section to any medical record that is not pertinent, relevant, or necessary to the public health investigation. (3) Any report or disclosure made in good faith pursuant to subsection (1) or (2) of this section shall not constitute libel or slander or a violation of any right of privacy or privileged communication. (4) Reports and records resulting from the investigation of epidemic and communicable diseases, environmental and chronic diseases, reports of morbidity and mortality, reports of cancer in connection with the statewide cancer registry, and reports and records resulting from the investigation of sexually transmitted infections, tuberculosis, and rabies and mammal bites held by the state department of public health and environment or county, district, or municipal public health agencies shall be strictly confidential. Such reports and records shall not be released, shared with any agency or institution, or made public, upon subpoena, search warrant, discovery proceedings, or otherwise, except under any of the following circumstances: (a) Release may be made of medical and epidemiological information in a manner such that no individual person can be identified. (b) Release may be made of medical and epidemiological information to the extent necessary for the treatment, control, investigation, and prevention of diseases and conditions dangerous to the public health; except that every effort shall be made to limit disclosure of personal identifying information to the minimal amount necessary to accomplish the public health purpose. (c) Release may be made to the person who is the subject of a medical record or report with written authorization from such person. , control, investigation, and prevention of diseases and conditions dangerous to the public health; except that every effort shall be made to limit disclosure of personal identifying information to the minimal amount necessary to accomplish the public health purpose. (c) Release may be made to the person who is the subject of a medical record or report with written authorization from such person. (d) An officer or employee of the county, district, or municipal public health agency or the state department of public health and environment may make a report of child abuse to agencies responsible for receiving or investigating reports of child abuse or neglect in accordance with the applicable provisions of the "Child Protection Act of 1987" set forth in part 3 of article 3 of title 19, C.R.S. However, in the event a report is made by the state department of public health and environment, only the following information shall be included in the report: (I) The name, address, and sex of the child; (II) The name and address of the person responsible for the child; (III) The name and address of the person who is alleged to be responsible for the suspected abuse or neglect, if known; and (IV) The general nature of the child's injury. (e) Medical and epidemiological information may be released to a peace officer as described in section 16-2.5-101, C.R.S., the federal bureau of investigation, a federal law enforcement agency as designated by the United States attorney for the district of Colorado, or any prosecutor to the extent necessary for any investigation or prosecution related to bioterrorism; except that reasonable efforts shall be made to limit disclosure of personal identifying information to the minimal amount necessary to accomplish the law enforcement purpose. For purposes of this paragraph (e), "bioterrorism" means the intentional use of, attempted use of, conspiracy to use, or solicitation to use microorganisms or toxins of biological origin or chemical or radiological agents to cause death or disease among humans or animals. (5) No officer or employee or agent of the state department of public health and environment or county, district, or municipal public health agency shall be examined in any judicial, executive, legislative, or other proceeding as to the existence or content of any individual's report obtained by such department pursuant to subsection (1) or (2) of this section without that individual's consent. However, this provision shall not apply to individuals who are under isolation or quarantine, school exclusion, or other restrictive action taken pursuant to section 25-1.5-102 (1)(c) or part 4, 5, 6, or 9 of article 4 of this title. (6) Any officer or employee or agent of the state department of public health and environment or a county, district, or municipal public health agency who violates this section by releasing or making public confidential public health reports or records or by otherwise breaching the confidentiality requirements of subsection (4) or (5) of this section commits a class 2 misdemeanor and, upon conviction thereof, shall be punished as provided in section 18-1.3-501 (1). (7) Nothing in subsections (4) to (6) of this section applies to records and reports held by the state or local department of health pursuant to part 4 of article 4 of this title. (8) Pursuant to section 25-1-113, any person may seek judicial review of a decision of the board or of the department affecting such person under this section. (9) Notwithstanding any other provision of law to the contrary, the department shall administer the provisions of this section regardless of an individual's race, religion, gender, ethnicity, national origin, or immigration status.

C.R.S. § 25-1-122.5 Confidentiality of genetic testing records - "Uniform Parentage Act"

25-1-122.5. Confidentiality of genetic testing records - "Uniform Parentage Act". Notwithstanding any other law concerning public records, any records or information concerning the genetic testing of a person for purposes of the determination of parentage pursuant to article 4 of title 19, C.R.S., shall be confidential and shall not be disclosed except as otherwise provided in section 19-1-308, C.R.S.

C.R.S. § 25-1-123 Restructure of health and human services - development of plan - participation of department required

25-1-123. Restructure of health and human services - development of plan - participation of department required. The department, in cooperation with the department of health care policy and financing and the department of human services, shall develop a plan for the restructuring of the health and human services delivery system in the state in accordance with article 1.7 of title 24, C.R.S.

C.R.S. § 25-1-124 Health-care facilities - consumer information - reporting - release

25-1-124. Health-care facilities - consumer information - reporting - release. (1) The general assembly hereby finds that an increasing number of people are faced with the difficult task of choosing a health-care facility for themselves and their family members. This task may be made less difficult by improved access to reliable, helpful, and unbiased information concerning the quality of care and the safety of the environment offered by each health-care facility. The general assembly further finds that it is appropriate that the department, in keeping with its role of protecting and improving the public health, solicit this information from health-care facilities and disseminate it to the public in a form that will assist people in making informed choices among health-care facilities. (2) Each health-care facility licensed pursuant to section 25-3-101 or certified pursuant to section 25-1.5-103 (1)(a)(II) shall report to the department all of the following occurrences: (a) Any occurrence that results in the death of a patient or resident of the facility and is required to be reported to the coroner pursuant to section 30-10-606, C.R.S., as arising from an unexplained cause or under suspicious circumstances; (b) Any occurrence that results in any of the following serious injuries to a patient or resident: (I) Brain or spinal cord injuries; (II) Life-threatening complications of anesthesia or life-threatening transfusion errors or reactions; (III) Second- or third-degree burns involving twenty percent or more of the body surface area of an adult patient or resident or fifteen percent or more of the body surface area of a child patient or resident; (c) Any time that a resident or patient of the facility cannot be located following a search of the facility, the facility grounds, and the area surrounding the facility and there are circumstances that place the resident's health, safety, or welfare at risk or, regardless of whether such circumstances exist, the patient or resident has been missing for eight hours; (d) Any occurrence involving physical, sexual, or verbal abuse of a patient or resident, as described in section 18-3-202, 18-3-203, 18-3-204, 18-3-206, 18-3-402, 18-3-403, as it existed prior to July 1, 2000, 18-3-404, or 18-3-405, C.R.S., by another patient or resident, an employee of the facility, or a visitor to the facility; (e) Any occurrence involving caretaker neglect of a patient or resident, as described in section 26-3.1-101 (2.3), C.R.S.; (f) Any occurrence involving misappropriation of a patient's or resident's property. For purposes of this paragraph (f), "misappropriation of a patient's or resident's property" means a pattern of or deliberately misplacing, exploiting, or wrongfully using, either temporarily or permanently, a patient's or resident's belongings or money without the patient's or resident's consent. (g) Any occurrence in which drugs intended for use by patients or residents are diverted to use by other persons. If the diverted drugs are injectable, the health-care facility shall also report the full name and date of birth of any individual who diverted the injectable drugs, if known. ly or permanently, a patient's or resident's belongings or money without the patient's or resident's consent. (g) Any occurrence in which drugs intended for use by patients or residents are diverted to use by other persons. If the diverted drugs are injectable, the health-care facility shall also report the full name and date of birth of any individual who diverted the injectable drugs, if known. (h) Any occurrence involving the malfunction or intentional or accidental misuse of patient or resident care equipment that occurs during treatment or diagnosis of a patient or resident and that significantly adversely affects or if not averted would have significantly adversely affected a patient or resident of the facility. (2.5) (a) In addition to the reports required by subsection (2) of this section, if the Colorado attorney general, the department of health care policy and financing, a case management agency, as defined in section 25.5-6-1702, an adult protection service, or a law enforcement agency makes a report of an occurrence as described in subsection (2) of this section involving a licensed long-term care facility, that report must be provided to the department and made available for inspection consistent with the provisions of subsection (6) of this section. Any reports concerning an adult protection service must be in compliance with the confidentiality requirements of section 26-3.1-102 (7). (b) For purposes of this subsection (2.5), a "licensed long-term care facility" means a licensed community residential or group home, a licensed intermediate care facility for individuals with intellectual disabilities, and a licensed facility for persons with developmental disabilities. (3) The board by rule shall specify the manner, time period, and form in which the reports required pursuant to subsection (2) of this section shall be made. (4) Any report submitted pursuant to subsection (2) of this section shall be strictly confidential; except that information in any such report may be transmitted to an appropriate regulatory agency having jurisdiction for disciplinary or license sanctions. The information in such reports shall not be made public upon subpoena, search warrant, discovery proceedings, or otherwise, except as provided in subsection (6) of this section. (5) The department shall investigate each report submitted pursuant to subsection (2) of this section that it determines was appropriately submitted. For each report investigated, the department shall prepare a summary of its findings, including the department's conclusions and whether there was a violation of licensing standards or a deficiency or whether the facility acted appropriately in response to the occurrence. If the investigation is not conducted on site, the department shall specify in the summary how the investigation was conducted. Any investigation conducted pursuant to this subsection (5) shall be in addition to and not in lieu of any inspection required to be conducted pursuant to section 25-1.5-103 (1)(a) with regard to licensing. (6) (a) The department shall make the following information available to the public: (I) Any investigation summaries prepared pursuant to subsection (5) of this section; (II) Any complaints against a health-care facility that have been filed with the department and that the department has investigated, including the conclusions reached by the department and whether there was a violation of licensing standards or a deficiency or whether the facility acted appropriately in response to the subject of the complaint; and (III) A listing of any deficiency citations issued against each health-care facility. are facility that have been filed with the department and that the department has investigated, including the conclusions reached by the department and whether there was a violation of licensing standards or a deficiency or whether the facility acted appropriately in response to the subject of the complaint; and (III) A listing of any deficiency citations issued against each health-care facility. (b) The information released pursuant to this subsection (6) shall not identify the patient or resident or the health-care professional involved in the report. (7) Prior to the completion of an investigation pursuant to this section, the department may respond to any inquiry regarding a report received pursuant to subsection (2) of this section by confirming that it has received such report and that an investigation is pending. (8) In addition to the report to the department for an occurrence described in paragraph (d) of subsection (2) of this section, the occurrence shall be reported to a law enforcement agency.

C.R.S. § 25-1-124.5 Nursing care facilities - employees - record check - adult protective services data system check - definition

25-1-124.5. Nursing care facilities - employees - record check - adult protective services data system check - definition. (1) On and after September 1, 1996, prior to employing any person, a nursing care facility or the person seeking employment at a nursing care facility shall make an inquiry to the director of the Colorado bureau of investigation or to private criminal background check companies authorized to do business in the state of Colorado to ascertain whether the person has a criminal history, including arrest and conviction records. The Colorado bureau of investigation or private criminal background check companies are authorized to utilize fingerprints to ascertain from the federal bureau of investigation whether the person has a criminal history record. When the results of a fingerprint-based criminal history record check of an applicant performed pursuant to this section reveal a record of arrest without a disposition, the nursing care facility shall require that applicant to submit to a name-based judicial record check, as defined in section 22-2-119.3 (6)(d). The nursing care facility or the person seeking employment in a nursing care facility shall pay the costs of an inquiry or a name-based judicial record check performed pursuant to this section. The record check must be conducted not more than ninety days prior to the employment of the applicant. For purposes of this section, criminal background check companies must be approved by the state board of nursing. In approving the companies, approval must be based upon the provision of lawfully available, accurate, and thorough information pertaining to criminal histories, including arrest and conviction records. (2) As used in this section, "nursing care facility" includes: (a) A nursing facility as defined in section 25.5-4-103 (14), C.R.S.; (b) An intermediate nursing facility for persons with intellectual and developmental disabilities as defined in section 25.5-4-103 (9); (c) An adult day care facility as defined in section 25.5-6-303 (1), C.R.S.; (d) An alternative care facility as defined in section 25.5-6-303 (3), C.R.S.; (e) Any business that provides temporary nursing care services or that provides personnel who provide such services. (3) In addition to the background check required pursuant to this section, on and after January 1, 2024, prior to employment, a nursing care facility shall submit the name of a person who will be providing direct care, as defined in section 26-3.1-101 (3.5), to an at-risk adult, as defined in section 26-3.1-101 (1.5), and the name of a person who will be serving as a nursing home administrator, as defined in section 12-265-103 (2), as well as any other required identifying information, to the department of human services for a check of the Colorado adult protective services data system pursuant to section 26-3.1-111, to determine if the person is substantiated in a case of mistreatment of an at-risk adult.

C.R.S. § 25-1-124.7 Health facilities - employees - adult protective services data system check

25-1-124.7. Health facilities - employees - adult protective services data system check. On and after January 1, 2019, prior to employment, a health facility licensed pursuant to section 25-1.5-103 (1)(a)(I)(A), including health facilities wholly owned and operated by any governmental unit or agency, shall submit the name of a person who will be providing direct care, as defined in section 26-3.1-101 (3.5), to an at-risk adult, as defined in section 26-3.1-101 (1.5), as well as any other required identifying information, to the department of human services for a check of the Colorado adult protective services data system pursuant to section 26-3.1-111, to determine if the person is substantiated in a case of mistreatment of an at-risk adult.

C.R.S. § 25-1-125 Applications for licenses - authority to suspend licenses - rules

25-1-125. Applications for licenses - authority to suspend licenses - rules. (1) Every application by an individual for a license issued by the department or any authorized agent of the department shall require the applicant's name, address, and social security number. (2) The department or any authorized agent of the department shall deny, suspend, or revoke any license pursuant to the provisions of section 26-13-126, C.R.S., and any rules promulgated in furtherance thereof, if the department or agent thereof receives a notice to deny, suspend, or revoke from the state child support enforcement agency because the licensee or applicant is out of compliance with a court or administrative order for current child support, child support debt, retroactive child support, child support arrearages, or child support when combined with maintenance or because the licensee or applicant has failed to comply with a properly issued subpoena or warrant relating to a paternity or child support proceeding. Any such denial, suspension, or revocation shall be in accordance with the procedures specified by rule of the department, rules promulgated by the state board of human services, and any memorandum of understanding entered into between the department or an authorized agent thereof and the state child support enforcement agency for the implementation of this section and section 26-13-126, C.R.S. (3) (a) The department shall enter into a memorandum of understanding with the state child support enforcement agency, which memorandum shall identify the relative responsibilities of the department and the state child support enforcement agency in the department of human services with respect to the implementation of this section and section 26-13-126, C.R.S. (b) The appropriate rule-making body of the department is authorized to promulgate rules to implement the provisions of this section. (4) For purposes of this section, "license" means any recognition, authority, or permission that the department or any authorized agent of the department is authorized by law to issue for an individual to practice a profession or occupation or for an individual to participate in any recreational activity. "License" may include, but is not necessarily limited to, any license, certificate, certification, letter of authorization, or registration issued for an individual to practice a profession or occupation or for an individual to participate in any recreational activity.

