House Bill 25-1027 Introduced

A Bill for an Act

• Page 1, Line 101Concerning modifications to statutes governing disease

• Page 1, Line 102control.

Bill Summary

(Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov.)

The bill amends various statutes governing the operations of the department of public health and environment (department) regarding disease control. Specifically, sections 1 through 9 of the bill:

• Repeal the governor's expert emergency epidemic response committee (GEEERC);
• Direct the state board of health to review and approve the department's emergency response and recovery plan every 3 years; and
• Require the executive director of the department or, if the executive director is not the chief medical officer, the chief medical officer to convene a group of subject matter experts to develop crisis standards of care to be used in responding to a public health emergency.
• Allow the records of a physician assistant to be used to create a certificate of immunization for a student;
• Eliminate a provision regarding a plan for complying with immunization requirements since it is not one of the ways for complying with school immunization requirements;
• Repeal the 14-day period within which a student whose certificate of immunization is not up to date to comply with immunization requirements to attend school and instead direct the state board of health to establish a timeline for compliance that is no shorter than 14 days after notice of noncompliance is received;
• Extend from February 15 to April 15 the deadline for a school to distribute the annual letter to parents specifying the school's aggregate immunization rates and the immunization requirements applicable for the next school year;
• Remove gendered pronouns and replace them with gender-neutral language; and
• Repeal the requirement for schools to notify the department and the local public health agency when a student is suspended or expelled from school for noncompliance with immunization requirements.

Sections 10 through 15 modify school immunization provisions as follows to:

Section 16 extends from July 15 to September 15 the date by which the department is required to submit to the general assembly an annual report summarizing health-care-associated infections data received from health facilities in the state.

Section 17 repeals the requirement for certain health-care providers to offer a hepatitis C screening test to individuals born between 1945 and 1965 and instead directs the state board of health to adopt standards, consistent with recommendations from the federal centers for disease control and prevention, for hepatitis C screening tests.

• Page 2, Line 1Be it enacted by the General Assembly of the State of Colorado:

• Page 2, Line 2SECTION 1.  In Colorado Revised Statutes, 25-1-105, add (4) as

• Page 3, Line 1follows:

• Page 3, Line 225-1-105.  Executive director - chief medical officer -

• Page 3, Line 3qualifications - salary - office - duties - crisis standards of care.

• Page 3, Line 4(4) (a)  In the event of a public health emergency, if the governor

• Page 3, Line 5and the executive director and, if the executive director is not

• Page 3, Line 6the chief medical officer, the chief medical officer agree that

• Page 3, Line 7crisis standards of care are needed to respond to the public

• Page 3, Line 8health emergency, the executive director or, if the executive

• Page 3, Line 9director is not the chief medical officer, the chief medical

• Page 3, Line 10officer shall:

• Page 3, Line 11(I)  Assemble a group of subject matter experts to develop

• Page 3, Line 12crisis standards of care for use by health-care providers and

• Page 3, Line 13health-care facilities in responding to the public health

• Page 3, Line 14emergency; and

• Page 3, Line 15(II)  Activate all or portions of the crisis standards of

• Page 3, Line 16care as needed during the public health emergency.

• Page 3, Line 17(b)  Upon agreement of the governor and the executive

• Page 3, Line 18director and, if the executive director is not the chief medical

• Page 3, Line 19officer, the chief medical officer that the crisis standards of

• Page 3, Line 20care are no longer needed to respond to the public health

• Page 3, Line 21emergency, the executive director or, if the executive director

• Page 3, Line 22is not the chief medical officer, the chief medical officer shall

• Page 3, Line 23vacate the crisis standards of care.

