House Bill 25-1082 Preamended

A Bill for an Act

• Page 1, Line 101Concerning authorizing certain individuals to complete

• Page 1, Line 102actions related to death certificates, and, in

• Page 1, Line 103connection therewith, making an appropriation.

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.)

In current law, a "qualified individual" is authorized to determine the cause of death of an individual and complete the medical certification for a certificate of death. The bill defines the term "qualified individual" to include a physician, a physician assistant, an advanced practice registered nurse, or the chief medical officer of the institution in which the death occurred.

The bill requires that qualified individuals register to use the electronic death registration system used by the department of public health and environment and the state registrar prior to signing a death certificate.

• This Unofficial Version Includes Committee

• Amendments Not Yet Adopted on Second Reading

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

• Page 2, Line 2SECTION 1.  In Colorado Revised Statutes, 25-2-110, amend

• Page 2, Line 3(1)(b)(I), (1)(b)(III), (3)(a), (3)(a.5)(I) introductory portion, (3)(a.5)(I)(B),

• Page 2, Line 4(3)(a.5)(I)(C), (3)(a.5)(II), (4), (4.5), and (6); and add (1)(e) and (12) as follows:

• Page 2, Line 525-2-110.  Certificates of death - definitions. (1) (b) (I)  The

• Page 2, Line 6department of public health and environment shall create and the state

• Page 2, Line 7registrar shall use an electronic death registration system for the purpose

• Page 2, Line 8of collecting death information from funeral directors, coroners,

• Page 2, Line 9physicians, physician assistants, advanced practice registered

• Page 2, Line 10nurses, local registrars, health facilities, and other authorized

• Page 2, Line 11individuals, as determined by the department. Death information

• Page 2, Line 12submitted electronically by a funeral director, coroner, physician,

• Page 2, Line 13physician assistant, advanced practice registered nurse, local

• Page 2, Line 14registrar, health facility, or authorized individual, as determined by the

• Page 2, Line 15department, to the electronic death registration system for purposes of

• Page 2, Line 16fulfilling the requirements of this section satisfies the signature and filing requirements of this section and section 30-10-606. C.R.S.

• Page 2, Line 17(III)  Except as otherwise provided in subsection (4.5) of this

• Page 2, Line 18section, any individual, other than a family member of the decedent or

• Page 2, Line 19other individual acting assisting in a nonprofessional capacity as the

• Page 2, Line 20funeral director for the decedent, who is required to initiate, complete,

• Page 2, Line 21respond to, or file a certificate of death pursuant to this section must use the electronic death registration system used by the state registrar.

• Page 3, Line 1(e)  A physician assistant or advanced practice registered

• Page 3, Line 2nurse shall review the training materials regarding signing a

• Page 3, Line 3death certificate provided by the department of public health

• Page 3, Line 4and environment before the first time they sign a death certificate.

• Page 3, Line 5(3) (a)  The funeral director or person acting as such individual

• Page 3, Line 6assisting in a nonprofessional capacity who first assumes custody

• Page 3, Line 7of a dead body, stillborn fetus, or dead fetus is responsible for the filing

• Page 3, Line 8of the certificate of death required by subsection (1) of this section within

• Page 3, Line 9seventy-two hours after receipt of the electronic death registration request

• Page 3, Line 10unless the physician, their associate physician, the physician assistant,

• Page 3, Line 11the advanced practice registered nurse, the chief medical officer

• Page 3, Line 12of the institution in which the death occurred, or the physician who

• Page 3, Line 13performs an autopsy upon the decedent is unable to complete the medical

• Page 3, Line 14certification for the certificate of death within the required time frame.

• Page 3, Line 15The funeral director shall obtain the personal data required by the

• Page 3, Line 16certificate from the next of kin or the best qualified person or source

• Page 3, Line 17available. The funeral director shall obtain the medical certification

• Page 3, Line 18necessary to complete the portion of the certificate pertaining to the cause

• Page 3, Line 19of death from the best qualified person or source available, pursuant to subsection (4) of this section.