C.R.S. § 25-1-126 County practitioner rural recruitment grant program - creation - legislative declaration - administration - report - definitions - repeal

25-1-126. County practitioner rural recruitment grant program - creation - legislative declaration - administration - report - definitions - repeal. (Repealed)

C.R.S. § 25-1-127 Medical equipment for rural communities grant program - creation - legislative declaration - administration - report - repeal

25-1-127. Medical equipment for rural communities grant program - creation - legislative declaration - administration - report - repeal. (Repealed)

C.R.S. § 25-1-128 Designation of caregiver - notice - instructions - definitions - rules

25-1-128. Designation of caregiver - notice - instructions - definitions - rules. (1) As used in this section: (a) "Aftercare" means assistance provided by a caregiver to a patient in the patient's residence after the patient's discharge from a hospital, following an inpatient hospital stay, and may include: Assisting with basic activities of daily living; assisting with instrumental activities of daily living; and carrying out medical or nursing tasks such as managing wound care, assisting in administering medications, and operating medical equipment. (b) "Caregiver" means a person eighteen years of age or older designated by a patient to provide aftercare to a patient living in his or her residence. (c) "Hospital" means a facility currently licensed or certified by the department as a general hospital pursuant to the department's authority under sections 25-1.5-103 and 25-3-101. (d) "Residence" means the patient's home. "Residence" does not include a rehabilitation facility, hospital, nursing home, assisted living facility, or licensed group home. (2) (a) A hospital shall give each patient or the patient's legal guardian the opportunity to designate at least one caregiver no later than twenty-four hours after the patient's admission to the hospital and prior to the patient's release from the hospital or nonemergency transfer to another facility. (b) If a patient is unconscious or incapacitated upon his or her admission to the hospital, the hospital shall give the patient or the patient's legal guardian the opportunity to designate a caregiver as soon as practicable after the patient's recovery of consciousness or capacity. (c) A patient or patient's legal guardian is not obligated to designate a caregiver at any time. (d) If the patient or the patient's legal guardian declines to designate a caregiver, the hospital shall document this in the patient's medical record. (3) (a) If the patient or the patient's legal guardian designates a caregiver, the hospital shall request consent from the patient or the patient's legal guardian to release medical information to the caregiver. (b) The hospital shall record the designation of the caregiver, the relationship of the caregiver to the patient, and the name, telephone number, and address of the caregiver in the patient's medical record. (c) A patient or the patient's legal guardian may change the caregiver designation at any time. The hospital shall record the change in the patient's medical record within twenty-four hours of the change. (d) This section does not obligate a person designated as a caregiver to perform aftercare tasks for a patient. (4) If a patient or the patient's legal guardian designates a caregiver, the hospital shall notify the patient's caregiver of the patient's discharge or transfer to another facility as soon as practicable, which may be after the patient's physician issues a discharge order. If the hospital is unable to contact the caregiver, the lack of contact shall not interfere with, delay, or otherwise affect the medical care provided to the patient or the appropriate discharge of the patient. The hospital shall promptly document the attempt in the patient's medical record. (5) (a) As soon as possible and prior to the patient's release from the hospital, the hospital shall consult with the patient or the patient's legal guardian and the caregiver and issue a discharge plan that describes the patient's aftercare needs. The discharge plan must include: (I) The name and contact information of the caregiver, as provided by the caregiver; (II) A description of the aftercare tasks necessary to maintain the patient's ability to reside in his or her residence; and (III) Contact information for any health-care, community resources, and long-term services and support necessary to successfully carry out a patient's discharge plan. e plan must include: (I) The name and contact information of the caregiver, as provided by the caregiver; (II) A description of the aftercare tasks necessary to maintain the patient's ability to reside in his or her residence; and (III) Contact information for any health-care, community resources, and long-term services and support necessary to successfully carry out a patient's discharge plan. (b) The hospital shall provide the caregiver with instructions concerning all aftercare tasks described in the discharge plan. The instructions shall include: (I) A live demonstration of the aftercare tasks performed by a hospital employee or other authorized individual and provided in a culturally competent manner and in accordance with the hospital's requirements to provide language access services; (II) An opportunity for the caregiver and the patient or the patient's legal guardian to ask questions about the aftercare tasks; and (III) Answers to the caregiver's, patient's, and patient's legal guardian's questions in a culturally competent manner and in accordance with the hospital's requirements to provide language access services. (c) The hospital shall document the instructions required in this subsection (5) in the patient's medical record, including the date, time, and contents of the instructions, and whether the caregiver accepted or refused the offer of instruction. (6) Nothing in this section: (a) Interferes with the rights of an agent acting under a valid health-care directive; (b) Creates a private right of action against a hospital, a hospital employee, or a person with whom the hospital has a contractual relationship; (c) Creates additional civil or regulatory liability for a hospital or hospital employee; (d) Supersedes or replaces existing rights or remedies under any other law; or (e) Affects a license issued to a hospital pursuant to section 25-3-102. (7) The board of health may promulgate rules to ensure compliance with this section.

C.R.S. § 25-1-129 Prescription drug monitoring program integration methods - health care provider report cards - report - repeal

25-1-129. Prescription drug monitoring program integration methods - health care provider report cards - report - repeal. (Repealed)

C.R.S. § 25-1-130 Standing order - post-exposure prophylaxis - definition

25-1-130. Standing order - post-exposure prophylaxis - definition. (1) On or before August 1, 2020, and until a statewide drug therapy protocol is implemented pursuant to section 12-280-125.7, the department shall implement and maintain a standing order for post-exposure prophylaxis so that pharmacists may prescribe and dispense post-exposure prophylaxis pursuant to section 12-280-125.7. (2) As used in this section, "post-exposure prophylaxis" has the same meaning as set forth in section 12-280-125.7.

C.R.S. § 25-1-131 Firearms safe storage education campaign

25-1-131. Firearms safe storage education campaign. (1) (a) The office of suicide prevention within the department shall include on a public page of the department's website information about the following: (I) [Editor's note: This version of subsection (1)(a)(I) is effective until January 1, 2025.] The unlawful storage of a firearm offense described in section 18-12-114.5; (I) [Editor's note: This version of subsection (1)(a)(I) is effective January 1, 2025.] The unlawful storage of a firearm offense described in section 18-12-114 and the unlawful storage of a firearm in a vehicle offense described in section 18-12-114.5; (II) The penalties for an offense related to providing a handgun to a juvenile or allowing a juvenile to possess a firearm in violation of section 18-12-108.7; and (III) The requirement that a licensed gun dealer provide a locking device with each firearm transferred, as described in section 18-12-405 (1). (b) Any information described in subsection (1)(a) of this section posted on the department's website must be in both English and Spanish. (c) The office of suicide prevention shall include references to the offenses listed in subsection (1)(a) of this section and direction to the department's website for more information about those offenses in materials provided to the following: (I) Licensed gun dealers, shooting ranges, and safety instructors; and (II) Health-care providers, including facilities licensed or certified by the department pursuant to section 25-1.5-103. (2) [Editor's note: This version of subsection (2) is effective until January 1, 2025.] The department shall develop a notice intended to be displayed on the premises of a licensed gun dealer, and designed to be printed with each letter at a minimum of one inch in height, that informs firearms purchasers that unlawful storage of a firearm may result in imprisonment or fine. The department shall make electronic copies of the notice publicly available for download from its website without charge. (2) [Editor's note: This version of subsection (2) is effective January 1, 2025.] The department shall develop a notice intended to be displayed on the premises of a licensed gun dealer, and designed to be printed with each letter at a minimum of one inch in height, that informs firearms purchasers that unlawful storage of a firearm, including in a vehicle, may result in imprisonment or fine. The department shall make electronic copies of the notice publicly available for download from its website without charge. (3) (a) Subject to available money, including appropriations or gifts, grants, or donations received pursuant to subsection (4) of this section, the department shall develop and implement a firearms safe storage education campaign, referred to in this section as the "education campaign", to educate firearms owners, firearms purchasers, licensed gun dealers, shooting ranges, and safety instructors about safe storage of firearms and state requirements related to firearms safety and storage. The department shall consult with the division of criminal justice in the department of public safety in developing and implementing the education campaign. (b) As part of the education campaign, the department may: (I) Develop and provide materials to local law enforcement agencies to assist those agencies with educating the public about safe storage of firearms and state requirements related to firearms safety and storage; (II) Develop and provide materials to health-care providers to assist providers with educating the public about safe storage of firearms and state requirements related to firearms safety and storage; and (III) Provide information about programs that assist firearms owners with the cost of purchasing firearms locking devices, gun safes, or other secure firearms storage containers, including programs that provide free or reduced-price locking devices. iders to assist providers with educating the public about safe storage of firearms and state requirements related to firearms safety and storage; and (III) Provide information about programs that assist firearms owners with the cost of purchasing firearms locking devices, gun safes, or other secure firearms storage containers, including programs that provide free or reduced-price locking devices. (c) (I) As part of the education campaign, the department shall provide information on its website about community programs that allow firearms owners to voluntarily and temporarily store a firearm at a secure location outside of the home, including a firearms retailer, gun range, or law enforcement agency. (II) The department may provide assistance to any local entity that facilitates a program described in this subsection (3)(c). (d) In furtherance of the goals of the education campaign, the department may use television messaging, radio broadcasts, print media, digital strategies, or any other form of messaging deemed appropriate by the department. (4) The department may seek, accept, and expend gifts, grants, or donations, including in-kind donations, from private or public sources for the purposes of this section. (5) In fiscal years 2020-21, 2021-22, and 2022-23, the general assembly shall not appropriate money from the general fund for the purposes of this section. Notwithstanding any provision of section 24-75-1305, in fiscal year 2023-24 and any subsequent fiscal year, the general assembly may appropriate money from the general fund for the purposes of this section.

C.R.S. § 25-1-132 Two-year appropriation to the department - repeal

25-1-132. Two-year appropriation to the department - repeal. (1) For the 2022-23 and 2023-24 state fiscal years, the general assembly shall annually appropriate ten million dollars per fiscal year from the general fund to the department, for distribution to local public health agencies. (2) For the 2022-23 and 2023-24 state fiscal years, the general assembly shall annually appropriate eleven million ninety thousand one hundred forty-nine dollars per fiscal year from the general fund to the department, for use by the division of disease control and public health response for administration and support. (3) This section is repealed, effective July 1, 2025.

C.R.S. § 25-1-133 Environmental equity and cumulative impact analyses - selection of contractor - required components of analyses - selection of locations - requirements for contractors - definitions - report

25-1-133. Environmental equity and cumulative impact analyses - selection of contractor - required components of analyses - selection of locations - requirements for contractors - definitions - report. (1) As used in this section, unless the context otherwise requires: (a) "Colorado EnviroScreen tool" has the meaning set forth in section 24-4-109 (5)(a)(II). (b) "Contractor" means an academic institution or other party with which the department contracts to develop an EECIA. (c) "Disproportionately impacted community" has the meaning set forth in section 24-4-109 (2)(b)(II). (d) "Environmental equity and cumulative impact analysis" or "EECIA" means a cumulative impact analysis for a specific geographic area of the state developed in accordance with this section. (e) "EPA's cumulative impact analysis recommendations" means the federal environmental protection agency's "Cumulative Impacts Research: Recommendations for EPA's Office of Research and Development", published on September 30, 2022. (f) "Final report of the task force" means the "Final Report of Recommendations" published by the task force on November 14, 2022. (g) "Local government" means a home rule or statutory city, town, city and county, or county. (h) "Office of environmental justice" or "office" means the office of environmental justice created in section 25-1-133.5 (1)(a). (i) "Task force" means the environmental justice action task force created by the general assembly in 2021 through the enactment of House Bill 21-1266. (2) The department shall select one or more contractors to develop two or more environmental equity and cumulative impact analyses for the state. Each EECIA: (a) Must cover a geographic area of the state that includes a group of mostly contiguous census block groups and other surrounding areas that meet the definition of disproportionately impacted communities; (b) May be conducted for a community located on the Ute Mountain Ute or Southern Ute Indian reservation only if requested by the governing body of the affected tribe and following consultation with and approval by the governing body; (c) Once developed, may be used by any state agency for the purpose of analyzing cumulative impacts; (d) Must perform a scientifically rigorous analysis that includes most of the components recommended in the final report of the task force, as reflected on pages thirteen through fifteen of the final report of the task force; (e) Should identify key problems and indicators of cumulative impacts and how those problems and indicators can be avoided, minimized, and mitigated, but should not recommend solutions to individual agencies; and (f) Should empower agencies and local governments to score, evaluate, or compare alternative mitigation options proposed for future projects to ensure that the future projects are effective while considering potential unintended consequences. (3) (a) The office of environmental justice shall select locations for the environmental equity and cumulative impact analyses and oversee the department's selection of a contractor pursuant to subsection (2) of this section. or compare alternative mitigation options proposed for future projects to ensure that the future projects are effective while considering potential unintended consequences. (3) (a) The office of environmental justice shall select locations for the environmental equity and cumulative impact analyses and oversee the department's selection of a contractor pursuant to subsection (2) of this section. (b) By a deadline determined by the office and posted conspicuously on the department's website, a local government, a group of local governments, an elected official, the governing body of an affected tribe for any request within the boundaries of the Ute Mountain Ute or Southern Ute Indian reservation, a nonprofit organization, or any other interested person may submit a formal written request to the office to select a location for an EECIA. In selecting the locations for the EECIAs, the office shall: (I) Prioritize locations that: (A) Are most impacted by environmental contaminants; (B) Have the potential for widespread human exposure to the environmental contaminants; and (C) Include a greater proportion of individuals with heightened vulnerability to the environmental contaminants; (II) Use the Colorado EnviroScreen tool to help prioritize locations with disproportionate environmental health burdens; and (III) Seek input from various groups of interested stakeholders in the selection process. (c) In selecting the contractor for an EECIA location selected pursuant to subsection (3)(b) of this section, the office shall: (I) Be transparent with regard to any selection criteria used in the selection process; (II) Engage stakeholders for feedback on how to design the selection process; and (III) For an EECIA studying any lands within the boundaries of the Ute Mountain Ute or Southern Ute Indian reservation, consult with the governing body of the affected tribe and select a contractor only with the governing body's consent. (4) (a) In developing the environmental equity and cumulative impact analyses, a contractor selected pursuant to subsection (2) of this section shall, with input from interested stakeholders, set timelines and milestones for completion of an EECIA and submit the proposed timelines and milestones to the office for review and approval. (b) The office shall post in a conspicuous location on the department's public-facing website the approved timelines and milestones for each contractor to complete an EECIA and periodically post updates on whether each contractor has met the timelines and milestones. (5) A contractor selected pursuant to subsection (3)(c) of this section shall: (a) With oversight from the office, review existing cumulative impact analysis frameworks such as the EPA's cumulative impact analysis recommendations or frameworks from other states or jurisdictions; (b) Establish a process for interested stakeholders to submit input regarding an EECIA and for the contractor to review any input submitted; (c) Extensively engage interested stakeholders and the office throughout the EECIA development process; and (d) Ensure that an EECIA is crafted to be comprehensible, easy to utilize, and accessible. As used in this subsection (5)(d), "accessible" includes ensuring that the data supporting an EECIA is transparent, translated from English into the two most prevalent other languages spoken in the relevant community, and made readily available to communities. (6) (a) Except as provided in subsection (6)(b) of this section, the department may solicit, accept, and expend gifts, grants, or donations from private or public sources to help finance the development of environmental equity and cumulative impact analyses pursuant to this section. the two most prevalent other languages spoken in the relevant community, and made readily available to communities. (6) (a) Except as provided in subsection (6)(b) of this section, the department may solicit, accept, and expend gifts, grants, or donations from private or public sources to help finance the development of environmental equity and cumulative impact analyses pursuant to this section. (b) The department shall not accept gifts, grants, or donations from industry interests. As used in this subsection (6)(b), "industry interest" means an entity that currently holds or that applied to receive a permit or license from the division of administration or the hazardous materials and waste management division. (7) (a) Within nine months after completing the first EECIA, the department shall prepare a report regarding the EECIA and submit the report to the house of representatives energy and environment committee and the senate transportation and energy committee, or their successor committees. (b) The report must include: (I) Recommendations for implementing the findings of the EECIA; and (II) Identification of any resources or steps necessary for the department or other agencies to implement the findings of the EECIA once the EECIA is developed. (c) In preparing the report, the department shall consult with: (I) The Colorado energy office created in section 24-38.5-101 (1); (II) The department of natural resources created in section 24-1-124 (1); (III) The department of agriculture created in section 35-1-103; (IV) The public utilities commission created in section 40-2-101 (1)(a); (V) The department of transportation created in section 24-1-128.7 (1); and (VI) Representatives of disproportionately impacted communities.

C.R.S. § 25-1-133.5 Office of environmental justice - created - powers and duties - definitions

25-1-133.5. Office of environmental justice - created - powers and duties - definitions. (1) (a) There is created in the department the office of environmental justice, the head of which is the director of the office, who shall be appointed by the executive director of the department and may employ staff as necessary to carry out the powers and duties of the office. The office is a type 2 entity, as defined in section 24-1-105, and exercises its powers and performs its duties and functions under the department. (b) In carrying out its powers and duties, the office may collaborate with the environmental justice ombudsperson appointed pursuant to section 25-1-134 (1)(b), the environmental justice advisory board created in section 25-1-134 (2)(a), disproportionately impacted communities, local governments, other state agencies, the federal government, and other interested parties. (2) The office shall: (a) Increase state government engagement with and responsiveness to disproportionately impacted communities; (b) Develop and manage the department's environmental justice goals, metrics, and objectives; (c) Work with the environmental divisions within the department, the environmental justice ombudsperson, and the environmental justice advisory board to implement statutory environmental justice mandates, including benchmarks and targets set forth in the "Environmental Justice Act", as enacted in 2021 by House Bill 21-1266; (d) Work with the division of administration to implement part 10 of article 8 of this title 25 concerning mobile home water quality by leading community engagement efforts with mobile home park residents; (e) Coordinate environmental justice work within the department and with other state agencies as well as federal, local, and tribal government partners; (f) Advance the department's language justice goals by providing translation and interpretation services for the department's environmental divisions; and (g) Identify disproportionately impacted communities based on the best-available data and spatial analysis technology, including the Colorado EnviroScreen tool. (3) As used in this section, unless the context otherwise requires: (a) "Colorado EnviroScreen tool" has the meaning set forth in section 24-4-109 (5)(a)(II). (b) "Disproportionately impacted community" has the meaning set forth in section 24-4-109 (2)(b)(II). (c) "Office" means the office of environmental justice created in subsection (1)(a) of this section.