• Page 3, Line 24SECTION 2.  In Colorado Revised Statutes, 25-1-108, add (1)(i)

• Page 3, Line 25as follows:

• Page 3, Line 2625-1-108.  Powers and duties of state board of health - rules -

• Page 3, Line 27definitions. (1)  In addition to all other powers and duties conferred and

• Page 4, Line 1imposed upon the state board of health by this part 1, the board has the

• Page 4, Line 2following specific powers and duties:

• Page 4, Line 3(i) (I)  To review and approve the internal emergency

• Page 4, Line 4response and recovery plan submitted to the board every three

• Page 4, Line 5years.

• Page 4, Line 6(II)  As used in this subsection (1)(i):

• Page 4, Line 7(A)  "Internal emergency response and recovery plan"

• Page 4, Line 8means the portion of the state emergency operations plan

• Page 4, Line 9prepared and updated by the department that specifies

• Page 4, Line 10operations that will be implemented if there is an occurrence or

• Page 4, Line 11imminent threat of an emergency epidemic.

• Page 4, Line 12(B)  "State emergency operations plan" means the plan

• Page 4, Line 13developed in accordance with section 24-33.5-705 (2) by the office

• Page 4, Line 14of emergency management in the division of homeland security

• Page 4, Line 15and emergency management in the department of public safety

• Page 4, Line 16to address the preparation, prevention, mitigation, response, and

• Page 4, Line 17recovery from emergencies and disasters.

• Page 4, Line 18SECTION 3.  In Colorado Revised Statutes, repeal 24-33.5-704.5

• Page 4, Line 19(1).

• Page 4, Line 20SECTION 4.  In Colorado Revised Statutes, 24-33.5-704.5,

• Page 4, Line 21amend (2) as follows:

• Page 4, Line 2224-33.5-704.5.  Continuity of operations plans - reports to

• Page 4, Line 23general assembly. (2)  Each department that administers a publicly

• Page 4, Line 24funded safety net program shall develop a continuity of operations plan

• Page 4, Line 25The plan shall establish that establishes procedures for the response

• Page 4, Line 26by, and continuation of operations of, the department and the safety net

• Page 4, Line 27program in the event of an emergency epidemic. Each department shall

• Page 5, Line 1file its plan with the executive director of the department of public health

• Page 5, Line 2and environment and shall update the plan at least annually. In addition,

• Page 5, Line 3notwithstanding section 24-1-136 (11), each department shall submit a

• Page 5, Line 4report by March 1 of each year to the health and human services

• Page 5, Line 5committee committees of the senate and the public health care and

• Page 5, Line 6human services committee of the house of representatives, or any

• Page 5, Line 7successor committees, regarding the status of the department's plan, as

• Page 5, Line 8well as the status of any other plans or procedures of the department

• Page 5, Line 9regarding emergency and disaster preparedness.

• Page 5, Line 10SECTION 5.  In Colorado Revised Statutes, 2-3-1502, repeal (6)

• Page 5, Line 11as follows:

• Page 5, Line 122-3-1502.  Definitions. As used in this part 15, unless the context

• Page 5, Line 13otherwise requires:

• Page 5, Line 14(6)  "GEEERC" means the governor's expert emergency epidemic

• Page 5, Line 15response committee created in section 24-33.5-704.5.

• Page 5, Line 16SECTION 6.  In Colorado Revised Statutes, 2-3-1503, amend

• Page 5, Line 17(1)(a) and (2) as follows:

• Page 5, Line 182-3-1503.  Legislative emergency preparedness, response, and

• Page 5, Line 19recovery committee - creation - membership - duties. (1) (a)  There is

• Page 5, Line 20hereby created a legislative emergency preparedness, response, and

• Page 5, Line 21recovery committee. The legislative committee shall develop a plan for

• Page 5, Line 22the response by, and continuation of operations of, the general assembly

• Page 5, Line 23and the legislative service agencies in the event of an emergency

• Page 5, Line 24epidemic or disaster. The legislative committee shall cooperate and

• Page 5, Line 25coordinate with the division and the department and the GEEERC in

• Page 5, Line 26developing the plan The legislative committee shall develop and shall