• Page 3, Line 20(a.5) (I)  Except as otherwise provided in subsection (3)(a.5)(II) of

• Page 3, Line 21this section, if a decedent had an established primary care physician,

• Page 3, Line 22physician assistant, or advanced practice registered nurse, the

• Page 3, Line 23primary care physician, physician assistant, or advanced practice

• Page 3, Line 24registered nurse is responsible for completing the medical certification

• Page 4, Line 1for the certificate of death in accordance with subsections (1)(a) and (4) of this section if:

• Page 4, Line 2(B)  The decedent received medical care from the primary care

• Page 4, Line 3physician, physician assistant, or advanced practice registered nurse within a year of the death;

• Page 4, Line 4(C)  The death occurred when the decedent was not under the

• Page 4, Line 5direct care of another physician, physician assistant, or advanced

• Page 4, Line 6practice registered nurse charged with the patient's care during the illness or condition that resulted in death; and

• Page 4, Line 7(II)  If, within a year of the death, the decedent had been treated by

• Page 4, Line 8a physician, physician assistant, or advanced practice registered

• Page 4, Line 9nurse other than the decedent's established primary care physician,

• Page 4, Line 10physician assistant, or advanced practice registered nurse for a

• Page 4, Line 11chronic condition or terminal illness related to the decedent's death and

• Page 4, Line 12the conditions set forth in subsections (3)(a.5)(I)(A) and (3)(a.5)(I)(D) of

• Page 4, Line 13this section are met, that physician, physician assistant, or advanced

• Page 4, Line 14practice registered nurse is responsible for completing the medical

• Page 4, Line 15certification for the certificate of death in accordance with subsection (4) of this section.

• Page 4, Line 16(4)  Except when inquiry is required by any provision of section

• Page 4, Line 1730-10-606 other than section 30-10-606 (1)(b), the physician, physician

• Page 4, Line 18assistant, or advanced practice registered nurse in charge of the

• Page 4, Line 19patient's care for the illness or condition that resulted in death shall

• Page 4, Line 20complete the medical certification for the certificate of death within

• Page 4, Line 21seventy-two hours after receipt of the electronic death registration request

• Page 4, Line 22or, before March 1, 2024, only, for a physician, physician assistant, or

• Page 4, Line 23advanced practice registered nurse who is not yet registered to use

• Page 5, Line 1and using the electronic death registration system used by the department

• Page 5, Line 2of public health and environment and the state registrar pursuant to

• Page 5, Line 3subsection (1)(b)(I) of this section, within seventy-two hours after

• Page 5, Line 4receiving notice that a medical certification for a certificate of death must

• Page 5, Line 5be completed. In the absence of said the physician, physician

• Page 5, Line 6assistant, or advanced practice registered nurse or with the

• Page 5, Line 7physician's, physician assistant's, or advanced practice registered

• Page 5, Line 8nurse's approval, the certificate may be completed and signed by an

• Page 5, Line 9associate physician, physician assistant, advanced practice

• Page 5, Line 10registered nurse,by the chief medical officer of the institution in

• Page 5, Line 11which the death occurred, or by the physician who performed an autopsy

• Page 5, Line 12upon the decedent, if such individual has access to the medical history of

• Page 5, Line 13the case, if said individual views the decedent at or after the time of

• Page 5, Line 14death, and if the death is due to natural causes. If the death is or may be

• Page 5, Line 15due to unnatural causes, a physician, physician assistant, or

• Page 5, Line 16advanced practice registered nurse required to complete a medical

• Page 5, Line 17certification for a certificate of death in accordance with this subsection

• Page 5, Line 18(4) shall notify the coroner or the medical examiner when an inquiry or

• Page 5, Line 19an autopsy is required to be performed pursuant to sections 30-10-606 and

• Page 5, Line 2030-10-606.5. On and after March 1, 2024, a physician's, physician

• Page 5, Line 21assistant's, or advanced practice registered nurse's repeated or

• Page 5, Line 22willful failure without reasonable cause to comply with timely completion

• Page 5, Line 23of a medical certification for a certificate of death in accordance with

• Page 5, Line 24subsection (1)(a) of this section and this subsection (4) constitutes

• Page 5, Line 25unprofessional conduct, as defined in section 12-240-121 (1)(hh). If an

• Page 5, Line 26autopsy is performed, the certification shall indicate whether the decedent

• Page 5, Line 27was pregnant at the time of death, and said the information shall be

• Page 6, Line 1reported on the death certificate as required by subsection (9) of this

• Page 6, Line 2section. Except as otherwise provided in subsection (4.5) of this section,

• Page 6, Line 3the physician, physician assistant, or advanced practice

• Page 6, Line 4registered nurse or, in their absence, their designee in accordance with

• Page 6, Line 5this subsection (4), shall complete the medical certification for a

• Page 6, Line 6certificate of death required by this subsection (4) using the electronic

• Page 6, Line 7death registration system used by the department of public health and

• Page 6, Line 8environment and the state registrar pursuant to subsection (1)(b)(I) of this section.