C.R.S. § 25-1-134 Environmental justice - ombudsperson - advisory board - grant program - definitions - repeal

25-1-134. Environmental justice - ombudsperson - advisory board - grant program - definitions - repeal. (1) Environmental justice ombudsperson. (a) There is hereby created in the department the position of an environmental justice ombudsperson. The ombudsperson reports to the executive director of the department. The department shall provide administrative support for the ombudsperson. The ombudsperson otherwise functions independently in exercising its powers. (b) The governor shall appoint the ombudsperson as soon as practicable but no later than February 1, 2022, and as necessary thereafter to fill a vacancy. Prior to an appointment, the governor or the governor's designee shall consult with, and may receive recommendations from, the advisory board, the general assembly, representatives of disproportionately impacted communities, and other relevant stakeholders regarding the selection of the ombudsperson. (c) The ombudsperson must be qualified by training or experience in environmental justice, and should have been a resident of one or more disproportionately impacted communities or have worked to advance environmental justice within disproportionately impacted communities. (d) The ombudsperson shall: (I) Collaborate with the advisory board for the purpose of promoting environmental justice for the people of Colorado; (II) Serve as an advocate for disproportionately impacted communities and as a liaison between disproportionately impacted communities and the department, including with respect to communications regarding the grant program to fund environmental mitigation projects; (III) Work to improve the relationships and interactions between disproportionately impacted communities and the department; (IV) Increase the flow of information between the department and disproportionately impacted communities concerning the environment and departmental programs using methods of outreach that include, at a minimum: (A) Disseminating information through local schools, social media, local social and activity clubs, libraries, or other local services; and (B) Prioritizing in-person meetings in communities with populations that are predominantly Black, Indigenous, Latino, or Asian American that have a median income below the state's average, or that are in rural locations; (V) Identify ways to enable meaningful participation by disproportionately impacted communities in the decision-making processes of the department; (VI) Coordinate with the office of health equity, created in section 25-4-2204; (VII) Maintain a telephone number, website, e-mail address, and mailing address for the receipt of complaints and inquiries for matters pertaining to environmental justice; (VIII) Establish procedures to address complaints pertaining to environmental justice to the extent practicable; (IX) Consult with the division of administration in reporting to the air quality control commission, created in section 25-7-104, on equitable progress toward the state's greenhouse gas reduction goals; (X) Serve in an advisory capacity, as requested, to other state agencies conducting outreach to and engagement of disproportionately impacted communities in light of a proposed agency action; and (XI) Advocate for and liaise with mobile home residents in matters of water quality and work with residents on solutions and funding to improve water quality in accordance with part 10 of article 8 of title 25. (2) Environmental justice advisory board. (a) There is hereby created in the department the environmental justice advisory board. ted communities in light of a proposed agency action; and (XI) Advocate for and liaise with mobile home residents in matters of water quality and work with residents on solutions and funding to improve water quality in accordance with part 10 of article 8 of title 25. (2) Environmental justice advisory board. (a) There is hereby created in the department the environmental justice advisory board. (b) Except as otherwise provided in this subsection (2), the members of the advisory board are appointed by the governor. The governor shall make the initial appointments as soon as practicable, but no later than four months after July 2, 2021. An appointing authority may remove a member of the advisory board for malfeasance in office, failure to regularly attend meetings, or any cause that renders the member unable or unfit to discharge the member's duties. (c) The advisory board consists of the following twelve members who, to the extent practicable, must reside in different geographic areas of the state, reflect the racial and ethnic diversity of the state, and have experience with a range of environmental issues, including air pollution, water contamination, and public health impacts: (I) Four voting members appointed by the governor, who must be or have been residents of a disproportionately impacted community; (II) Three voting members appointed by the governor, one of whom must be from a nongovernmental organization that represents statewide interests to advance racial justice, one of whom must be from a nongovernmental organization that represents statewide interests to advance environmental justice, and one of whom must represent worker interests in disproportionately impacted communities; (III) The executive director of the department, or the executive director's designee, as a nonvoting member; and (IV) Four voting members appointed by the executive director of the department, at least one of whom must be a midwife who is practicing in a freestanding birth center, in a rural area, or as a home birth provider. (d) (I) Except as provided in subsection (2)(d)(II) of this section, each member's term of appointment is four years. Voting members may serve no more than two terms. The governor shall fill any vacancies on the advisory board, including for the remainder of any unexpired term. A member appointed to fill a vacancy may serve the remainder of the unexpired term of the member whose vacancy is being filled, and this remainder counts as one term for that appointee. (II) In order to ensure staggered terms of office, the initial term of two members appointed by the governor pursuant to subsection (2)(c)(I) of this section, as specified by the governor, and two members appointed pursuant to subsection (2)(c)(IV) of this section, as specified by the executive director of the department, is two years. (e) (I) Each voting member of the advisory board appointed pursuant to subsection (2)(c) of this section is entitled to receive a per diem of two hundred dollars for attendance at regularly scheduled meetings of the board during the 2021-22 state fiscal year. For each state fiscal year thereafter, the per diem amount shall be annually adjusted for inflation based on the percentage change in the United States department of labor's bureau of labor statistics consumer price index for Denver-Aurora-Lakewood for all items paid by all urban consumers, or its applicable successor index. Voting members of the board are also entitled to receive reimbursement for actual and necessary expenses incurred while performing official duties. (II) The nonvoting member of the advisory board may not receive a per diem, but may be reimbursed for actual and necessary expenses incurred while performing official duties. or all items paid by all urban consumers, or its applicable successor index. Voting members of the board are also entitled to receive reimbursement for actual and necessary expenses incurred while performing official duties. (II) The nonvoting member of the advisory board may not receive a per diem, but may be reimbursed for actual and necessary expenses incurred while performing official duties. (f) The advisory board shall elect a chair from among its members every year. The advisory board shall meet at least once every quarter. The chair may schedule all such additional meetings as are necessary for the advisory board to complete its duties. (g) The advisory board shall: (I) Serve in an advisory capacity to the ombudsperson in the performance of the duties of the ombudsperson; (II) Hold a portion of advisory board meetings for the ombudsperson to jointly receive stakeholder input into the activities and priorities of the ombudsperson; (III) Develop a public complaint process related to the performance of the ombudsperson; (IV) Develop recommendations to address any other matters relating to adverse environmental effects on disproportionately impacted communities as referred to the advisory board by the governor or the executive director of the department; (V) Develop policies as are necessary for the conduct of its affairs and its meetings, and post all policies on its website, including a conflict of interest policy for its members, which must require the disclosure of any potential financial interest of any member or relative of any member in a proposed environmental mitigation project. A board member who has a personal or financial interest in an environmental mitigation project under consideration shall recuse the board member from any vote on that project. (VI) Advise the department on matters to enable the department to interact with disproportionately impacted communities in the best manner possible; (VII) Support the implementation of a grant program to fund environmental mitigation projects from the community impact cash fund created in section 25-7-129 in accordance with this subsection (2)(g)(VII) by performing the following duties: (A) The advisory board shall develop guidelines for a grant program to fund environmental mitigation projects, with input from the department. The guidelines must include: Procedures for applicants to submit applications to the board, and for selection of environmental mitigation projects to fund; provisions to ensure that the applications are concise, straightforward, objective, inclusive, and accessible to all interested parties; a requirement that the applicant disclose any conflict of interest, such as a personal or financial relationship with any member of the advisory board; and identification of any information necessary to be included in an application to ensure the advisory board can prepare the report required by subsection (2)(g)(VII)(C) of this section. (B) The advisory board shall review each application that it receives and may award grants, subject to appropriations and available funding, to applicants to fund environmental mitigation projects in disproportionately impacted communities. ormation necessary to be included in an application to ensure the advisory board can prepare the report required by subsection (2)(g)(VII)(C) of this section. (B) The advisory board shall review each application that it receives and may award grants, subject to appropriations and available funding, to applicants to fund environmental mitigation projects in disproportionately impacted communities. (C) The advisory board shall compile an annual report that details information about the environmental mitigation projects that are awarded grants, including: Details about the disproportionately impacted community in which the project will take place, including information about pollution levels, health disparities, and demographics; the relationship between the community, the project, and any violations that gave rise to penalties paid into the community impact cash fund created in section 25-7-129; the status of the project, the engagement between the project and the community, and the reaction of the disproportionately impacted community to the project; and other details as the advisory board deems appropriate. The annual report shall be made publicly accessible, including on the advisory board's website. (h) This subsection (2) is repealed, effective September 1, 2027. Before the repeal, the advisory board and its functions are scheduled for review in accordance with section 2-3-1203. (3) Records and meetings. The advisory board and the ombudsperson are subject to all the applicable requirements of the "Colorado Open Records Act", part 2 of article 72 of title 24, and the open meetings law contained in part 4 of article 6 of title 24. (4) Definitions. As used in this section, unless the context otherwise requires: (a) "Advisory board" means the environmental justice advisory board created in subsection (2) of this section. (b) "Environmental mitigation project" means any project that avoids, minimizes, measures, or mitigates adverse environmental impacts in a disproportionately impacted community, including, without limitation, health effects, health disparities, and other environmental impacts or that promotes equitable participation in a rule-making proceeding that may affect a disproportionately impacted community. (c) "Ombudsperson" means the environmental justice ombudsperson appointed pursuant to subsection (1) of this section.

C.R.S. § 25-1-135 Health-care services reserve corps task force - created - powers and duties - report - repeal

25-1-135. Health-care services reserve corps task force - created - powers and duties - report - repeal. (Repealed)

C.R.S. § 25-1-136 Kidney disease prevention and education task force - created - powers and duties - report - selection of chair and vice-chair - sunset review - repeal

25-1-136. Kidney disease prevention and education task force - created - powers and duties - report - selection of chair and vice-chair - sunset review - repeal. (1) The kidney disease prevention and education task force, referred to in this section as the "task force", is hereby created. (2) The task force consists of the following nine voting members: (a) Two members from the general assembly, collectively referred to in this section as the "elected members", as follows: (I) One member of the senate, appointed by the president of the senate; and (II) One member of the house of representatives, appointed by the speaker of the house of representatives. (b) The task force consists of the following other voting members, collectively referred to in this section as the "nonelected members", with four members being appointed by the president of the senate and the speaker of the house of representatives and three members being appointed by the minority leader of the senate and the minority leader of the house of representatives: (I) The executive director of the department or the executive director's designee; (II) One member representing the renal provider community; (III) One member representing a Colorado medical center with a program dedicated to treating kidney disease; (IV) One member representing the nephrologist community; (V) One member from a nonprofit organization focusing on kidney disease; (VI) One member representing the kidney patient community; and (VII) One member from an organization representing the health interests of minority populations. (3) (a) All appointments to the task force shall be made no later than October 1, 2021. The elected members appointed to serve on the task force shall be of different party affiliations. The terms of the elected members terminate on the convening date of the first regular session of the seventy-fourth general assembly. As soon as practicable after such convening date, but no later than the end of the legislative session, the speaker of the house of representatives and the president of the senate shall each appoint or reappoint the elected members. Thereafter, the terms of the elected members expire on the convening date of the first regular session of each general assembly, and all subsequent appointments and reappointments of the elected members must be made as soon as practicable after the convening date, but no later than the end of the legislative session. (b) The terms of the nonelected members are for the duration of the task force. The person making the original appointment or reappointment to the task force shall fill any vacancy by appointment for the remainder of an unexpired term. Members appointed or reappointed serve at the pleasure of the appointing authority and continue to serve until the member's successor is appointed. (4) (a) The elected members shall convene the first meeting of the task force no later than November 1, 2021. At the first meeting, the members shall select a chair and a vice-chair from among the elected members. The elected members shall alternate as chair and vice-chair every year thereafter for the duration of the task force. (b) The task force shall meet at least four times each year and at such other times as it deems necessary. The chair and vice-chair may establish such organizational and procedural rules as are necessary for the operation of the task force. (5) The purposes of the task force are: (a) To work directly with policymakers, public health entities, nonprofit organizations that work with people with disabilities, and educational institutions to create health educational programs concerning kidney disease and to increase awareness of kidney disease throughout the state of Colorado; (b) To examine chronic kidney disease, transplantation, living and deceased kidney donation, kidney disease in children and people with disabilities, and the higher rates of affliction in minority populations; and disabilities, and educational institutions to create health educational programs concerning kidney disease and to increase awareness of kidney disease throughout the state of Colorado; (b) To examine chronic kidney disease, transplantation, living and deceased kidney donation, kidney disease in children and people with disabilities, and the higher rates of affliction in minority populations; and (c) To develop a sustainable plan to raise awareness about early detection of kidney disease, to promote health equity and transplantation, and to reduce the burden of kidney disease, throughout the state of Colorado, which shall include an ongoing campaign that incorporates: (I) Health education workshops and seminars; (II) Preventative screenings; (III) Social media campaigns; and (IV) Television and radio commercials. (6) The department shall select a Colorado medical center owned or operated by a hospital authority created in state law with a program dedicated to treating kidney disease to administer the task force. The department shall award grants to the medical center to provide for the reasonable costs of administering the task force. The department may seek, accept, and expend gifts, grants, or donations from private or public sources for the purposes of this section. (7) (a) On or before December 1, 2023, the task force shall submit its initial report, including its findings and recommendations on the issues identified in subsection (5) of this section, to the department. (b) On or before August 31, 2026, the task force shall submit its final report, including its findings and recommendations on the issues identified in subsection (5) of this section, to the department. (c) Notwithstanding section 24-1-136 (11), after December 1, 2023, the department shall include the initial report or final report submitted to the department, as applicable, as part of the department's presentation to its joint committees of reference at a hearing held pursuant to section 2-7-203 (2)(a) of the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act". (8) This section is repealed, effective September 1, 2026. Before the repeal, the task force is scheduled for review in accordance with section 2-3-1203.

C.R.S. § 25-1-137 Task force to reduce youth violence, suicide, and delinquency risk factors - creation - membership - reporting - definitions

25-1-137. Task force to reduce youth violence, suicide, and delinquency risk factors - creation - membership - reporting - definitions. (1) On or before December 31, 2023, the department shall convene a task force to establish shared goals, objectives, and guidelines for governmental agencies and community-based agencies to achieve maximum impact in reducing youth violence, suicide, and delinquency risk factors for target communities with the highest rates of youth violence, suicide, or delinquency risk factors. (2) The purpose of the task force is to bring together diverse groups and perspectives from governmental agencies and community-based organizations to: (a) Identify three target communities in the state where disproportionately high levels of youth violence, suicide, and delinquency risk factors exist. The target communities may include any zip code or contiguous zip codes with the top three to five rates of youth violence, suicide, or delinquency risk factors, including, but not limited to, school performance, average education level, income level, employment levels, crime statistics, and housing and food insecurity. The three target communities selected pursuant to this subsection (2)(a) must represent, to the extent practicable, geographic and urban and rural diversity. (b) Beginning July 1, 2025, and for a minimum of three years thereafter, establish clear and shared goals, objectives, and guidelines to prioritize, align, and pool agency resources, including new and state grant money, to guide intervention, prevention, and tracking statistics to achieve the maximum impact on reducing youth violence, suicide, and delinquency risk factors; and (c) Beginning July 1, 2025, and for a minimum of three years thereafter, establish clear and shared goals, objectives, and guidelines to prioritize the distribution of new grant money across multiple governmental agencies to guide intervention, prevention, and tracking statistics to achieve the maximum impact on reducing youth violence, suicide, and delinquency risk factors. This includes creating: (I) A process for streamlining state grant applications across agencies that does not violate federal laws, rules, or guidelines for federal dollars as it pertains to state grant-making among agencies; (II) A common application form to the extent possible without violating federal laws, rules, or guidelines and that is practical and accessible for grantees to use; (III) A clearinghouse of resources for applicants; and (IV) A job description for a full-time employee support for the five agencies of the task force to provide technical support and assistance to grant applicants who may lack the organizational capacity to complete competitive and complete applications. (3) (a) The task force consists of the following members, at a minimum: (I) Two representatives from the department of public health and environment. One representative must have experience in substance use and be appointed by the executive director. The other representative must be from the office of gun violence prevention and be appointed by the director of the office of gun violence prevention. (II) A representative from the department of early childhood, appointed by the executive director of the department of early childhood; (III) Two representatives from the office of children, youth, and families in the division of child welfare in the department of human services; (IV) Three representatives from the department of education, one with expertise in workforce development, one with expertise in post-secondary pathways, and one who represents rural K-12 communities or has rural K-12 expertise, all appointed by the commissioner of education; ives from the office of children, youth, and families in the division of child welfare in the department of human services; (IV) Three representatives from the department of education, one with expertise in workforce development, one with expertise in post-secondary pathways, and one who represents rural K-12 communities or has rural K-12 expertise, all appointed by the commissioner of education; (V) Two representatives from the behavioral health administration in the department of human services and appointed by the behavioral health commissioner. One representative must have experience in substance use and drug prevention and one representative must have experience with mental health issues. (VI) Two representatives from the division of criminal justice in the department of public safety, appointed by the executive director of the department of public safety; and (VII) Five representatives from community-based organizations, as well as current agency grantees, working in the target communities, as identified by the task force pursuant to subsection (2)(a) of this section, and appointed by the task force. Two of the representatives from community-based organizations must be ones that focus on individuals with intellectual and developmental disabilities or severe mental or behavioral health disorders. (b) The task force must also either: (I) Include a nonvoting member who is a person with experience in, or represents an organization with experience in, delivery of actionable data information and analysis and data readiness; or (II) Allow for presentations on actionable data information and analysis and data readiness. (4) For insights into grant alignment practices, the task force shall consult with the following agencies: (a) The department of personnel and administration; and (b) The department of higher education. (5) After the task force identifies the target communities pursuant to subsection (2)(a) of this section, the task force shall consult with local governmental entities that include, but are not limited to, city and county government officials; local law enforcement and district attorneys; local education providers; local and regional public health administrators; and any local community-based organizations that have received state-level grants in the areas of youth suicide, violence prevention and intervention, and reducing youth risk factors. (6) The task force must have an employee to support work of the task force. (7) The members of the task force shall serve on a voluntary basis without compensation, except for the representatives from nongovernmental agencies, who may receive a per diem stipend. All members are entitled to compensation for actual and necessary expenses incurred in the performance of the task force members' duties. (8) (a) The task force shall present its preliminary findings, goals, objectives, and guidelines to the judiciary committees of the house of representatives and the senate and to the public and behavioral health and human services committee of the house of representatives and the health and human services committee of the senate, or any successor committees, during the department's "SMART Act" hearings held in January 2024. The 2024 "SMART Act" report must include further descriptions of how the task force identified which target communities to prioritize, including whether or if certain factors were weighted or assessed. The task force shall report a timeline with specific deliverables, including when target communities will be defined, when data sources will be identified, and when data sharing agreements will be conformed. "SMART Act" report must include further descriptions of how the task force identified which target communities to prioritize, including whether or if certain factors were weighted or assessed. The task force shall report a timeline with specific deliverables, including when target communities will be defined, when data sources will be identified, and when data sharing agreements will be conformed. (b) In January 2025, the task force shall present its final report that establishes clear and shared goals, objectives, and guidelines to prioritize, align, and pool agency resources, including new and existing grant money, that would guide intervention, prevention, and tracking statistics to achieve the maximum impact on reducing youth violence, suicide, and delinquency risk factors in priority communities. The task force shall include in its report how it will display and track data towards the efficacy of the strategies and goals; how the task force will collect future data from streamlined grant applications, such as reflected in annual reports, as narrative or data tables; and how or if the task force will reassess factors and data on an ongoing basis. The task force shall make its presentation to the judiciary committees of the house of representatives and the senate and to the public and behavioral health and human services committee of the house of representatives and the health and human services committee of the senate, or any successor committees, during the department's "SMART Act" hearings held in January 2025. (9) As used in this section, unless the context otherwise requires: (a) "Community-based organization" means a person, private nonprofit agency, corporation, association, or other nongovernmental agency. (b) "Governmental unit" means any county, city and county, city, town, district attorney's office, or school district. (c) "Target communities" means the communities identified by the task force as part of the task force's duties pursuant to subsection (2)(a) of this section. (d) "Task force" means the task force created in subsection (1) of this section to establish shared goals, objectives, and guidelines for entities to utilize in prioritizing new and existing grant money to ensure achieving a maximum impact in reducing youth violence, suicide, and delinquency risk factors for target communities with the highest rates of youth violence, suicide, or delinquency risk factors.