• Page 5, Line 27submit the plan to the speaker of the house of representatives, the

• Page 6, Line 1president of the senate, the governor, the executive director of the

• Page 6, Line 2department, and the director of the division. and the GEEERC no later

• Page 6, Line 3than July 1, 2011. The legislative committee shall meet at least annually

• Page 6, Line 4to review and amend the plan as necessary and shall provide any updated

• Page 6, Line 5plan to the persons individuals or entities specified in this paragraph (a)

• Page 6, Line 6subsection (1)(a). The legislative committee may recommend legislation

• Page 6, Line 7pertaining to the preparedness, response, and recovery by, and

• Page 6, Line 8continuation of operations of, the general assembly and the legislative

• Page 6, Line 9service agencies in the event of an emergency epidemic or disaster. The

• Page 6, Line 10legislative committee shall provide information to and fully cooperate

• Page 6, Line 11with the division and the department and the GEEERC in fulfilling its

• Page 6, Line 12duties under this section.

• Page 6, Line 13(2)  In the event of an emergency epidemic or disaster that the

• Page 6, Line 14governor declares to be a disaster emergency pursuant to section

• Page 6, Line 1524-33.5-704, C.R.S., the legislative committee shall convene as rapidly

• Page 6, Line 16and as often as necessary to advise the speaker of the house of

• Page 6, Line 17representatives, the president of the senate, and the legislative service

• Page 6, Line 18agencies regarding reasonable and appropriate measures to be taken by

• Page 6, Line 19the general assembly and the legislative service agencies to respond to the

• Page 6, Line 20emergency epidemic or disaster and protect the public health, safety, and

• Page 6, Line 21welfare. The legislative committee shall communicate, cooperate, and

• Page 6, Line 22seek advice and assistance from the division and the department and the

• Page 6, Line 23GEEERC in responding to the emergency epidemic or disaster.

• Page 6, Line 24SECTION 7.  In Colorado Revised Statutes, 24-33.5-703, repeal

• Page 6, Line 25(2) as follows:

• Page 6, Line 2624-33.5-703.  Definitions. As used in this part 7, unless the

• Page 6, Line 27context otherwise requires:

• Page 7, Line 1(2)  "Committee" means the governor's expert emergency epidemic

• Page 7, Line 2response committee created in section 24-33.5-704.5.

• Page 7, Line 3SECTION 8.  In Colorado Revised Statutes, 24-33.5-711.5,

• Page 7, Line 4amend (1) as follows:

• Page 7, Line 524-33.5-711.5.  Liability - limits on damages and compensation

• Page 7, Line 6- immunity for good faith compliance with rules and orders.

• Page 7, Line 7(1)  Neither The state nor the members of the expert emergency epidemic

• Page 7, Line 8response committee designated or appointed pursuant to section

• Page 7, Line 924-33.5-704.5 are is not liable for any a claim based upon the

• Page 7, Line 10committee's advice provided by an officer or employee of a state

• Page 7, Line 11department to the governor or the alleged negligent exercise or

• Page 7, Line 12performance of, or failure to exercise or perform, an act relating to an

• Page 7, Line 13emergency epidemic. Liability against a member of the committee an

• Page 7, Line 14officer or employee of a state department may be found only for

• Page 7, Line 15wanton or willful misconduct or willful disregard of the best interests of

• Page 7, Line 16protecting and maintaining the public health. Damages awarded on the

• Page 7, Line 17basis of such liability shall not exceed one hundred thousand dollars for

• Page 7, Line 18any injury to or damage suffered by one person or three hundred thousand

• Page 7, Line 19dollars for an injury to or damage suffered by three or more persons in the

• Page 7, Line 20course of an emergency epidemic.