• Page 6, Line 9(4.5) (a)  The department of public health and environment shall

• Page 6, Line 10ensure that all physicians are registered to use the electronic death

• Page 6, Line 11registration system created and used pursuant to subsection (1)(b)(I) of

• Page 6, Line 12this section on or before March 1, 2024. A physician shall use the system

• Page 6, Line 13for all medical certifications for certificates of death required by

• Page 6, Line 14subsection (4) of this section immediately upon being registered but is not required to do so before being registered.

• Page 6, Line 15(b)  A qualified individual shall register to use the

• Page 6, Line 16electronic death registration system prior to signing a death certificate.

• Page 6, Line 17(6)  If the cause of death cannot be determined within forty-eight

• Page 6, Line 18hours after a death, the medical certification shall be completed as

• Page 6, Line 19provided by rule. If an autopsy is performed, the certification shall

• Page 6, Line 20indicate whether the decedent was pregnant at the time of death, and said

• Page 6, Line 21the information shall be reported on the death certificate as required by

• Page 6, Line 22subsection (9) of this section. The attending physician, physician

• Page 6, Line 23assistant, advanced practice registered nurse, or coroner shall

• Page 6, Line 24give the funeral director or person acting as such individual assisting

• Page 7, Line 1in a nonprofessional capacity notice of the reason for the delay, and

• Page 7, Line 2final disposition of the body shall not be made until authorized by the

• Page 7, Line 3office designated or established pursuant to section 25-2-103 in the

• Page 7, Line 4county where the death occurred or, if such an office does not exist in the

• Page 7, Line 5county where the death occurred, final disposition of the body shall not be made until authorized by the coroner or the coroner's designee.

• Page 7, Line 6(12)  As used in this section, "qualified individual" means a

• Page 7, Line 7physician; a physician assistant licensed pursuant to article 240

• Page 7, Line 8of title 12; an advanced practice registered nurse, as defined in

• Page 7, Line 9section 12-255-104 (1); or the chief medical officer of the institution in which the death occurred.

• Page 7, Line 10SECTION 2.  In Colorado Revised Statutes, 25-2-111, amend (1) as follows:

• Page 7, Line 1125-2-111.  Dead bodies - disposition - removal from state -

• Page 7, Line 12records. (1)  Any person requested to act as funeral director for a dead

• Page 7, Line 13body or otherwise whoever A funeral director or individual

• Page 7, Line 14assisting in a nonprofessional capacity who first assumes custody

• Page 7, Line 15of a dead body shall, prior to final disposition of the body, obtain

• Page 7, Line 16authorization for final disposition of the body. The office designated or

• Page 7, Line 17established pursuant to section 25-2-103 in the county where the death

• Page 7, Line 18occurred or, if such an office does not exist in the county where the death

• Page 7, Line 19occurred, the coroner or the coroner's designee shall authorize final

• Page 7, Line 20disposition of the body on a form prescribed and furnished by the state

• Page 7, Line 21registrar. No body shall be buried, cremated, deposited in a vault or tomb,

• Page 7, Line 22or otherwise disposed of, nor shall any body be removed from this state,

• Page 7, Line 23until such authorization has been obtained, completed, and approved. The

• Page 7, Line 24coroner or the coroner's designee shall include in the authorization notice of the requirements of subsection (7) of this section.

• Page 8, Line 1SECTION 3.  Appropriation. For the 2025-26 state fiscal year,

• Page 8, Line 2$25,000 is appropriated to the department of public health and

• Page 8, Line 3environment for use by the center for health and environmental data. This

• Page 8, Line 4appropriation is from the vital statistics records cash fund created in

• Page 8, Line 5section 25-2-121 (2)(b)(I), C.R.S. To implement this act, the center may

• Page 8, Line 6use this appropriation for operating expenses related to health statistics and vital records.

• Page 8, Line 7SECTION 4.  Act subject to petition - effective date. This act

• Page 8, Line 8takes effect at 12:01 a.m. on the day following the expiration of the

• Page 8, Line 9ninety-day period after final adjournment of the general assembly; except

• Page 8, Line 10that, if a referendum petition is filed pursuant to section 1 (3) of article V

• Page 8, Line 11of the state constitution against this act or an item, section, or part of this

• Page 8, Line 12act within such period, then the act, item, section, or part will not take

• Page 8, Line 13effect unless approved by the people at the general election to be held in

• Page 8, Line 14November 2026 and, in such case, will take effect on the date of the official declaration of the vote thereon by the governor.