C.R.S. § 25-1-138 Health facilities - on-site administered topical medication - use for continued treatment - definitions

25-1-138. Health facilities - on-site administered topical medication - use for continued treatment - definitions. (1) As used in this section, unless the context otherwise requires: (a) "Facility-provided medication" or "medication" means a topical medication that a health facility has on hand or is retrieved from a dispensing system for a specified patient for use during a surgical procedure or a visit to a health facility. (b) "Health facility" means a hospital licensed pursuant to section 25-1.5-103 and an ambulatory surgical center licensed pursuant to article 3 of this title 25. (2) (a) A health facility or hospital pharmacy may offer any unused portion of a facility-provided medication to a patient upon the patient's discharge from the health facility if the medication is required for continued treatment, the medication does not contain a controlled substance, and the medication was administered to the patient during the patient's visit to the health facility. A health facility shall document within the patient's medical record that the patient must continue the medication at home, including the patient's dosage and directions for use. (b) A health facility or hospital pharmacy shall: (I) Label a facility-provided medication with, at a minimum, the facility name, the prescribing health-care provider's name, the patient's name, the drug identification, and the directions for use if the instructions are not provided to the patient at the time of discharge from the facility; or (II) If the facility-provided medication's container includes only the name and strength of the medication, include the facility name, the prescribing health-care provider's name, the patient's name, and the directions for use with education materials provided to the patient at the time of discharge from the facility. (3) If a facility-provided medication is used for a patient in an operating room or emergency department setting or for a visit to a health facility and the facility-provided medication is provided to the patient for continuity of treatment, the health facility or hospital pharmacy, whichever provides the medication, is responsible for counseling the patient on the proper use of the medication, and a pharmacist's requirement to counsel the patient concerning the medication pursuant to section 12-280-138 is waived.

C.R.S. § 25-1-401 Office of state chemist created

25-1-401. Office of state chemist created. The professor of food and drug chemistry in the department of chemistry at the university of Colorado is the state chemist of Colorado. The office and laboratory of the state chemist is in the department of chemistry at the university of Colorado. The office of state chemist is a section of the division of administration of the department of public health and environment. The office of state chemist is a type 2 entity, as defined in section 24-1-105.

C.R.S. § 25-1-402 Employment of assistants

25-1-402. Employment of assistants. The state chemist has the power to employ such assistants as are necessary for the carrying out of this part 4. The appropriations for the office of state chemist shall be determined by each general assembly in the general appropriation bill. The state chemist and his assistant shall also be reimbursed for all legitimate and necessary expenses incurred in the performance of the duties of the office of state chemist.

C.R.S. § 25-1-403 Analyses of food and drugs

25-1-403. Analyses of food and drugs. It is the duty of the state chemist to make or cause to be made chemical analyses of all such samples of foods and drugs as may be collected for the purpose of analysis by the department of public health and environment. The state chemist shall make full and complete written reports, without unnecessary delay, of such analyses to the department of public health and environment.

C.R.S. § 25-1-404 Certificate presumptive evidence

25-1-404. Certificate presumptive evidence. By the authority of this part 4, every certificate of analysis of foods or drugs duly signed by the state chemist shall be presumptive evidence of the facts therein stated.

C.R.S. § 25-1-501 Legislative declaration

25-1-501. Legislative declaration. (1) The general assembly hereby finds and declares that: (a) The public health system reduces health-care costs by preventing disease and injury, promoting healthy behavior, and reducing the incidents of chronic diseases and conditions. Thus, the public health system is a critical part of any health-care reform. (b) Each community in Colorado should provide high-quality public health services regardless of its location. Thus, the state of Colorado and each local public health agency should have a comprehensive public health plan outlining how quality public health services will be provided. (c) Each county should establish or be part of a local public health agency organized under a local board of health with a public health director and other staff necessary to provide public health services; (d) A strong public health infrastructure is needed to provide essential public health services and is a shared responsibility among state and local public health agencies and their partners within the public health system; and (e) Developing a strong public health infrastructure requires the coordinated efforts of state and local public health agencies and their public and private sector partners within the public health system to: (I) Identify and provide leadership for the provision of essential public health services; (II) Develop and support an information infrastructure that supports essential public health services and functions; (III) Develop and provide effective education and training for members of the public health workforce; (IV) Develop performance-management standards for the public health system that are tied to improvements in public health outcomes or other measures; and (V) Develop a comprehensive plan and set priorities for providing essential public health services.

C.R.S. § 25-1-502 Definitions

25-1-502. Definitions. As used in this part 5, unless the context otherwise requires: (1) "Agency" means a county or district public health agency established pursuant to section 25-1-506. (2) "Core public health" shall be defined by the state board and shall include, but need not be limited to, the assessment of health status and health risks, development of policies to protect and promote health, and assurance of the provision of the essential public health services. (2.5) "Dementia diseases and related disabilities" is a condition where mental ability declines and is severe enough to interfere with an individual's ability to perform everyday tasks. Dementia diseases and related disabilities includes Alzheimer's disease, mixed dementia, Lewy body dementia, vascular dementia, frontotemporal dementia, and other types of dementia. (3) "Essential public health services" means to: (a) Monitor health status to identify and solve community health problems; (b) Investigate and diagnose health problems and health hazards in the community; (c) Inform, educate, and empower individuals about health issues; (d) Mobilize public and private sector collaboration and action to identify and solve health problems; (e) Develop policies, plans, and programs that support individual and community health efforts; (f) Enforce laws and rules that protect health and promote safety; (g) Link individuals to needed personal health services and ensure the provision of health care; (h) Encourage a competent public health workforce; (i) Evaluate effectiveness, accessibility, and quality of personal and population-based public health services; and (j) Contribute to research into insightful and innovative solutions to health problems. (4) "Medical officer" means a volunteer or paid licensed physician who contracts with or is employed by a county or district public health agency to advise the public health director on medical decisions if the public health director is not a licensed physician. (5) "Public health" means the prevention of injury, disease, and premature mortality; the promotion of health in the community; and the response to public and environmental health needs and emergencies and is accomplished through the provision of essential public health services. (6) "Public health agency" means an organization operated by a federal, state, or local government or its designees that acts principally to protect or preserve the public's health. "Public health agency" includes a county public health agency or a district public health agency. (7) "Public health director" means the administrative and executive head of each county or district public health agency. (8) "Public health system" means state, county, and district public health agencies and other persons and organizations that provide public health services or promote public health. (9) "State board" means the state board of health created pursuant to section 25-1-103. (10) "State department" means the department of public health and environment created pursuant to section 25-1-102.

C.R.S. § 25-1-503 State board - public health duties

25-1-503. State board - public health duties. (1) In addition to all other powers and duties conferred and imposed upon the state board, the state board has the following specific powers and duties: (a) To establish, by rule, the core public health services that each county and district public health agency must provide or arrange for the provision of said services; (b) To establish, by rule, the minimum quality standards for public health services; (c) To establish, by rule, the minimum qualifications for county and district public health directors and medical officers; (d) To ensure the development and implementation of a comprehensive, statewide public health improvement plan; (e) To review all county and district public health agency public health plans, which review shall be based on criteria established by rule by the state board and against which each county or district public health plan shall be evaluated; and (f) To establish, by rule, for the fiscal year beginning July 1, 2009, if practicable, and for each fiscal year thereafter, a formula for allocating moneys to county or district public health agencies based on input from the state department and from county or district public health agencies.

C.R.S. § 25-1-504 Comprehensive public health plan - development - approval - reassessment - cash fund

25-1-504. Comprehensive public health plan - development - approval - reassessment - cash fund. (1) On or before December 31, 2009, and at a minimum on or before December 31 every five years thereafter, the state department shall develop a comprehensive, statewide public health improvement plan, referred to in this section as the "plan", that assesses and sets priorities for the public health system. The state board may appoint ad hoc or advisory committees as needed for the plan development process. The plan shall be developed in consultation with the state board and representatives from the state department, county or district public health agencies, and their partners within the public health system. The plan shall rely on existing or available data or other information acquired pursuant to this part 5, as well as national guidelines or recommendations concerning public health outcomes or improvements. (2) (a) The plan shall assess and set priorities for the public health system and shall: (I) Guide the public health system in targeting core public health services and functions through program development, implementation, and evaluation; (II) Increase the efficiency and effectiveness of the public health system; (III) Identify areas needing greater resource allocation to provide essential public health services; (IV) Incorporate, to the extent possible, goals and priorities of public health plans developed by county or district public health agencies; and (V) Consider available resources, including but not limited to state and local funding, and be subject to modification based on actual subsequent allocations. (b) The plan shall include or address at a minimum the following elements: (I) Core public health services and standards for county and district public health agencies; (II) Recommendations for legislative or regulatory action, including but not limited to updating public health laws, eliminating obsolete statutory language, and establishing an effective and comprehensive state and local public health infrastructure; (III) Identification and quantification of existing public health problems, disparities, or threats at the state and county levels; (IV) Identification of existing public health resources at the state and local levels; (V) Declaration of the goals of the plan; (VI) Identification of specific recommendations for meeting these goals; (VII) Development of public and environmental health infrastructure that supports core public health functions and essential public health services at the state and local levels; (VIII) Explanation of the prioritization of one or more conditions of public health importance; (IX) Detailed description of strategies to develop and promote culturally and linguistically appropriate services; (X) Development, evaluation, and maintenance of, and improvements to, an information infrastructure that supports essential public health services; (XI) Detailed description of the programs and activities that will be pursued to address existing public and environmental health problems, disparities, or threats; (XII) Detailed description of how public health services will be integrated and public health resources shared to optimize efficiency and effectiveness of the public health system; (XIII) Detailed description of how the plan will support county or district public health agencies in achieving the goals of their county or district public health plans; (XIV) Estimation of costs of implementing the plan; (XV) A timeline for implementing various elements of the plan; (XVI) A strategy for coordinating service delivery within the public health system; and (XVII) Measurable indicators of effectiveness and successes. plan will support county or district public health agencies in achieving the goals of their county or district public health plans; (XIV) Estimation of costs of implementing the plan; (XV) A timeline for implementing various elements of the plan; (XVI) A strategy for coordinating service delivery within the public health system; and (XVII) Measurable indicators of effectiveness and successes. (c) The plan, including core public health services and standards, shall prospectively cover up to five years, subject to annual revisions and the implementation schedule established by the state board. (3) The state department shall make the plan available to the governor, the general assembly, the state board, county and district public health agencies, and other partners. (4) The state department is authorized to solicit and accept any gifts, grants, or donations to pay for the development of the plan. Any moneys received pursuant to this subsection (4) shall be transmitted to the state treasurer, who shall credit the same to the comprehensive public health plan cash fund, which is hereby created and referred to in this subsection (4) as the "fund". Any interest derived from the deposit and investment of moneys in the fund shall be credited to the fund. Any unexpended and unencumbered moneys remaining in the fund at the end of any fiscal year shall remain in the fund and shall not be credited or transferred to the general fund or another fund. Moneys in the fund may be expended by the state department, subject to annual appropriation by the general assembly, for the development of the plan described in this section. (5) If the moneys received by the state department through gifts, grants, and donations are insufficient to cover the direct and indirect costs of complying with the provisions of section 25-1-503 and this section, the state department shall not be required to implement the provisions of said sections.

C.R.S. § 25-1-505 County and district public health plans - approval

25-1-505. County and district public health plans - approval. (1) As soon as practicable after the approval of each comprehensive, statewide public health improvement plan pursuant to section 25-1-504, each county or district public health agency shall prepare a county or district public health plan, referred to in this section as the "local plan". Each local plan shall not be inconsistent with the comprehensive, statewide public health improvement plan required under section 25-1-504. (2) Each local plan shall, at a minimum: (a) Examine data about health status and risk factors in the local community; (b) Assess the capacity and performance of the county or district public health system; (c) Identify goals and strategies for improving the health of the local community; (d) Describe how representatives of the local community develop and implement the local plan; (e) Address how county or district public health agencies coordinate with the state department and others within the public health system to accomplish goals and priorities identified in the comprehensive, statewide public health improvement plan; and (f) Identify financial resources available to meet identified public health needs and to meet requirements for the provision of core public health services. (3) Subject to available appropriations, the state department shall encourage and provide technical assistance to county or district public health agencies that request such assistance and otherwise work with county or district public health agencies to generate their local plans.