• Page 7, Line 21SECTION 9.  In Colorado Revised Statutes, 25-1.5-102, amend

• Page 7, Line 22(1)(b)(I) as follows:

• Page 7, Line 2325-1.5-102.  Epidemic and communicable diseases - powers and

• Page 7, Line 24duties of department - rules - definitions. (1)  The department has, in

• Page 7, Line 25addition to all other powers and duties imposed upon it by law, the

• Page 7, Line 26powers and duties provided in this section as follows:

• Page 7, Line 27(b) (I)  To investigate and monitor the spread of disease that is

• Page 8, Line 1considered part of an emergency epidemic, as defined in section

• Page 8, Line 224-33.5-703 (4), to determine the extent of environmental contamination

• Page 8, Line 3resulting from the emergency epidemic, and to rapidly provide

• Page 8, Line 4epidemiological and environmental information to the governor's expert

• Page 8, Line 5emergency epidemic response committee, created in section

• Page 8, Line 624-33.5-704.5 state board of health.

• Page 8, Line 7SECTION 10.  In Colorado Revised Statutes, 25-4-901, amend

• Page 8, Line 8(1)(a) as follows:

• Page 8, Line 925-4-901.  Definitions. As used in this part 9, unless the context

• Page 8, Line 10otherwise requires:

• Page 8, Line 11(1)  "Certificate of immunization" means one of the following

• Page 8, Line 12forms of documentation that include the dates and types of immunizations

• Page 8, Line 13administered to a student:

• Page 8, Line 14(a)  A paper or electronic document that includes information

• Page 8, Line 15transferred from the records of a licensed physician, physician

• Page 8, Line 16assistant authorized pursuant to section 12-240-107 (6),

• Page 8, Line 17advanced practice registered nurse, or public health official; or

• Page 8, Line 18SECTION 11.  In Colorado Revised Statutes, 25-4-902, amend

• Page 8, Line 19(1) introductory portion, (1)(a), (2), (3), and (4)(b); and repeal (1)(b) as

• Page 8, Line 20follows:

• Page 8, Line 2125-4-902.  Immunization prior to attending school -

• Page 8, Line 22standardized immunization information - rules - repeal. (1)  A student

• Page 8, Line 23shall not attend any school in the state of Colorado on or after the dates

• Page 8, Line 24specified in section 25-4-906 (4) unless he or she the student or the

• Page 8, Line 25student's parent or legal guardian has presented one of the

• Page 8, Line 26following to the appropriate school official:

• Page 8, Line 27(a)  An up-to-date certificate of immunization from a licensed

• Page 9, Line 1physician, physician assistant authorized pursuant to section 12-240-107

• Page 9, Line 2(6), advanced practice registered nurse, or authorized representative of the

• Page 9, Line 3department of public health and environment or a local public health

• Page 9, Line 4agency stating that the student has received immunization against

• Page 9, Line 5communicable diseases as specified by the state board of health, based on

• Page 9, Line 6recommendations of the advisory committee on immunization practices

• Page 9, Line 7of the centers for disease control and prevention in the federal department

• Page 9, Line 8of health and human services; or

• Page 9, Line 9(b)  A written authorization signed by one parent or legal guardian,

• Page 9, Line 10an emancipated student, or a student eighteen years of age or older

• Page 9, Line 11requesting that local public health officials administer the immunizations;

• Page 9, Line 12or

• Page 9, Line 13(2) (a) (I)  If the student's certificate of immunization is not up to

• Page 9, Line 14date according to the requirements of the state board of health, the parent

• Page 9, Line 15or guardian of the student or, if the student is emancipated or

• Page 9, Line 16eighteen years of age or older, the emancipated student or the

• Page 9, Line 17student eighteen years of age or older shall submit to the school, within

• Page 9, Line 18fourteen days after receiving direct personal notification that the

• Page 9, Line 19certificate is not up to date, documentation indicating that the next

• Page 9, Line 20required immunization has been given and that includes a written plan

• Page 9, Line 21for completion of all required immunizations. The scheduling of

• Page 9, Line 22immunizations in the written plan shall follow medically recommended

• Page 9, Line 23minimum intervals approved by the state board of health. If the student

• Page 9, Line 24begins but does not continue or complete the written plan, he or she the

• Page 9, Line 25school shall be suspended or expelled suspend or expel the student

• Page 9, Line 26pursuant to this part 9.