C.R.S. § 25-1-506 County or district public health agency

25-1-506. County or district public health agency. (1) Each county, by resolution of its board of county commissioners, shall establish and maintain a county public health agency or shall participate in a district public health agency. Any two or more contiguous counties, by resolutions of the boards of county commissioners of the respective counties, may establish and maintain a district public health agency. An agency shall consist of a county or district board of health, a public health director, and all other personnel employed or retained under the provisions of this subpart 3. (2) (a) (I) The jurisdiction of any agency shall extend over all unincorporated areas and over all municipal corporations within the territorial limits of the county or the counties comprising the district, but not over the territory of any municipal corporation that maintains its own public health agency. If the county has a county public health agency or a district board of health and if the county is within a district public health agency, any municipal corporation not otherwise within the jurisdiction of an agency, by agreement of its city council, board of trustees or other governing body, and the board of county commissioners of the county wherein the municipal corporation is situated may merge its department with the county or district public health agency. (II) In the event of a merger between a health department of a municipal corporation with a county or district public health agency, the agreement of merger, among other things, shall provide that a member or members of the county or district board of health, as is specified in the agreement, shall be appointed by the city council or board of trustees of the municipal corporation rather than as provided in this section. The city council or board of trustees shall appoint the number of members specified in the agreement of merger, and the remaining members shall be appointed as provided in this section. (III) The board of county commissioners, in order to give the municipal corporation representation on a county board of health previously established, may declare vacancies in the county board of health and permit the vacancies to be filled by the city council or board of trustees of the municipal corporation. (b) All county or district boards of health existing within the county or district shall be dissolved upon the organization of a county or district public health agency under the provisions of this part 5 or upon the acceptance of a county into a district already established. (c) In the event of the dissolution of any county or district public health agency, the withdrawal of a county from an established district, or the withdrawal of a municipal corporation that has voluntarily merged its health department or agency with a county or district public health agency, local boards of health shall be reestablished under the provisions of this part 5 and assume the powers and duties conferred upon such local boards. (3) (a) Subject to available appropriations, an agency shall provide or arrange for the provisions of services necessary to carry out the public health laws and rules of the state board, the water quality control commission, the air quality control commission, and the solid and hazardous waste commission according to the specific needs and resources available within the community as determined by the county or district board of health or the board of county commissioners and as set out in both the comprehensive, statewide public health improvement plan developed pursuant to section 25-1-504 and the county or district public health plan developed pursuant to section 25-1-505. rdous waste commission according to the specific needs and resources available within the community as determined by the county or district board of health or the board of county commissioners and as set out in both the comprehensive, statewide public health improvement plan developed pursuant to section 25-1-504 and the county or district public health plan developed pursuant to section 25-1-505. (b) In addition to other powers and duties, an agency shall have the following duties: (I) To complete a community health assessment and to create the county or district public health plan at least every five years under the direction of the county or district board and to submit the plan to the county or district board and state board for review; (II) To advise the county or district board on public policy issues necessary to protect public health and the environment; (III) To provide or arrange for the provision of quality, core public health services deemed essential by the state board and the comprehensive, statewide public health improvement plan; except that the agency shall be deemed to have met this requirement if the agency can demonstrate to the county or district board that other providers offer core public health services that are sufficient to meet the local needs as determined by the plan; (IV) To the extent authorized by the provisions of this title or article 20 of title 30, C.R.S., to administer and enforce the laws pertaining to: (A) Public health, air pollution, solid and hazardous waste, and water quality; (B) Vital statistics; and (C) The orders, rules, and standards of the state board and any other type 1 agency created pursuant to the provisions of this title; (V) To investigate and control the causes of epidemic or communicable diseases and conditions affecting public health; (VI) To establish, maintain, and enforce isolation and quarantine, and in pursuance thereof, and for this purpose only, to exercise physical control over property and over the persons of the people within the jurisdiction of the agency as the agency may find necessary for the protection of the public health; (VII) To close schools and public places and to prohibit gatherings of people when necessary to protect public health; (VIII) To investigate and abate nuisances when necessary in order to eliminate sources of epidemic or communicable diseases and conditions affecting public health; (IX) To establish, maintain, or make available chemical, bacteriological, and biological laboratories, and to conduct such laboratory investigations and examinations as it may deem necessary or proper for the protection of the public health; (X) To purchase and distribute to licensed physicians and veterinarians, with or without charge, as the county or district board may determine upon considerations of emergency or need, approved biological or therapeutic products necessary for the protection of public health; (XI) To initiate and carry out health programs consistent with state law that are necessary or desirable by the county or district board to protect public health and the environment; (XII) To collect, compile, and tabulate reports of marriages, dissolutions of marriage, and declarations of invalidity of marriage, births, deaths, and morbidity, and to require any person having information with regard to the same to make such reports and submit such information as is required by law or the rules of the state board; (XIII) To make necessary sanitation and health investigations and inspections, on its own initiative or in cooperation with the state department, for matters affecting public health that are within the jurisdiction and control of the agency; any person having information with regard to the same to make such reports and submit such information as is required by law or the rules of the state board; (XIII) To make necessary sanitation and health investigations and inspections, on its own initiative or in cooperation with the state department, for matters affecting public health that are within the jurisdiction and control of the agency; (XIV) To collaborate with the state department and the state board in all matters pertaining to public health, the water quality control commission in all matters pertaining to water quality, the air quality control commission and the division of administration of the state department in all matters pertaining to air pollution, and the solid and hazardous waste commission in all matters pertaining to solid and hazardous waste; and (XV) To establish or arrange for the establishment of, by January 1, 2015, and subject to available appropriations, a local or regional child fatality prevention review team pursuant to section 25-20.5-404. (c) If a county or district board of health does not receive sufficient appropriations to fulfill all the duties described in paragraph (b) of this subsection (3), the county or district board shall set priorities for fulfilling the duties and shall include the list of priorities in its county or district public health plan submitted pursuant to section 25-1-505. (4) Repealed.

C.R.S. § 25-1-507 Municipal board of health

25-1-507. Municipal board of health. Except as otherwise provided by law, the mayor and council of each incorporated town or city, whether incorporated under general statutes or special charter in this state, may establish a municipal public health agency and appoint a municipal board of health. If appointed, the municipal board of health shall have all the powers and responsibilities and perform all the duties of a county or district board of health as provided in this part 5 within the limits of the respective city or town of which they are the officers.

C.R.S. § 25-1-508 County or district boards of public health - public health directors

25-1-508. County or district boards of public health - public health directors. (1) Within ninety days after the adoption of a resolution to establish and maintain a county public health agency or to participate in a district public health agency, the respective board of county commissioners shall proceed to organize the agency by the appointment of a county or district board of health, referred to in this part 5 as a "county or district board". (2) (a) (I) Each county board of health shall consist of at least five members to be appointed by the board of county commissioners for five-year terms; except that the board of county commissioners shall stagger the terms of the initial appointments. Thereafter, full-term appointments shall be for five years. (II) Notwithstanding the provisions of subparagraph (I) of this paragraph (a), a county with a population of less than one hundred thousand people may have a county board of health that consists of at least three members to be appointed by the board of county commissioners for five-year terms; except that the board of county commissioners shall stagger the terms of the initial appointments. Thereafter, full-term appointments shall be for five years. (b) Each member of the county board of health shall be a resident of the county in which the county agency is located. Appointments shall be made to the board so that no business or professional group or governmental entity shall constitute a majority of the board. Any vacancy on the board shall be filled in the same manner as full-term appointments by the appointment of a qualified person for the unexpired term. (c) In a county with a population of less than one hundred thousand people that, as of July 1, 2008, does not have a board of health that is separate from the board of county commissioners, the board of county commissioners may designate itself as the county board of health as of July 1, 2008. The terms of the members of the county board of health shall coincide with their terms as commissioners. Such county boards shall assume all the duties of appointed county boards. (d) Notwithstanding the provisions of paragraphs (a) to (c) of this subsection (2), a county board of health in a home-rule county shall comply with the requirements of its home-rule charter. (3) (a) Each district board of health shall consist of a minimum of five members. The membership of each district board of health shall include at least one representative from each county in the district. The members of the board shall be appointed by an appointments committee composed of one member of each of the boards of county commissioners of the counties comprising the district. The appointments committee for each district board shall designate the number of members of its district board and shall establish staggered terms for the initial appointments. Thereafter, full-term appointments shall be for five years. (b) Each member of the district board shall be a resident of one of the counties comprising the district, and there shall be at least one member from each of the counties comprising the district. Appointments shall be made to the district board so that no business or professional group or governmental entity shall constitute a majority of the district board. The appointments committee shall fill any vacancy on the district board by the appointment of a qualified person for the remainder of the unexpired term. e shall be at least one member from each of the counties comprising the district. Appointments shall be made to the district board so that no business or professional group or governmental entity shall constitute a majority of the district board. The appointments committee shall fill any vacancy on the district board by the appointment of a qualified person for the remainder of the unexpired term. (c) Upon establishment of a district board, all county boards previously existing within the county or district shall be dissolved. Upon the acceptance of a new county into an established district, the county or district board previously existing for the county being added shall be dissolved and the chair of the previous county or district board or the chair's designee shall represent the new county on the district board until a new member is appointed by the appointments committee. (4) (a) A county or district board, at its organizational meeting, shall elect from its members a president and other officers as it shall determine. The public health director of the agency, at the discretion of the board, may serve as secretary but shall not be a member of the board. All officers and the public health director shall hold their positions at the pleasure of the board. (b) (I) Regular meetings of a county or district board shall be held at least once every three months at such times as may be established by resolution of the board. Special meetings of a board may be called by the president, by the public health director, or by a majority of the members of the board at any time on three days' prior notice; except that, in case of emergency, twenty-four hours' notice shall be sufficient. (II) A county or district board may adopt, and at any time may amend, bylaws in relation to its meetings and the transaction of its business. A majority of the board shall constitute a quorum. Members of the board shall serve without compensation but shall be reimbursed for their actual and necessary travel and subsistence expenses to attend meetings. (5) In addition to all other powers and duties conferred and imposed upon a county board of health or a district board of health by the provisions of this subpart 3, a county board of health or a district board of health shall have and exercise the following specific powers and duties: (a) To develop and promote the public policies needed to secure the conditions necessary for a healthy community; (b) To approve the local public health plan completed by the county or district agency, and to submit the local plan to the state board for review; (c) (I) To select a public health director to serve at the pleasure of the county or district board. The public health director shall possess such minimum qualifications as may be prescribed by the state board. A public health director may be a physician, physician assistant, public health nurse, or other qualified public health professional. A public health director may practice medicine, nursing, or his or her profession within his or her license and scope of practice, as necessary, to carry out the functions of the office of the public health director. The qualifications shall reflect the resources and needs of the county or counties covered by the agency. If the public health director is not a physician, the county or district board shall employ or contract with at least one medical officer to advise the public health director on medical decisions. The public health director shall maintain an office location designated by the county or district board and shall be the custodian of all property and records of the agency. (II) A person employed or under contract to act as a medical officer pursuant to this paragraph (c) shall be covered by the "Colorado Governmental Immunity Act", article 10 of title 24, C.R.S., for duties performed for the agency. ublic health director shall maintain an office location designated by the county or district board and shall be the custodian of all property and records of the agency. (II) A person employed or under contract to act as a medical officer pursuant to this paragraph (c) shall be covered by the "Colorado Governmental Immunity Act", article 10 of title 24, C.R.S., for duties performed for the agency. (d) (I) In the event of a vacancy in the position of public health director or medical officer, to either employ or contract with a person deemed qualified to fill the position or to request temporary assistance from a public health director or a medical officer from another county. The county or district board may also request that an employee of the state department, such as a qualified executive director or the chief medical officer, serve on an interim basis with all the powers and duties of the position. (II) A person filling a temporary vacancy as public health director or medical officer shall be covered by the "Colorado Governmental Immunity Act", article 10 of title 24, C.R.S., for duties performed for the agency. (e) To provide, equip, and maintain suitable offices and all necessary facilities for the proper administration and provision of core public health services, as defined by the state board; (f) To determine general policies to be followed by the public health director in administering and enforcing public health laws, orders, and rules of the county or district board, and orders, rules, and standards of the state board; (g) To issue orders and to adopt rules not inconsistent with the public health laws of this state nor with the orders or rules of the state board as the county or district board may deem necessary for the proper exercise of the powers and duties vested in or imposed upon an agency or county or district board by this part 5; (h) To act in an advisory capacity to the public health director on all matters pertaining to public health; (i) To hold hearings, administer oaths, subpoena witnesses, and take testimony in all matters relating to the exercise and performance of the powers and duties vested in or imposed upon a county or district board; (j) To provide environmental health services and to assess fees to offset the actual, direct cost of such services; except that no fee for a service shall be assessed against any person who has already paid a fee to the state or federal government for the service, and except that the only fee that shall be charged for annual retail food establishment inspections shall be the fee set forth in section 25-4-1607; (k) To accept and, through the public health director, to use, disburse, and administer all federal aid, state aid, or other property, services, or moneys allotted to an agency for county or district public health functions or allotted without designation of a specific agency for purposes that are within the functions of an agency, and to prescribe, by rule consistent with the laws of this state, the conditions under which the property, services, or moneys shall be accepted and administered. The county or district board is empowered to make agreements that may be required to receive such moneys or other assistance. (l) To approve, as provided for in section 25-1-520, a clean syringe exchange program proposed by an agency. A county board of health or district board of health shall not be required to approve a proposed program. (6) Repealed. (7) Members of a county board of health or a district board of health, and the members of the state board of health shall attend both: (a) Annual public health training provided by the department of public health and environment and developed by the department of public health and environment along with the Colorado school of public health; and uired to approve a proposed program. (6) Repealed. (7) Members of a county board of health or a district board of health, and the members of the state board of health shall attend both: (a) Annual public health training provided by the department of public health and environment and developed by the department of public health and environment along with the Colorado school of public health; and (b) Annual public health training developed and provided by the department of public health and environment and the director of the office of emergency management created in section 24-33.5-705 concerning the role of a board of health in preparing for, responding to, and recovering from an emergency disaster. (8) The department of public health and environment shall provide guidance on recruiting persons who are eligible and willing to serve on county and district boards of health. The department of public health and environment shall provide the guidance in an electronic format to any board of county commissioners, county board of health, or district board of health that requests it. (9) Changes to this section made by House Bill 21-1115, enacted in 2021, take effect January 1, 2022.

C.R.S. § 25-1-509 County and district public health directors

25-1-509. County and district public health directors. (1) (a) The director of each agency shall be the public health director. (b) All other personnel required by an agency shall be selected by the public health director. All personnel shall perform duties as prescribed by the public health director. (c) In the event of a public health emergency, the agency shall issue orders and adopt rules consistent with the laws and rules of the state as the public health director may deem necessary for the proper exercise of the powers and duties vested in or imposed upon the agency or county or district board. (2) In addition to the other powers and duties conferred by this part 5 or by the agency, a public health director has the following powers and duties: (a) To administer and enforce: (I) The public health laws of the state and, as authorized by the provisions of this title or article 20 of title 30, C.R.S., the public health orders, rules, and standards of the state department or the state board; and (II) The orders and rules of the county or district board; (b) To exercise all powers and duties conferred and imposed upon agencies not expressly delegated by the provisions of this part 5 to a county or district board; (c) To hold hearings, administer oaths, subpoena witnesses, and take testimony in all matters relating to the exercise and performance of his or her powers and duties; (d) To act as the local registrar of vital statistics or to contract out the responsibility of registrar in the area over which the agency has jurisdiction; (e) To direct the resources needed to carry out the county or district public health plan developed pursuant to section 25-1-505; and (f) If requested by the county or district board, to serve as secretary to the board responsible for maintaining all records required by part 2 of article 72 of title 24, C.R.S., and ensuring public notice of all meetings in accordance with part 4 of article 6 of title 24, C.R.S. The director shall be the custodian of all properties and records for the agency.

C.R.S. § 25-1-510 County or district board unable or unwilling to act

25-1-510. County or district board unable or unwilling to act. (1) If the county or district board is unable or unwilling to efficiently or promptly abate a nuisance or prevent the introduction or spread of a contagious or infectious disease, the county or district board or agency shall notify the state department and request assistance to take measures that will abate the nuisance or prevent the introduction or spread of disease. (2) Upon receipt of the notice and request described in subsection (1) of this section, or upon determination that the county or district board is unable or unwilling to act, the state department has full power to take measures to ensure the abatement of the nuisance or prevent the introduction or spread of disease. The state department, for this purpose, may assume all powers conferred by law on the county or district board. (3) The state department may reallocate state moneys from an agency that is not able to provide core public health services or standards to another entity to deliver services in that agency's jurisdiction.

C.R.S. § 25-1-511 County treasurer - agency funds

25-1-511. County treasurer - agency funds. (1) (a) In the case of a county public health agency, the county treasurer, as a part of his or her official duties as county treasurer, shall serve as treasurer of the agency, and the treasurer's official bond as county treasurer shall extend to and cover his or her duties as treasurer of the agency. In the case of a district public health agency, the county treasurer of the county in the district having the largest population as determined by the most recent federal census, as a part of his or her official duties as county treasurer, shall serve as treasurer of the district agency, and the treasurer's official bond as county treasurer shall extend to and cover his or her duties as treasurer of the district agency. (b) Notwithstanding paragraph (a) of this subsection (1), in a district where the combined population of the counties is four thousand or fewer, the boards of the county commissioners of the counties may, by consent of all counties in the district, select the county whose treasurer shall serve as treasurer of the district. (2) The treasurer of an agency, upon organization of the agency, shall create a county or district public health agency fund, to which shall be credited: (a) Any moneys appropriated from a county general fund; and (b) Any moneys received from state or federal appropriations or any other gifts, grants, donations, or fees for local public health purposes. (3) Any moneys credited to a fund created pursuant to subsection (2) of this section shall be expended only for the purposes of this part 5, and claims or demands against the fund shall be allowed only if certified by the public health director and the president of the county or district board or any other member of the county or district board designated by the president for such purpose. (4) On or before September 1, 2008, and on or before September 1 of each year thereafter, a county board of health shall estimate the total cost of maintaining the county public health agency for the ensuing fiscal year, and the amount of moneys that may be available from unexpended surpluses or from state or federal funds or other grants or donations. On or before September 1 of each year, the estimates shall be submitted in the form of a budget to the board of county commissioners. The board of county commissioners is authorized to provide any moneys necessary, over estimated moneys from surpluses, grants, and donations, to cover the total cost of maintaining the agency for the ensuing fiscal year by an appropriation from the county general fund. (5) (a) On or before September 1, 2008, and on or before September 1 of each year thereafter, a district board of health shall estimate the total cost of maintaining the district public health agency for the ensuing fiscal year, and the amount of moneys that may be available from unexpended surpluses or from state or federal funds or other grants or donations. On or before September 1 of each year, the estimates shall be submitted in the form of a budget to a committee composed of the chairs of the boards of county commissioners of all counties comprising the district. The cost for maintaining the agency, over estimated moneys from surpluses, grants, or donations, shall be apportioned by the committee among the counties comprising the district in the proportion that the population of each county in the district bears to the total population of all counties in the district, population figures to be based on the most recent federal census. The boards of county commissioners of the respective counties are authorized to provide any moneys necessary to cover the proportionate shares of their counties by an appropriation from the county general fund. roportion that the population of each county in the district bears to the total population of all counties in the district, population figures to be based on the most recent federal census. The boards of county commissioners of the respective counties are authorized to provide any moneys necessary to cover the proportionate shares of their counties by an appropriation from the county general fund. (b) Notwithstanding paragraph (a) of this subsection (5), in a district where the combined population of the counties is four thousand or fewer, the boards of the county commissioners of the counties may apportion the costs for each county maintaining the agency by consent of all the counties in the district.