• Page 9, Line 27(II)  This subsection (2)(a) is repealed, effective July 1, 2026.

• Page 10, Line 1(b) (I)  If the student's certificate of immunization is not up

• Page 10, Line 2to date according to the requirements of the state board of

• Page 10, Line 3health, the parent or guardian of the student or, if the student

• Page 10, Line 4is emancipated or eighteen years of age or older, the student

• Page 10, Line 5shall submit to the school, within the period specified by the

• Page 10, Line 6state board of health by rule, documentation indicating that

• Page 10, Line 7the next required immunization has been given and that includes

• Page 10, Line 8a written plan for completion of all required immunizations. The

• Page 10, Line 9scheduling of immunizations in the written plan must follow

• Page 10, Line 10medically recommended minimum intervals approved by the

• Page 10, Line 11state board of health. If the student begins but does not

• Page 10, Line 12continue or complete the written plan, the school shall suspend

• Page 10, Line 13or expel the student pursuant to this part 9.

• Page 10, Line 14(II)  The state board of health shall adopt rules

• Page 10, Line 15establishing the period within which a parent, legal guardian, or

• Page 10, Line 16student must submit the documentation specified in subsection

• Page 10, Line 17(2)(b)(I) of this section, which period shall be not less than

• Page 10, Line 18fourteen days after the parent, legal guardian, or student

• Page 10, Line 19receives direct, personal notification that the certificate of

• Page 10, Line 20immunization is not up to date. The rules adopted by the board

• Page 10, Line 21pursuant to this subsection (2)(b)(II) shall take effect on July 1,

• Page 10, Line 222026.

• Page 10, Line 23(3)  Notwithstanding the provisions of subsection (1) of this

• Page 10, Line 24section, a school shall enroll a student who is in out-of-home placement

• Page 10, Line 25within five school days after receiving the student's education information

• Page 10, Line 26and records as required in section 22-32-138, C.R.S., regardless of

• Page 10, Line 27whether the school has received the items specified in subsection (1) of

• Page 11, Line 1this section. Upon enrolling the student, the requirements of

• Page 11, Line 2subsections (1) and (2) of this section apply, and the school shall

• Page 11, Line 3notify the student's legal guardian that, unless the school receives the

• Page 11, Line 4student's certificate of immunization or a written authorization for

• Page 11, Line 5administration of immunizations certificate of exemption within

• Page 11, Line 6fourteen days after the student enrolls, the school shall will suspend the

• Page 11, Line 7student until such time as the school receives the certificate of

• Page 11, Line 8immunization or the authorization certificate of exemption.

• Page 11, Line 9(4) (b)  On or before February 15, 2021 April 15, 2026, and on or

• Page 11, Line 10before February 15 April 15 each year thereafter, a school shall include

• Page 11, Line 11on the document described in subsection (4)(a) of this section the

• Page 11, Line 12school's specific immunization and exemption rates for the measles,

• Page 11, Line 13mumps, and rubella vaccine for the school's enrolled student population

• Page 11, Line 14for the prior school year compared to the vaccinated children standard

• Page 11, Line 15described in section 25-4-911. The school may include on the document

• Page 11, Line 16the school's specific immunization and exemption rates for any other

• Page 11, Line 17vaccine for the school's enrolled student population for the prior school

• Page 11, Line 18year. The school shall directly distribute the document to the parent or

• Page 11, Line 19legal guardian of each student enrolled in its school, emancipated

• Page 11, Line 20students, or students eighteen years of age or older, consistent with

• Page 11, Line 21section 25-4-903 (5).

• Page 11, Line 22SECTION 12.  In Colorado Revised Statutes, 25-4-903, amend

• Page 11, Line 23(2) introductory portion, (2)(a), (2)(b)(II)(B), (2.2)(a)(III), (2.2)(b)(II),

• Page 11, Line 24and (2.2)(b)(III) as follows:

• Page 11, Line 2525-4-903.  Exemptions from immunization - rules. (2)  A

• Page 11, Line 26Unless a student is exempted pursuant to this section, the parent

• Page 11, Line 27or legal guardian of a student shall have his or her the student

• Page 12, Line 1immunized, unless the student is exempted pursuant to this section, or an

• Page 12, Line 2emancipated student or a student eighteen years of age or older or, if a

• Page 12, Line 3student is emancipated or eighteen years of age or older, the

• Page 12, Line 4student shall have himself or herself themself immunized. unless the

• Page 12, Line 5student is exempted pursuant to this section. A student is exempted from

• Page 12, Line 6receiving the required immunizations in the following manner:

• Page 12, Line 7(a)  By submitting to the student's school a completed certificate

• Page 12, Line 8of medical exemption from a licensed physician, physician assistant

• Page 12, Line 9authorized pursuant to section 12-240-107 (6), or advanced practice

• Page 12, Line 10registered nurse that the physical condition of the student is such that one

• Page 12, Line 11or more specified immunizations would endanger his or her the

• Page 12, Line 12student's life or health or are medically contraindicated due to other

• Page 12, Line 13medical conditions; or

• Page 12, Line 14(b) (II) (B)  A complete certificate of nonmedical exemption must

• Page 12, Line 15include the signature of a person who is authorized pursuant to title 12 to

• Page 12, Line 16administer immunizations within his or her the person's scope of

• Page 12, Line 17practice to the student for whom the certificate of nonmedical exemption

• Page 12, Line 18is sought. Nothing in this subsection (2)(b)(II)(B) requires a person

• Page 12, Line 19authorized pursuant to title 12 to administer immunizations within his or

• Page 12, Line 20her the person's scope of practice to sign a certificate of nonmedical

• Page 12, Line 21exemption. Notwithstanding any law or rule to the contrary, a body that

• Page 12, Line 22regulates the professional conduct of a person who is authorized pursuant

• Page 12, Line 23to title 12 to administer immunizations within his or her the person's

• Page 12, Line 24scope of practice to the student for whom the certificate is sought shall

• Page 12, Line 25not order a disciplinary action against the person because the person

• Page 12, Line 26authorized to sign the certificate signed such certificate pursuant to this

• Page 12, Line 27subsection (2)(b)(II)(B). It is unlawful for the employer or any a

• Page 13, Line 1professional organization to retaliate against a person because the person

• Page 13, Line 2authorized to sign a certificate signed such certificate pursuant to this

• Page 13, Line 3subsection (2)(b)(II)(B).

• Page 13, Line 4(2.2) (a) (III)  A person authorized pursuant to title 12 to

• Page 13, Line 5administer immunizations within his or her the person's scope of

• Page 13, Line 6practice to the student for whom the certificate of nonmedical exemption

• Page 13, Line 7is sought and who signs the certificate of nonmedical exemption form

• Page 13, Line 8shall provide a copy of a completed certificate of nonmedical exemption

• Page 13, Line 9to the student's parent or legal guardian, the emancipated student, or the

• Page 13, Line 10student eighteen years of age or older.

• Page 13, Line 11(b) (II)  A person authorized pursuant to title 12 to administer

• Page 13, Line 12immunizations within his or her the person's scope of practice to the

• Page 13, Line 13student for whom the certificate of nonmedical exemption is sought and

• Page 13, Line 14who signs the certificate of nonmedical exemption shall submit the

• Page 13, Line 15nonmedical exemption data to the immunization tracking system created

• Page 13, Line 16in section 25-4-2403.