C.R.S. § 25-1-512 Allocation of moneys - public health services support fund - created

25-1-512. Allocation of moneys - public health services support fund - created. (1) (a) The state department shall allocate any moneys that the general assembly may appropriate for distribution to county or district public health agencies organized pursuant to this part 5 for the provision of local health services. The state board shall determine the basis for the allocation of moneys to the agencies. In determining the allocation of moneys, the state board shall take into account the population served by each agency, the additional costs involved in operating small or rural agencies, and the scope of services provided by each agency. (b) (I) In order to qualify for state assistance, each county and city and county shall contribute a minimum of one dollar and fifty cents per capita for its local health services and may contribute additional amounts as it may determine to be necessary to meet its local health needs. (II) Notwithstanding the provisions of subparagraph (I) of this paragraph (b), for a district public health agency, the counties or cities and counties of the district in total shall contribute a minimum of one dollar and fifty cents per capita for local health services within the district. (c) Federally funded and state-funded special projects and demonstrations shall be in addition to the allotments specified in paragraph (b) of this subsection (1). (2) Repealed.

C.R.S. § 25-1-513 Enlargement of or withdrawal from public health agency

25-1-513. Enlargement of or withdrawal from public health agency. (1) Any county contiguous to a district maintaining a district public health agency may become a part of the district by agreement between its board of county commissioners and the boards of county commissioners of the counties comprising the district. The county, upon being accepted into the district, shall thereupon become subject to the provisions of this part 5. (2) Any county in a district maintaining a district public health agency may withdraw from the district by resolution of its board of county commissioners. A county may not withdraw from a district within the two-year period following the establishment of the district or the county becoming a part of the district. A county may only withdraw from a district after one year's written notice given to the agency. In the event of withdrawal of a county from a district, any moneys that had been appropriated by the county before withdrawal to cover its proportionate share of maintaining the district may be returned to the county. A county shall establish a county public health agency or join another district public health agency once the county withdraws from a district. (3) A municipal corporation that has voluntarily merged its public health agency with a county or district public health agency under the authority of section 25-1-506 may withdraw from the county or district public health agency by resolution of its city council, board of trustees, or other governing body. A municipal corporation may not withdraw from an agency within the two-year period following the municipal corporation becoming a part of the agency. A county may only withdraw from a district ninety days after a written notice is given to the agency.

C.R.S. § 25-1-514 Legal adviser - county attorney - actions

25-1-514. Legal adviser - county attorney - actions. The county attorney for the county or the district attorney of the judicial district in which a cause of action arises shall bring any civil or criminal action requested by a county or district public health director to abate a condition that exists in violation of, or to restrain or enjoin any action that is in violation of, or to prosecute for the violation of or for the enforcement of, the public health laws and the standards, orders, and rules of the state board or a county or district board of health. If the county attorney or the district attorney fails to act, the public health director may bring an action and be represented by special counsel employed by him or her with the approval of the county or district board. An agency, through its county or district board of health or through its public health director, may employ or retain and compensate an attorney to be the legal adviser of the agency and to defend the agency and the officers and employees of the agency against all actions and proceedings brought against them.

C.R.S. § 25-1-515 Judicial review of decisions

25-1-515. Judicial review of decisions. (1) Any person aggrieved and affected by a decision of a county or district board of health or a public health director acting under the provisions of this part 5 shall be entitled to judicial review by filing, in the district court of any county over which the county or district board or public health director has jurisdiction, an appropriate action requesting the review within ninety days after the public announcement of the decision. The court may make any interested person a party to the action. The review shall be conducted by the court without a jury and shall be confined to the record, if a complete record is presented. In a case of alleged irregularities in the record or in the procedure before the county or district board or public health director, testimony may be taken in the court. The court may affirm the decision or may reverse or modify it if the substantial rights of the appellant have been prejudiced as a result of the findings and decision of the county or district board being: (a) Contrary to constitutional rights or privileges; (b) In excess of the statutory authority or jurisdiction of the county or district board or public health director; (c) Affected by any error of law; (d) Made or promulgated upon unlawful procedure; (e) Unsupported by substantial evidence in view of the entire record as submitted; or (f) Arbitrary or capricious. (2) Any party may have a review of the final judgment or decision of the district court by appellate review in accordance with law and the Colorado appellate rules.

C.R.S. § 25-1-516 Unlawful acts - penalties

25-1-516. Unlawful acts - penalties. (1) It is unlawful for any person, association, or corporation and the officers thereof to: (a) Willfully violate, disobey, or disregard the provisions of the public health laws or the terms of any lawful notice, order, standard, or rule; (b) Fail to make or file a report required by law or rule of the state board relating to the existence of disease or other facts and statistics relating to the public health; (c) Willfully and falsely make or alter a certificate or certified copy of any certificate issued pursuant to the public health laws; (d) Willfully fail to remove from private property under his or her control at his or her own expense, within forty-eight hours after being ordered to do so by the county or district public health agency, any nuisance, source of filth, or cause of sickness within the jurisdiction and control of the agency whether the person, association, or corporation is the owner, tenant, or occupant of the private property; except that, when the condition is due to an act of God, it shall be removed at public expense; or (e) Pay, give, present, or otherwise convey to any officer or employee of an agency any gift, remuneration, or other consideration, directly or indirectly, that the officer or employee is forbidden to receive by the provisions of this part 5. (2) It is unlawful for any officer or employee of any agency or member of any county or district board of health to accept any gift, remuneration, or other consideration, directly or indirectly, for an incorrect or improper performance of the duties imposed upon him or her by or on behalf of the agency or by the provisions of this part 5. (3) Any person, association, or corporation, or the officers thereof, who violates any provision of this section commits a class 2 misdemeanor and, upon conviction thereof, shall be punished pursuant to the provisions of section 18-1.3-501. In addition to the fine or imprisonment, the person, association, or corporation shall be liable for any expense incurred by health authorities in removing any nuisance, source of filth, or cause of sickness. Conviction under the penalty provisions of this part 5 or any other public health law shall not relieve any person from any civil action in damages that may exist for an injury resulting from any violation of the public health laws.

C.R.S. § 25-1-517 Mode of treatment inconsistent with religious creed or tenet

25-1-517. Mode of treatment inconsistent with religious creed or tenet. Nothing in this part 5 authorizes a county or district board of health to impose on any person any mode of treatment inconsistent with the creed or tenets of any religious denomination of which he or she is an adherent if the person complies with sanitary and quarantine laws and rules.

C.R.S. § 25-1-518 Nuisances

25-1-518. Nuisances. (1) Removal of nuisances. The county or district board of health shall examine all nuisances, sources of filth, and causes of sickness, which, in its opinion, may be injurious to the health of the inhabitants, within its town, city, county, city and county, or district, and it shall destroy, remove, or prevent the nuisance, source of filth, or cause of sickness, as the case may require. (2) Unhealthy premises cleaned - structures removed. If any cellar, vault, lot, sewer, drain, place, or premises within any city is damp, unwholesome, offensive, or filthy, or is covered for any portion of the year with stagnant or impure water, or is in a condition as to produce unwholesome or offensive exhalations, the county or district board of health may cause the area to be drained, filled up, cleaned, amended, or purified; or may require the owner or occupant or person in charge of the lot, premises, or place to perform such duty; or may cause the removal to be done by the proper officers of the city. (3) Expense for abating nuisance. If any person or company neglects to remove or abate any nuisance or to perform any requirement made by or in accordance with any ordinance or resolution of the county or district board of health for the protection of the health of the inhabitants and if any expense is incurred by the board in removing or abating the nuisance or in causing such duty or requirement to be performed, such expense may be recovered by the board in an action against such person or company. In all cases where the board incurs any expense for draining, filling, cleaning, or purifying any lot, place, or premises, or for removing or abating any nuisance found upon such lot or premises, the board, in addition to all other remedies, may provide for the recovery of such expense, charge the same or such part thereof as it deems proper to the lot or premises upon or on account of which such expense was incurred or from which such nuisance was removed or abated, and cause the same to be assessed upon such lot or premises and collected as a special assessment. (4) Removal of nuisance on private property - penalty. Whenever any nuisance, source of filth, or cause of sickness is found on private property, the county or district board of health shall order the owner or occupant or the person who has caused or permitted such nuisance, at his or her own expense, to remove the same within twenty-four hours. In default thereof, he or she shall forfeit a sum not to exceed one hundred dollars at the suit of the board of county commissioners of the proper county or the board of the proper city, town, or village for the use of the county or district board of health of the city or town where the nuisance is found. (5) Board to remove - when. If the owner or occupant does not comply with an order of the county or district board of health, the board may cause the nuisance, source of filth, or cause of sickness to be removed, and all expense incurred thereby shall be paid by the owner or occupant or by such other person who has caused or permitted the nuisance, source of filth, or cause of sickness. (6) Conviction - nuisance to be abated. Whenever any person is convicted of maintaining a nuisance that may be injurious to the public health, the court, in its discretion, may order the nuisance abated, removed, or destroyed at the expense of the defendant under the direction of the county or district board of health of the town, city, county, or district where the nuisance is found, and the form of the warrant to the sheriff or other officer may be varied accordingly. (7) Stay warrant of conviction. The court, on the application of the defendant, may order a stay of a warrant issued pursuant to subsection (6) of this section for such time as may be necessary, not exceeding six months, to give the defendant an opportunity to remove the nuisance upon giving satisfactory security to do so within the time specified in the order. officer may be varied accordingly. (7) Stay warrant of conviction. The court, on the application of the defendant, may order a stay of a warrant issued pursuant to subsection (6) of this section for such time as may be necessary, not exceeding six months, to give the defendant an opportunity to remove the nuisance upon giving satisfactory security to do so within the time specified in the order. (8) Expense of abating. The expense of abating and removing the nuisance pursuant to a warrant issued pursuant to subsection (6) of this section shall be collected by the officer in the same manner as damages and costs are collected upon execution; except that the materials of any buildings, fences, or other things that may be removed as a nuisance may be sold by the officer in like manner as goods are sold on execution for the payment of debts. The officer may apply the proceeds of the sale to defray the expenses of the removal and shall pay over the balance thereof, if any, to the defendant upon demand. If the proceeds of the sale are not sufficient to defray the expenses incurred pursuant to this subsection (8), the sheriff shall collect the residue thereof as provided in subsection (3) of this section. (9) Refusal of admittance to premises. (a) Whenever a county or district board of health finds it necessary for the preservation of the lives or health of the inhabitants to enter any building, car, or train of cars in its town, city, county, or district for the purpose of examining and abating, removing, or preventing any nuisance, source of filth, or cause of sickness and is refused entry, any member of the board may make complaint under oath to the county court of his or her county stating the facts of the case as far as he or she has knowledge thereof. (b) The court may thereupon issue a warrant directed to the sheriff commanding him or her to take sufficient aid and, being accompanied by any two or more members of the county or district board of health, during daylight hours, to return to the place where the nuisance, source of filth, or cause of sickness complained of may be and destroy, remove, or prevent the nuisance, source of filth, cause of sickness, or danger to life or limb under the direction of the members of the board of health. (10) Damages occasioned by nuisance - action. Any person injured either in his or her comfort or in the enjoyment of his or her estate by any nuisance may have an action for damages sustained thereby.

C.R.S. § 25-1-519 Existing intergovernmental agreements

25-1-519. Existing intergovernmental agreements. Nothing in this part 5 shall void the terms of any intergovernmental agreement concerning public health entered into as of July 1, 2008, so long as all core and essential public health services continue to be provided.

C.R.S. § 25-1-520 Clean syringe exchange programs - operation - approval - testing supplies

25-1-520. Clean syringe exchange programs - operation - approval - testing supplies. (1) A county public health agency or district public health agency may request approval from its county board of health or district board of health, referred to in this section as the "board", for a clean syringe exchange program operated by the agency or by a nonprofit organization with which the agency contracts to operate the clean syringe exchange program. Prior to approving or disapproving any such optional program, the board shall consult with the agency and interested stakeholders concerning the establishment of the clean syringe exchange program. Interested stakeholders must include, but need not be limited to, local law enforcement agencies, district attorneys, substance use disorder treatment providers, persons with a substance use disorder in remission, nonprofit organizations, hepatitis C and HIV advocacy organizations, and members of the community. The board and interested stakeholders shall consider, at a minimum, the following issues: (a) The scope of the problem being addressed and the population the program would serve; (b) Concerns of the law enforcement community; and (c) The parameters of the proposed program, including methods for identifying program workers and volunteers. (2) Each proposed clean syringe exchange program must, at a minimum, have the ability to: (a) Provide an injection drug user with the information and the means to protect himself or herself, his or her partner, and his or her family from exposure to blood-borne disease through access to education, sterile injection equipment, voluntary testing for blood-borne diseases, and counseling; (b) Provide thorough referrals to facilitate entry into substance use disorder treatment programs, including opioid substitution therapy; (c) Encourage usage of medical care and mental health services as well as social welfare and health promotion; (d) Provide safety protocols and classes for the proper handling and disposal of injection materials; (e) Plan and implement the clean syringe exchange program with the clear objective of reducing the transmission of blood-borne diseases within a specific geographic area; (f) Develop a timeline for the proposed program and for the development of policies and procedures; and (g) Develop an education program regarding the legal rights under this section and section 18-18-428 (1)(b), C.R.S., that encourages participants to always disclose their possession of hypodermic needles or syringes to peace officers or emergency medical technicians or other first responders prior to a search. (2.3) A clean syringe exchange program operating pursuant to this section may purchase and distribute other supplies and tools intended to reduce health risks associated with the use of drugs, including, but not limited to, smoking materials. (2.5) (a) A nonprofit organization with experience operating a clean syringe exchange program or a health facility licensed or certified by the state may operate a clean syringe exchange program without prior board approval. (b) Prior to operating a clean syringe exchange program pursuant to this subsection (2.5), a nonprofit organization shall consult with interested stakeholders and discuss the issues described in subsection (1) of this section. perating a clean syringe exchange program or a health facility licensed or certified by the state may operate a clean syringe exchange program without prior board approval. (b) Prior to operating a clean syringe exchange program pursuant to this subsection (2.5), a nonprofit organization shall consult with interested stakeholders and discuss the issues described in subsection (1) of this section. (c) Each nonprofit organization and health facility that operates a clean syringe exchange program pursuant to this subsection (2.5) shall annually report to the state department specifying the nonprofit organization's or health facility's number of syringe access episodes in the previous year and the number of used syringes collected by the nonprofit organization or health facility. (3) The board may approve or disapprove the proposed clean syringe exchange program based on the results of the meetings held pursuant to subsection (1) of this section. (4) If the board approves a clean syringe exchange program that is operated through a contract with a nonprofit organization, the contract shall be subject to annual review and shall be renewed only if the board approves the contract after consultation with the county or district public health agency and interested stakeholders as described in subsection (1) of this section. (4.5) A clean syringe exchange program operating pursuant to this section may acquire and use supplies or devices intended for use in testing controlled substances or controlled substance analogs for potentially dangerous adulterants. (5) One or more counties represented on a district board of health may at any time opt out of a clean syringe exchange program proposed or approved pursuant to this section. (6) Repealed.