• Page 13, Line 17(III)  Notwithstanding subsections (2.2)(b)(I) and (2.2)(b)(II) of

• Page 13, Line 18this section, a licensed physician, a physician assistant authorized

• Page 13, Line 19pursuant to section 12-240-107 (6), an advanced practice registered nurse,

• Page 13, Line 20or a person authorized pursuant to title 12 to administer immunizations

• Page 13, Line 21within his or her the person's scope of practice is not subject to a

• Page 13, Line 22regulatory sanction for failing to submit medical exemption or

• Page 13, Line 23nonmedical exemption data to the immunization tracking system.

• Page 13, Line 24SECTION 13.  In Colorado Revised Statutes, amend 25-4-905 as

• Page 13, Line 25follows:

• Page 13, Line 2625-4-905.  Immunization of indigent children. (1)  The county,

• Page 13, Line 27district, or municipal public health agency; a public health or school nurse

• Page 14, Line 1under the supervision of a licensed physician or physician assistant

• Page 14, Line 2authorized under section 12-240-107 (6); or the department of public

• Page 14, Line 3health and environment, in the absence of a county, district, or municipal

• Page 14, Line 4public health agency or public health nurse, shall provide, at public

• Page 14, Line 5expense to the extent that funds are funding is available, immunizations

• Page 14, Line 6required by this part 9 to each child whose parents or guardians cannot

• Page 14, Line 7afford to have the child immunized or, if emancipated, who cannot

• Page 14, Line 8himself or herself themself afford immunization and who has not been

• Page 14, Line 9exempted. The department of public health and environment shall provide

• Page 14, Line 10all vaccines necessary to comply with this section as far as funds funding

• Page 14, Line 11will permit. Nothing in this section precludes the department of public

• Page 14, Line 12health and environment from distributing vaccines to physicians,

• Page 14, Line 13physician assistants authorized under section 12-240-107 (6),

• Page 14, Line 14advanced practice registered nurses, or others as required by law or the

• Page 14, Line 15rules of the department. No An indigent child shall not be excluded,

• Page 14, Line 16suspended, or expelled from school unless the immunizations have been

• Page 14, Line 17available and readily accessible to the child at public expense.

• Page 14, Line 18(2)  Notwithstanding any other provision of this part 9 to the

• Page 14, Line 19contrary, programs and services that provide immunizations to children

• Page 14, Line 20for communicable diseases shall be made available to a child regardless

• Page 14, Line 21of his or her the child's race, religion, gender, ethnicity, national origin,

• Page 14, Line 22or immigration status.

• Page 14, Line 23SECTION 14.  In Colorado Revised Statutes, 25-4-906, amend

• Page 14, Line 24(1) as follows:

• Page 14, Line 2525-4-906.  Certificate of immunization - forms. (1)  The

• Page 14, Line 26department of public health and environment shall provide official

• Page 14, Line 27certificates of immunization to the schools, private physicians, and

• Page 15, Line 1county, district, and municipal public health agencies. Upon the

• Page 15, Line 2commencement of the gathering of epidemiological information pursuant

• Page 15, Line 3to section 25-4-2403 to implement the immunization tracking system,

• Page 15, Line 4such form shall include a notice that informs a parent or legal guardian

• Page 15, Line 5that he or she the parent or legal guardian has the option to exclude

• Page 15, Line 6his or her their infant's, child's, or student's immunization information

• Page 15, Line 7from the immunization tracking system created in section 25-4-2403. Any

• Page 15, Line 8immunization record provided by paper or electronic document that

• Page 15, Line 9includes information transferred from the records of a licensed

• Page 15, Line 10physician, a licensed physician assistant authorized under section

• Page 15, Line 1112-240-107 (6), an advanced practice registered nurse, or a public

• Page 15, Line 12health official may be accepted by the school official as certification of

• Page 15, Line 13immunization. if the information is transferred to the official certificate

• Page 15, Line 14of immunization and verified by the school official.

• Page 15, Line 15SECTION 15.  In Colorado Revised Statutes, 25-4-907, repeal (2)

• Page 15, Line 16as follows:

• Page 15, Line 1725-4-907.  Noncompliance. (2)  In the event of suspension or

• Page 15, Line 18expulsion of a student, school officials shall notify the state department

• Page 15, Line 19of public health and environment or the county, district, and municipal

• Page 15, Line 20public health agency. An agent of said department shall then contact the

• Page 15, Line 21parent or guardian or the emancipated student or student eighteen years

• Page 15, Line 22of age or older in an effort to secure compliance with this part 9 in order

• Page 15, Line 23that the student may be reenrolled in school.

• Page 15, Line 24SECTION 16.  In Colorado Revised Statutes, 25-3-603, amend

• Page 15, Line 25(1) as follows:

• Page 15, Line 2625-3-603.  Department reports. (1)  Notwithstanding section

• Page 15, Line 2724-1-136 (11)(a)(I), on or before July 15, 2017 September 15, 2025, and

• Page 16, Line 1each July 15 September 15 thereafter, the department shall submit to the

• Page 16, Line 2health and human services committees of the house of representatives and

• Page 16, Line 3of the senate, or their successor committees, a report summarizing

• Page 16, Line 4the risk-adjusted health-facility data. The department shall post the report

• Page 16, Line 5on its website.

• Page 16, Line 6SECTION 17.  In Colorado Revised Statutes, 25-4-2005, amend

• Page 16, Line 7(1) as follows:

• Page 16, Line 825-4-2005.  Hepatitis C testing - recommendations - definitions

• Page 16, Line 9- rules - repeal. (1) (a) (I)  The department recommends that each

• Page 16, Line 10primary health-care provider or physician, physician assistant, or nurse

• Page 16, Line 11practitioner who treats a patient in an inpatient or outpatient setting offer

• Page 16, Line 12a person born between the years of 1945 and 1965 a hepatitis C screening

• Page 16, Line 13test or hepatitis C diagnostic test unless the health-care provider providing

• Page 16, Line 14such services reasonably believes that:

• Page 16, Line 15(a)  (A)  The patient is being treated for a life-threatening

• Page 16, Line 16emergency;

• Page 16, Line 17(b)  (B)  The patient has previously been offered or has been the

• Page 16, Line 18subject of a hepatitis C screening; or

• Page 16, Line 19(c)  (C)  The patient lacks capacity to consent to a hepatitis C

• Page 16, Line 20screening test.

• Page 16, Line 21(II)  This subsection (1)(a) is repealed, effective July 1, 2026.

• Page 16, Line 22(b) (I)  The state board of health created in section

• Page 16, Line 2325-1-103 shall adopt rules establishing standards for hepatitis

• Page 16, Line 24C screening and diagnostic tests for use by primary health-care

• Page 16, Line 25providers, physicians, physician assistants, or nurse

• Page 16, Line 26practitioners who treat patients in an inpatient or outpatient

• Page 16, Line 27setting. The board shall ensure that the screening and

• Page 17, Line 1diagnostic test standards align with recommendations of the

• Page 17, Line 2federal centers for disease control and prevention for hepatitis

• Page 17, Line 3C screening and diagnostic testing.

• Page 17, Line 4(II)  The rules adopted by the board pursuant to this

• Page 17, Line 5subsection (1)(b) shall take effect on July 1, 2026.

• Page 17, Line 6SECTION 18.  Safety clause. The general assembly finds,

• Page 17, Line 7determines, and declares that this act is necessary for the immediate

• Page 17, Line 8preservation of the public peace, health, or safety or for appropriations for

• Page 17, Line 9the support and maintenance of the departments of the state and state

• Page 17, Line 10institutions.