C.R.S. § 25-1-521 State department - local public health agencies - address substance use disorders - appropriation - repeal

25-1-521. State department - local public health agencies - address substance use disorders - appropriation - repeal. (Repealed)

C.R.S. § 25-1-801 Patient records in custody of health-care facility - definitions

25-1-801. Patient records in custody of health-care facility - definitions. (1) (a) Every patient record in the custody of a health facility licensed or certified pursuant to section 25-1.5-103 (1) or article 3 of this title, or both, or any entity regulated under title 10, C.R.S., providing health-care services, as defined in section 10-16-102 (33), C.R.S., directly or indirectly through a managed care plan, as defined in section 10-16-102 (43), C.R.S., or otherwise, shall be available for inspection to the patient or the patient's personal representative through the attending health-care provider or the provider's designated representative at reasonable times and upon reasonable notice, except records withheld in accordance with 45 CFR 164.524 (a). A summary of records pertaining to a patient's mental health problems may, upon written request and signed and dated authorization, be made available to the patient or the patient's personal representative following termination of the treatment program. (b) (I) (A) A health facility licensed or certified pursuant to section 25-1.5-103 (1) or article 3 of this title, or both, or an entity regulated under title 10, C.R.S., providing health-care services, as defined in section 10-16-102 (33), C.R.S., directly or indirectly through a managed care plan, as defined in section 10-16-102 (43), C.R.S., or otherwise, must provide copies of a patient's medical records, including X rays, to the patient or the patient's personal representative upon request and payment of the fee a covered entity may impose in accordance with the "Health Insurance Portability and Accountability Act of 1996", Pub.L. 104-191, as amended, and any rules promulgated pursuant to the act, or to a third person who requests the records upon submission of a HIPAA-compliant authorization, valid subpoena, or court order and upon the payment of the reasonable fees. (B) The health-care facility must deliver the medical records in electronic format if the person requests electronic format, the original medical records are stored in electronic format, and the medical records are readily producible in electronic format. (II) In the event that a licensed health-care professional determines that a copy of any X ray, mammogram, CT SCAN, MRI, or other film is not sufficient for diagnostic or other treatment purposes, the health facility or entity shall make the original of any such film available to the patient or another health-care professional or facility as specifically directed by the patient pursuant to a written authorization-request for films and upon the payment of the reasonable costs for such film. If a health facility releases an original film pursuant to this subparagraph (II), it shall not be responsible for any loss, damage, or other consequences as a result of such release. Any original X ray, mammogram, CT SCAN, MRI, or other film made available pursuant to this subparagraph (II) shall be returned upon request to the lending facility within thirty days. (c) The hospital or related facility or institution shall post in conspicuous public places on the premises a statement of the requirements set forth in paragraphs (a) and (b) of this subsection (1) and shall make available a copy of said statement to each patient upon admission. vailable pursuant to this subparagraph (II) shall be returned upon request to the lending facility within thirty days. (c) The hospital or related facility or institution shall post in conspicuous public places on the premises a statement of the requirements set forth in paragraphs (a) and (b) of this subsection (1) and shall make available a copy of said statement to each patient upon admission. (d) Nothing in this section requires a person responsible for the diagnosis or treatment of sexually transmitted infections, a substance use disorder, or the use of drugs in the case of minors pursuant to sections 13-22-102 and 25-4-409 to release patient records of such diagnosis or treatment to a parent, guardian, or person other than the minor or his or her designated representative. (2) All requests by a patient or the patient's personal representative for inspection of the patient's medical records made under this section shall be noted with the time and date of the request and the time and date of inspection noted by the attending health-care provider or his or her designated representative. The patient or personal representative shall acknowledge the fact of the inspection by dating and signing the record file. A health-care facility shall not charge a fee for the inspection of medical records. (3) Nothing in this section shall apply to any nursing institution conducted by or for the adherents of any well-recognized church or religious denomination for the purpose of providing facilities for the care and treatment of the sick who depend exclusively upon spiritual means through prayer for healing and the practice of the religion of such church or denomination. (4) For the purposes of this section, medical information transmitted during the delivery of health care via telemedicine, as defined in section 12-240-104 (6), is part of the patient's medical record maintained by the health-care facility. (5) As used in this part 8, unless the context otherwise requires: (a) "HIPAA-compliant" means in compliance with the "Health Insurance Portability and Accountability Act of 1996", Pub.L. 104-191, as amended. (b) "Personal representative" has the meaning set forth in 45 CFR 164.502. (c) (I) "Reasonable fees" means an amount not to exceed: (A) Eighteen dollars and fifty-three cents for the first ten pages, eighty-five cents per page for the next thirty pages, and fifty-seven cents per page for each additional page; except that, if the medical records are stored on microfilm, one dollar and fifty cents per page; (B) For radiographic studies, actual reproduction costs for each copy of a radiograph; (C) If the authorized person requests certification of the medical records, a fee of ten dollars; (D) Actual postage and electronic media costs, if applicable; and (E) Applicable taxes. (II) Notwithstanding any other provision of this part 8: (A) If a patient record is requested by a third-party entity that is performing duties under the "Laura Hershey Disability Support Act", part 2 of article 88 of title 8, the third party may obtain one free copy of the record for the application process or for an appeal or reapplication when required by the disability benefit administrator; (B) If maximum rates have already been established by statute or rule for a state or local government entity, those rates prevail over the rates set forth in this part 8; and (C) This part 8 does not apply to coroners requesting medical records pursuant to section 30-10-606, C.R.S.

C.R.S. § 25-1-802 Patient records in custody of individual health-care providers

25-1-802. Patient records in custody of individual health-care providers. (1) (a) Every patient record in the custody of a podiatrist, chiropractor, dentist, doctor of medicine, doctor of osteopathy, nurse, certified midwife, optometrist, occupational therapist, audiologist, acupuncturist, direct-entry midwife, or physical therapist required to be licensed under title 12; a naturopathic doctor required to be registered pursuant to article 250 of title 12; or a person practicing psychotherapy under article 245 of title 12, except records withheld in accordance with 45 CFR 164.524 (a), must be available to the patient or the patient's personal representative upon submission of a valid authorization for inspection of records, dated and signed by the patient, at reasonable times and upon reasonable notice. A summary of records pertaining to a patient's mental health problems may, upon written request accompanied by a signed and dated authorization, be made available to the patient or the patient's personal representative following termination of the treatment program. (b) (I) (A) A copy of the records, including radiographic studies, must be made available to the patient or the patient's personal representative, upon request and payment of the fee a covered entity may impose in accordance with the "Health Insurance Portability and Accountability Act of 1996", Pub.L. 104-191, as amended, or to a third person who requests the medical records upon submission of a HIPAA-compliant authorization, a valid subpoena, or a court order, and payment of reasonable fees. (B) The health-care provider must provide the medical records in electronic format if the person requests electronic format, the original medical records are stored in electronic format, and the medical records are readily producible in electronic format. (II) If a licensed health-care professional determines that a copy of a radiographic study, including an X ray, mammogram, CT scan, MRI, or other film, is not sufficient for diagnostic or other treatment purposes, the podiatrist, chiropractor, dentist, doctor of medicine, doctor of osteopathy, nurse, certified midwife, optometrist, audiologist, acupuncturist, direct-entry midwife, or physical therapist required to be licensed under title 12, or, subject to the provisions of section 25-1-801 (1)(a) and subsection (1)(a) of this section, the person practicing psychotherapy under article 245 of title 12, shall make the original of any radiographic study available to the patient, the patient's personal representative, a person authorized by the patient, or another health-care professional or facility as specifically directed by the patient, personal representative, authorized person, or health-care professional or facility pursuant to a HIPAA-compliant authorization and upon the payment of the reasonable fees for the radiographic study. If a practitioner releases an original radiographic study pursuant to this subsection (1)(b)(II), the practitioner is not responsible for any loss, damage, or other consequences as a result of the release. Any original radiographic study made available pursuant to this subsection (1)(b)(II) must be returned upon request to the lending practitioner within thirty days. (2) Nothing in this section requires a person responsible for the diagnosis or treatment of sexually transmitted infections, substance use disorders, or the use of drugs in the case of minors pursuant to sections 13-22-102 and 25-4-409 to release patient records of such diagnosis or treatment to a parent, guardian, or person other than the minor or his or her designated representative. (3) For purposes of this section, "patient record" does not include a doctor's office notes. atment of sexually transmitted infections, substance use disorders, or the use of drugs in the case of minors pursuant to sections 13-22-102 and 25-4-409 to release patient records of such diagnosis or treatment to a parent, guardian, or person other than the minor or his or her designated representative. (3) For purposes of this section, "patient record" does not include a doctor's office notes. (4) All requests by a patient or the patient's personal representative for inspection of his or her medical records made under this section shall be noted with the time and date of the request and the time and date of inspection noted by the health-care provider or his or her designated representative. The patient or the patient's personal representative shall acknowledge the inspection by dating and signing the record file. A health-care provider shall not charge a fee for the inspection of medical records. (5) For the purposes of this section, medical information transmitted during the delivery of health care via telemedicine, as defined in section 12-240-104 (6), is part of the patient's medical record maintained by a health-care provider.

C.R.S. § 25-1-803 Effect of this part 8 on similar rights of a patient

25-1-803. Effect of this part 8 on similar rights of a patient. (1) Nothing in this part 8: (a) Limits the right of a patient, the patient's personal representative, or a person who requests the medical records upon submission of a HIPAA-compliant authorization, a valid subpoena, or a court order to inspect the patient's medical or mental health data pursuant to section 24-72-204 (3)(a)(I), C.R.S.; or (b) Limits or expands a right to inspect the patient's records that is otherwise granted by state statute to the patient, the patient's personal representative, or a person who requests the medical records upon submission of a HIPAA-compliant authorization, a valid subpoena, or a court order.

C.R.S. § 25-1-1001 Legislative declaration

25-1-1001. Legislative declaration. The general assembly hereby finds that the operation of child care centers in nursing home facilities is desirable because the benefit to nursing home facility employees in having on-location child care will improve the quality of care in nursing home facilities by stabilizing the nursing home work force and because the general public, especially in rural areas, will benefit from the increased availability of day care centers in their communities. The general assembly also finds that the operation of child care centers in nursing home facilities is desirable because the intergenerational contact has been proven to be beneficial to the health and well-being of elderly persons and, therefore, will improve the quality of life of elderly residents in nursing home facilities and because the intergenerational contact will be beneficial to the children as well. The general assembly, therefore, declares that the intent of this part 10 is to encourage the development of child care centers in nursing home facilities by encouraging the creation of private grants to provide funds to start such centers and by requiring the state agencies which license nursing home facilities and child care centers to study and recommend statutory and regulatory changes to facilitate and encourage the development of child care centers in nursing home facilities.

C.R.S. § 25-1-1002 Definitions

25-1-1002. Definitions. As used in this part 10, unless the context otherwise requires: (1) "Nursing home facility" means a facility which provides skilled nursing home services or intermediate care nursing home services.

C.R.S. § 25-1-1003 Grant program - requirements - use of medical assistance funds prohibited

25-1-1003. Grant program - requirements - use of medical assistance funds prohibited. (1) The department of public health and environment may encourage the development of a private grant program to provide start-up funds to nursing home facilities for the purpose of establishing child care centers located in such nursing home facilities. (2) The state board of health, after consultation with the division in the department of human services involved in licensing child care centers and if the committee formed in section 25-1-1004 recommends the establishment of child care facilities in nursing homes, shall promulgate reasonable rules and regulations establishing any necessary requirements for operating a day care center in a nursing home facility. Such rules and regulations shall include, but need not be limited to, the following: (a) Requirements for the operation of a safe and good-quality child care operation in the nursing home facility or upon the nursing home facility's grounds, which shall include: (I) Precautions required to be taken to ensure that all staff and residents who will participate in the intergenerational programs have not been involved in incidents of sexual abuse or child abuse; (II) Requirements relating to the ability to properly care for the children; (III) Child care ratios of staff to children; (IV) Requirements relating to the constant supervision of the children by staff members and not by nursing home residents; (V) Life safety and fire regulations; (b) Requirements on the amount and type of liability insurance necessary to insure the risks associated with the child care operation; (c) Requirements on the ways in which the nursing home residents may be involved in the child care center and the requirement that the participation of nursing home residents in intergenerational activities with the children in the child care operation shall be on a voluntary basis; (d) Requirements that any fees assessed to the employees of the nursing home facility whose children participate in the child care program will be based on a sliding scale; (e) Requirements that the participation of employees of the nursing home facility in the enrollment of their children in the intergenerational day care program of the nursing home facility shall be on a voluntary basis. (3) No medical assistance funds under the "Colorado Medical Assistance Act", articles 4, 5, and 6 of title 25.5, C.R.S., shall be used to subsidize the cost of operating a day care center or day care program in a nursing home facility.

C.R.S. § 25-1-1004 Study of statutes and rules and regulations pertaining to nursing home facilities and day care centers

25-1-1004. Study of statutes and rules and regulations pertaining to nursing home facilities and day care centers. (1) The department of public health and environment and the department of human services, in conjunction with representatives of the nursing home industry, child care operators, and experts on child care programs in nursing home facilities, shall examine and study the existing statutes and rules and regulations concerning the licensing of child care centers and of nursing home facilities to determine what statutory or regulatory changes or both would make it easier for a nursing home facility to operate a child care center. The study shall also include an examination of the advantages and disadvantages of operating such intergenerational programs and the most appropriate and practical ways to design such intergenerational child care programs which are beneficial both to the children and to the elderly persons. (2) The study conducted by the department of public health and environment and the department of human services shall include, but need not be limited to, consideration of the following: (a) The establishment of new rules and regulations by the department of public health and environment and the department of human services which would allow nursing home facilities to operate a child care operation in the nursing home facilities; (b) A coordinated licensure program to license a child care operation in a nursing home facility which would be based on rules and regulations designed specifically for the operation of a child care center in a nursing home facility. (3) Repealed. (4) The department of public health and environment and the department of human services shall comply with the requirements of this part 10 within the current appropriation established for each department. No request for appropriations shall be made to the general assembly for the implementation of this part 10.

C.R.S. § 25-1-1201 Legislative declaration

25-1-1201. Legislative declaration. The general assembly hereby finds, determines, and declares that maintaining the confidentiality of medical records is of the utmost importance to the state and of critical importance to patient privacy for high quality medical care. Most people in the United States consider confidentiality of health information important and worry that the increased computerization of health records may result in inappropriate disclosure of such records. Patients have a strong interest in preserving the privacy of their personal health information, but they also have an interest in medical research and other efforts by health-care organizations to improve the medical care they receive. How best to preserve confidentiality within a state health information infrastructure is an important discussion that is affected by recent regulations promulgated by the federal department of health and human services related to the electronic storage of health information. The purpose of this part 12 is to index the provisions that govern medical record confidentiality to facilitate locating the law concerning the confidentiality of medical records and health information. It is not intended to expand, narrow, or clarify existing provisions.

C.R.S. § 25-1-1202 Index of statutory sections regarding medical record confidentiality and health information

25-1-1202. Index of statutory sections regarding medical record confidentiality and health information. (1) Statutory provisions concerning policies, procedures, and references to the release, sharing, and use of medical records and health information include the following: (a) Section 10-16-1003, C.R.S., concerning use of information by health-care cooperatives; (b) Section 8-43-404, C.R.S., concerning examinations by a physician or chiropractor for the purposes of workers' compensation; (c) Section 8-43-501, C.R.S., concerning utilization review related to workers' compensation; (d) Section 8-73-108, C.R.S., concerning the award of benefits for unemployment compensation benefits; (e) Section 10-3-1104.7, C.R.S., concerning the confidentiality and use of genetic testing information; (f) Section 10-16-113, C.R.S., concerning the procedures related to the denial of health benefits by an insurer; (g) Section 10-16-113.5, C.R.S., concerning the use of independent external review when health benefits have been denied; (h) Section 10-16-423, C.R.S., concerning the confidentiality of medical information in the custody of a health maintenance organization; (i) Section 12-290-113, concerning disciplinary actions against podiatrists; (j) Section 12-215-126, concerning confidential communications between a licensed chiropractor and a patient; (k) Section 12-220-201, concerning disciplinary actions against dentists, dental therapists, and dental hygienists; (l) Section 12-240-125, concerning disciplinary actions against physicians; (m) Section 12-240-139 (1), concerning reporting requirements for physicians pertaining to certain injuries; (n) Section 12-30-204, concerning professional review committees for health-care providers specified in part 2 of article 30 of title 12; (o) Section 12-30-205, concerning hospital professional review committees; (p) Section 13-22-704, concerning reporting requirements by physicians related to abortions for minors; (q) Section 12-255-119, concerning disciplinary proceedings against a practical nurse, a professional nurse, a certified midwife, or a psychiatric technician; (r) Section 12-245-220, concerning the disclosure of confidential communications by a mental health professional; (s) Section 12-245-226 (4), concerning disciplinary proceedings against a mental health professional; (t) Section 13-21-110, C.R.S., concerning confidentiality of information, data, reports, or records of a utilization review committee of a hospital or other health-care facility; (u) Section 13-21-117, concerning civil liability of a mental health professional, mental health hospital, or behavioral health safety net provider related to a duty to warn or protect; (v) Sections 13-22-101 to 13-22-106, C.R.S., concerning the age of competence for certain medical procedures; (w) Section 13-64-502, C.R.S., concerning civil liability related to genetic counseling and screening and prenatal care, or arising from or during the course of labor and delivery, or the period of postnatal care in a health institution; (x) Repealed. (y) Section 13-90-107 (1)(d), C.R.S., concerning when a physician, surgeon, or registered professional nurse may testify related to the care and treatment of a person; , C.R.S., concerning civil liability related to genetic counseling and screening and prenatal care, or arising from or during the course of labor and delivery, or the period of postnatal care in a health institution; (x) Repealed. (y) Section 13-90-107 (1)(d), C.R.S., concerning when a physician, surgeon, or registered professional nurse may testify related to the care and treatment of a person; (z) Section 14-10-124, C.R.S., concerning the best interests of a child for the purposes of a separation or dissolution of marriage; (aa) Section 14-10-127, C.R.S., concerning the allocation of parental responsibilities with respect to a child; (bb) Repealed. (cc) Section 18-3-203, concerning assault in the second degree and the availability of medical testing for certain circumstances; (dd) Section 18-4-412, C.R.S., concerning theft of medical records or medical information; (ee) Repealed. (ee.5) Section 18-18-406.3, C.R.S., concerning medical marijuana patient records; (ff) Section 18-18-503, C.R.S., concerning cooperative agreements to control substance abuse; (gg) Section 19-3-304, C.R.S., concerning persons required to report child abuse or neglect; (hh) Section 19-3-305, C.R.S., concerning postmortem investigation related to the death of a child; (ii) Section 19-3-306, C.R.S., concerning evidence of abuse or neglect of a child; (jj) Section 19-5-103 (2), C.R.S., concerning relinquishment of rights concerning a child; (kk) Section 19-5-305, C.R.S., concerning access to adoption records; (ll) Section 22-1-123 (5), C.R.S., concerning the protection of student data; (mm) Sections 22-32-109.1 (6) and 22-32-109.3 (2), C.R.S., concerning specific powers and duties of the state board of education; (nn) Repealed. (oo) Section 24-51-213, C.R.S., concerning confidentiality of records maintained by the public employees' retirement association; (pp) Section 24-72-204 (3), C.R.S., concerning public records not open to public inspection; (qq) Section 25-1-122, concerning reporting of certain diseases and conditions for investigation of epidemic and communicable diseases, morbidity and mortality, cancer in connection with the statewide cancer registry, environmental and chronic diseases, sexually transmitted infections, tuberculosis, and rabies and mammal bites by the department of public health and environment; (rr) Section 25-1-124 (2), concerning health-care facilities and reporting requirements; (ss) Sections 27-81-110 and 27-81-113, C.R.S., concerning the treatment of intoxicated persons; (tt) Section 25-1-801, concerning patient records in the care of a health-care facility; (uu) Section 25-1-802, concerning patient records in the care of individual health-care providers; (vv) Sections 27-81-109 and 27-81-113, concerning the treatment of persons with substance use disorders; (vv.5) Section 25-1.5-106, concerning the medical marijuana program; (ww) Section 25-2-120, concerning reports of electroconvulsive treatment; nt records in the care of a health-care facility; (uu) Section 25-1-802, concerning patient records in the care of individual health-care providers; (vv) Sections 27-81-109 and 27-81-113, concerning the treatment of persons with substance use disorders; (vv.5) Section 25-1.5-106, concerning the medical marijuana program; (ww) Section 25-2-120, concerning reports of electroconvulsive treatment; (xx) Section 25-3-109, concerning quality management functions of health-care facilities licensed by the department of public health and environment; (yy) Section 25-3.5-501, concerning records maintained by ambulance services and emergency medical service providers; (zz) Section 25-3.5-704 (2)(d) and (2)(f), concerning the designation of emergency medical facilities and the statewide trauma system; (aaa) Sections 25-4-406 and 25-4-409, concerning the reporting of sexually transmitted infections; (bbb) Section 25-4-1003, concerning newborn screening programs and genetic counseling; (ccc) Repealed. (ddd) Section 25-4-1705, concerning immunization information; (eee) Section 25-4-1905, concerning records collected related to gulf war syndrome; (fff) Section 25-32-106, concerning the release of medical information to a poison control service provider; (ggg) Section 26-3.1-102 (2), C.R.S., concerning reporting requirements related to at-risk adults; (hhh) Section 26-11.5-108, C.R.S., concerning the long-term ombudsman program and access to medical records; (iii) Section 27-65-103 (2), C.R.S., concerning voluntary applications for mental health services; (jjj) Sections 27-65-121 (2) and 27-65-122, C.R.S., concerning records related to mental health services for minor children; (kkk) Section 30-10-606 (6), C.R.S., concerning postmortem investigations and records; (lll) Section 35-9-109, C.R.S., concerning confidentiality of information released to the commissioner of agriculture related to human exposure to pesticide applications; (mmm) Section 42-2-112, C.R.S., concerning information supplied to the department of revenue for the purpose of renewing or obtaining a license to operate a motor vehicle; and (nnn) Section 12-280-406, concerning information entered into the prescription drug monitoring program database.

C.R.S. § 25-1-1203 Electronic storage of medical records

25-1-1203. Electronic storage of medical records. Health plans, health-care clearinghouses, and health-care providers shall develop policies, procedures, and systems to comply with federal regulations promulgated by the federal department of health and human services related to electronic storage and maintenance of medical record information pursuant to federal law.

C.R.S. § 25-1-1204 Online exchange of advanced directives forms permitted

25-1-1204. Online exchange of advanced directives forms permitted. A public or private entity, including a nonprofit organization, that facilitates the exchange of health information among emergency medical service providers, doctors, hospitals, nursing homes, pharmacies, home health agencies, health plans, and local health information agencies through the use of health information technology may facilitate the voluntary, secure, and confidential exchange of forms containing advanced directives regarding a person's acceptance or rejection of life-sustaining medical or surgical treatment.

C.R.S. § 25-1-1301 Short title

25-1-1301. Short title. This part 13 shall be known and may be cited as the "Colorado Climate Change Markets Act".

C.R.S. § 25-1-1302 Legislative declaration

25-1-1302. Legislative declaration. (1) The general assembly hereby finds and declares that: (a) As the United States and other countries take action to address issues related to climate change, Colorado faces important policy choices. (b) Emerging technologies and markets related to climate change promise significant economic opportunities for the state, particularly for agriculture and rural economies. (c) The general assembly enacts the "Colorado Climate Change Markets Act" for the purpose of positioning Colorado at the forefront of emerging markets related to climate change and helping affected industries and economies benefit from these opportunities.

C.R.S. § 25-1-1303 Grants for research - reports to general assembly

25-1-1303. Grants for research - reports to general assembly. (1) The department of public health and environment shall administer a program to award grants pursuant to this section. (2) (a) A grant of fifty thousand dollars shall be awarded to Colorado state university to conduct research on the potential for the use of terrestrial carbon sequestration in agricultural, rangeland, and forest soils as a technique for mitigating the emissions of greenhouse gases in the state. (b) A grant of fifty thousand dollars shall be awarded to the Colorado school of mines to conduct research on the potential for the use of geologic carbon sequestration as a technique for mitigating the emissions of greenhouse gases in the state. (c) A grant of thirty-five thousand dollars shall be awarded to the university of Colorado to conduct research on the emerging international and domestic markets in greenhouse gas emissions and to conduct research on private firms in various economic sectors that are reducing emissions of greenhouse gases. (3) Each recipient of a grant awarded pursuant to this section shall report the results of the research conducted under the grant to the agriculture committees of the senate and the house of representatives no later than March 15, 2007.

C.R.S. § 25-1-1501 Legislative declaration

25-1-1501. Legislative declaration. (1) The general assembly finds and declares that: (a) A rare disease, sometimes called an "orphan" disease, is a disease that affects fewer than two hundred thousand people in the United States; (b) There are seven thousand known rare diseases affecting approximately thirty million adults and children in the United States; (c) While the exact cause for many rare diseases remains unknown, many rare diseases are genetic in origin and can be linked to mutations in a single gene or in multiple genes, which can be passed down from generation to generation; (d) People with rare diseases face many challenges, including delays in obtaining a diagnosis, misdiagnosis, shortages of medical specialists who can provide treatment, and lack of affordable access to therapies and medication used to treat rare diseases; and (e) A Colorado rare disease advisory council composed of qualified professionals and people living with rare diseases could educate medical professionals, government agencies, legislators, and the public about rare diseases as an important public health issue and encourage research for the development of new treatments for rare diseases.

C.R.S. § 25-1-1502 Definitions

25-1-1502. Definitions. As used in this part 15, unless the context otherwise requires: (1) "Council" means the Colorado rare disease advisory council created in section 25-1-1503. (2) "Department" means the department of public health and environment. (3) "Facilitator" means the person selected by the council to facilitate the work of the council as described in section 25-1-1507. (4) "Rare disease" means a disease that affects fewer than two hundred thousand people in the United States.

C.R.S. § 25-1-1503 Colorado rare disease advisory council - creation

25-1-1503. Colorado rare disease advisory council - creation. There is created in the department the Colorado rare disease advisory council. The purpose of the council is to study and make findings and recommendations to the general assembly, state agencies, and others, as appropriate, concerning the needs of individuals living in Colorado with rare diseases.

C.R.S. § 25-1-1504 Council membership

25-1-1504. Council membership. (1) The appointing authorities shall conduct the appointment process in a transparent manner to provide interested individuals an opportunity to apply for membership on the council. All members of the council must be full-time residents of Colorado. (2) (a) The council consists of twelve voting members appointed as follows: (I) The president of the senate shall appoint three members, including: (A) One representative from academic research in the state who receives grant funding for rare disease research; (B) One geneticist practicing in Colorado; and (C) One physician licensed and practicing in Colorado with experience treating rare diseases; (II) The minority leader of the senate shall appoint three members, including: (A) One registered nurse or advanced practice registered nurse licensed and practicing in Colorado with experience treating rare diseases; (B) One pharmacist with experience dispensing drugs used to treat rare diseases; and (C) One person who has a rare disease; (III) The speaker of the house of representatives shall appoint three members, including: (A) One representative of a rare disease patient organization operating in Colorado that is not affiliated with the facilitator; (B) One representative of the biotechnology or pharmaceutical industry; and (C) One representative of a health insurer; and (IV) The minority leader of the house of representatives shall appoint three members, including: (A) One person who has a rare disease; (B) One parent whose child or children have been diagnosed with a rare disease; and (C) One caregiver of a person with a rare disease. (b) The director of the office of health equity, created in section 25-4-2204, or the director's designee, shall serve as an ex officio, nonvoting member of the council. (3) (a) The appointing authorities shall make their initial appointments to the council by October 1, 2022. In making appointments, to the extent practicable, the appointing authorities shall consider gender, ethnicity, geographic diversity, and other considerations that will result in a diverse and inclusive council. (b) Each member who is appointed pursuant to subsection (2)(a) of this section serves at the pleasure of the official who appointed the member. Any vacancy in membership is filled by the appointing authority. (c) Members shall serve three-year terms; except that, in order to provide continuity and knowledge transfer among council members, during the initial appointments to the council and for any members appointed in the first five years after the council is established, members may serve initial terms of up to four years. (4) (a) Members of the council serve without compensation and without reimbursement for expenses incurred by the members in serving on the council or participating in council activities. (b) Notwithstanding subsection (4)(a) of this section, a council member may be reimbursed for actual and necessary expenses relating to the council's duties to the extent that the council receives gifts, grants, or donations to cover the cost of reimbursement.

C.R.S. § 25-1-1505 Activities carried out by the council - duties

25-1-1505. Activities carried out by the council - duties. (1) The council shall conduct the following activities to benefit rare disease patients in Colorado: (a) Convene public meetings, make inquiries, and solicit comments from Coloradans to assist the council with a survey of the needs of rare disease patients, caregivers, and providers in the state, to be completed within eighteen months after the council is established; (b) Consult with experts on rare diseases to develop policy recommendations to improve patient access to and quality of rare disease specialists, affordable and comprehensive health-care coverage, better access to clinical trials, relevant diagnostics, and timely treatment; (c) Educate and make recommendations to state agencies and to health insurers providing health benefit plans to persons with rare diseases on the impact of imposing prior authorization, cost sharing, tiering, or other utilization management procedures on the provision of treatment and care for patients; (d) Research and identify best practices to ensure continuity of care for rare disease patients transitioning from pediatric care to adult care; (e) Establish a Colorado rare disease council web page or website, housed on its own website or as part of a host website, and publish a list of existing, publicly accessible resources on research, diagnosis, treatment, and educational materials for health-care providers and patients relating to rare diseases; and (f) Prepare and submit a report annually to the governor and to specified committees of the general assembly pursuant to section 25-1-1509. (2) Prior to publishing any final recommendations of the council, the council shall provide an opportunity for public comment on draft recommendations. (3) In addition to any other council activities, the council may: (a) Adopt rules of procedure for the council that it deems necessary to facilitate the orderly conduct of its business; (b) Establish task forces or committees of its members and nonmembers to assist in the performance of the council's duties; (c) Accept written or oral input from the public or any relevant source; (d) Publicize its findings and recommendations concerning the needs of individuals with rare diseases living in Colorado and advocate on behalf of the council for its recommended actions; (e) Seek, accept, and expend gifts, grants, and donations for purposes of carrying out the duties of the council; and (f) Offer input to the Colorado prescription drug affordability review board, as described in section 10-16-1406 (2)(e) and (4)(h)(III).

C.R.S. § 25-1-1506 Department - fiscal agent

25-1-1506. Department - fiscal agent. (1) The department may, as necessary: (a) Act as fiscal agent for the council; (b) Receive gifts, grants, or donations from the council or facilitator for use by the council; (c) Host the council's web page or website; and (d) Provide meeting space and other administrative supports to the council.

C.R.S. § 25-1-1507 Council facilitator - duties

25-1-1507. Council facilitator - duties. (1) Unless the council determines that an administrator is not needed, the council shall contract for the services of a facilitator to provide assistance to the council, as determined by the council, in an annual amount not to exceed fifty thousand dollars. The facilitator's assistance to the council may include: (a) Scheduling and conducting meetings, preparing meeting minutes, and managing the council's online content; (b) Organizing the work of the council; (c) Conducting research and providing information to the council concerning issues addressed by the council; (d) Conducting public outreach and soliciting public feedback, as well as publicizing the findings and recommendations of the council; (e) Inviting and coordinating interested persons and experts to provide information to the council; (f) Soliciting gifts, grants, and donations, including in-kind donations, for the council; (g) Securing and managing the council's money and facilitating council expenditures; and (h) Any other duties in support of the council's activities. (2) The facilitator must be a nonprofit entity in Colorado with experience organizing and advocating for the needs of persons with respect to all rare diseases.

C.R.S. § 25-1-1508 Council meetings - requirements - transparency - information

25-1-1508. Council meetings - requirements - transparency - information. (1) At its first meeting, the council shall select a chair and vice-chair from among its membership by majority vote. Unless otherwise determined by the council, the chair and vice-chair serve two-year terms. The chair and vice-chair may be reappointed without limit. (2) (a) The council shall hold its first meeting within forty-five days after the final council member is appointed pursuant to section 25-1-1504. (b) During the first twelve months after the council is established, the council shall meet at least once per month. Thereafter, the council shall meet at least once per quarter. Council meetings may be conducted in person or via an online platform. (3) In conducting meetings, the council shall: (a) Schedule meetings in advance with meaningful notice to affected persons and stakeholders and the public; and (b) Provide opportunities for interested persons to hear updates and provide input on the council's work, including through online testimony, if feasible. (4) The council is subject to the open meetings law, part 4 of article 6 of title 24, and the "Colorado Open Records Act", part 2 of article 72 of title 24. (5) The council shall create and maintain, or provide content for, a public website where meeting notices and minutes are posted and public comments may be offered.

C.R.S. § 25-1-1509 Reporting - recommendations

25-1-1509. Reporting - recommendations. (1) Within twelve months after the establishment of the council, the council shall submit a report to the governor, the public and behavioral health and human services committee and the health and insurance committee of the house of representatives, and the health and human services committee of the senate, or their successor committees, concerning: (a) The council's activities, including progress on the activities described in section 25-1-1505; (b) The status of council funding, including: (I) The balance of any appropriations made to the council and any gifts, grants, or donations that were sought, accepted, or received, including in-kind donations; and (II) The use of money appropriated to or received by the council; and (c) Recommendations to the governor and the general assembly to address the needs of people living with rare diseases in Colorado. (2) (a) After the initial report, the council shall report annually to the governor and to committees of the general assembly, as specified in subsection (1) of this section. (b) Notwithstanding section 24-1-136 (11)(a)(I), the reporting requirements set forth in subsection (2)(a) of this section continue until the repeal of this part 15 pursuant to section 25-1-1511. (3) The council shall make annual reports public and available on the council's website described in section 25-1-1505.

C.R.S. § 25-1-1510 Funding - gifts, grants, or donations

25-1-1510. Funding - gifts, grants, or donations. (1) The general assembly may appropriate money from the general fund to the department for allocation to the council to carry out council activities and to contract for the services of a facilitator. (2) Members of the council and any facilitator may seek, accept, and expend gifts, grants, or donations from private or public sources for the purposes of this part 15. (3) The council shall deposit any money collected through gifts, grants, or donations in an insured account at a Colorado financial institution and otherwise exercise fiduciary responsibilities over council money.

C.R.S. § 25-1-1511 Repeal of part - sunset review

25-1-1511. Repeal of part - sunset review. This part 15 is repealed, effective September 1, 2032. Before the repeal, this part 15 is scheduled for review in accordance with section 2-3-1203.

Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://leg.colorado.gov/sites/default/files/images/olls/crs2024-title-25.docxFetched: 10/6/2026