(1) The office of saving people money on health care in the lieutenant governor's office shall study:
(a) The level of preparedness of health facilities licensed pursuant to section 25-1.5-103 to respond to post-viral illness resulting from the COVID-19 virus;
(b) The effects of post-viral illness resulting from the COVID-19 virus on the mental, behavioral, and physical health and the financial security of the people of Colorado; and
(c) The effects of the COVID-19 pandemic on the cost of health care in Colorado and on the ability of Colorado's public health system to respond to emergencies.
(2) On or before January 1, 2023, and on or before January 1 each year thereafter, the office of saving people money on health care shall report its findings to the governor.
(3) The office of saving people money on health care shall coordinate, monitor, and support the efforts to improve the affordability of health care, health outcomes, and public health readiness in state programs and departments.
Source: L. 2022: Entire section added, (HB 22-1401), ch. 178, p. 1179, � 1, effective May 18.
25-3-130. Intimate examination of sedated or unconscious patient - informed consent required - rules - definitions. (1) (a) (I) Except as provided in subsection (1)(b) of this section, a health-care facility shall not permit a licensed health-care provider, or a student or trainee under the supervision of a licensed health-care provider, to perform an intimate examination of a sedated or unconscious patient at the health-care facility unless the patient has provided specific informed consent to the examination in accordance with subsection (2) of this section.
(II) In addition to the requirement to obtain a patient's specific informed consent, a health-care facility may allow a student or trainee to perform an intimate examination of a sedated or unconscious patient for educational or training purposes only if:
(A) The examination is related to the planned procedure to be performed on the patient at the health-care facility;
(B) The student or trainee has been introduced to the patient as part of the patient's care team, and the student's or trainee's role in performing an intimate examination for educational or training purposes has been shared with the patient; and
(C) The student or trainee is under the direct supervision of the licensed health-care provider responsible for supervising the student or trainee.
(b) The requirements of subsection (1)(a) of this section do not limit the ability of a health-care facility to allow:
(I) A licensed health-care provider to perform an intimate examination of a patient who is sedated or unconscious without obtaining the patient's specific informed consent in emergency situations when the intimate examination is medically necessary for the life or well-being of the patient, but the licensed health-care provider must make a record of performing the examination without obtaining the patient's specific informed consent, including an explanation of the reason for not obtaining the patient's consent, and the record must be provided to the patient prior to discharge; or
(II) A licensed health-care provider who has obtained the patient's consent to provide health care that includes an intimate examination to perform the intimate examination if the licensed health-care provider has informed the patient of the intimate examination in the course of obtaining the patient's consent to the health care.
(2) To obtain specific informed consent to perform an intimate examination on a sedated or unconscious patient, a health-care facility shall, during a preoperative appointment before the procedure at which the examination will be performed or, in the absence of a preoperative appointment, as soon as possible before the intimate examination occurs:
(a) Provide a written or electronic document to the patient, separate from any other notice or agreement, that:
(I) Includes the following heading at the top of the document, in no smaller than eighteen-point, bold-faced type: CONSENT FOR EXAMINATION OF BREASTS, PELVIC REGION, RECTUM, AND/OR PROSTATE;
(II) Specifies the nature and purpose of the intimate examination;
(III) Names one or more licensed health-care providers whom the patient may authorize to perform the intimate examination;
(IV) States whether there may be one or more students or trainees whom the patient may authorize to perform an intimate examination for educational or training purposes or to observe or otherwise be present at the examination, either in person or through electronic means, and identifies the students or trainees by name; and
(V) Provides the patient the ability to consent to or decline the following:
(A) An intimate examination for diagnosis or treatment, to be performed by a licensed health-care provider;
(B) An intimate examination for educational or training purposes, to be performed by a licensed health-care provider; and
(C) One or more, but no more than three, additional intimate examinations for educational or training purposes, to be performed by up to three different students or trainees;
(b) Obtain the signature of the patient on the written or electronic document; and
(c) Sign the written or electronic document.
(3) (a) For purposes of complying with subsection (2) of this section, a health-care facility may:
(I) Develop and use its own written or electronic document, so long as the document satisfies the requirements of subsection (2) of this section; or
(II) Use a written or electronic document developed by the department for use by health-care facilities and licensed health-care providers, so long as the document satisfies the requirements of subsection (2) of this section.
(b) If the department develops a written or electronic document for use by health-care facilities, the department shall develop a single, consistent document for use by all health-care facilities and all licensed health-care providers, regardless of practice area, that complies with the requirements of subsection (2) of this section.
(c) The health-care facility shall make the completed, signed specific informed consent document available to the patient.
(4) (a) (I) If a health-care facility violates this section, or retaliates against an individual, including a whistleblower, for filing a complaint regarding a violation of this section with the department or a regulator or for otherwise complaining to any other person, the aggrieved individual may file a complaint with the department. The department may receive and investigate complaints filed pursuant to this subsection (4)(a) against a health-care facility and, as appropriate, may refer matters related to a licensed health-care provider or a student or trainee under the supervision of a licensed health-care provider to the appropriate regulator.
(II) If the department determines, after a hearing on the matter in accordance with the requirements and procedures specified in article 4 of title 24, that a health-care facility has violated this section or has retaliated against an individual, including a whistleblower, for filing a complaint with the department or a regulator regarding a violation of this section or for otherwise complaining to any other person, the department may take action authorized in this article 3 against the health-care facility's license or impose restrictions or conditions on the health-care facility as the department determines appropriate.
(III) The state board of health may adopt rules as necessary to enforce this section.
(b) A patient who has been subjected to an intimate examination in violation of this section may file a civil action for damages in a court of competent jurisdiction. Such action is not a medical malpractice action, and the limitation on damages for noneconomic loss or injury established pursuant to section 13-21-102.5 applies to any award to the patient for noneconomic damages.
(5) Nothing in this section affects the ability to perform a medical forensic examination, including the collection of evidence, in connection with an alleged sexual assault or other crime or the investigation of an alleged sexual assault or other crime, pursuant to applicable laws.
(6) As used in this section:
(a) Health-care facility means a health-care facility licensed or certified by the department pursuant to section 25-1.5-103 (1)(a) and includes an individual authorized to act on behalf of the health-care facility.
(b) (I) Intimate examination means palpation of a breast or an internal pelvic, prostate, or rectal examination.
(II) Intimate examination does not include a visual examination of a part of the body specified in subsection (6)(b)(I) of this section that occurs incidental to the care being provided.
(c) Licensed health-care provider means:
(I) A physician or physician assistant licensed pursuant to article 240 of title 12;
(II) A person who holds a physician training license issued pursuant to section 12-240-128 and is:
(A) A resident enrolled in an approved residency, as defined in section 12-240-104 (4);
(B) An intern enrolled in an approved internship, as defined in section 12-240-104 (2); or
(C) A fellow enrolled in an approved fellowship, as defined in section 12-240-104 (1);
(III) An advanced practice registered nurse, as defined in section 12-255-104 (1); a registered nurse, as defined in section 12-255-104 (11); or a midwife, other than a direct-entry midwife or certified nurse midwife, practicing in this state whose scope of practice includes performing intimate examinations; or
(IV) A direct-entry midwife registered pursuant to article 225 of title 12.
(d) Patient means an individual under the care of a licensed health-care provider or health-care facility or the patient's authorized representative.
(e) Patient's authorized representative means an individual who is authorized to make health-care decisions for or exercise rights on behalf of the patient, including, for a patient who is under eighteen years of age, the parent or legal guardian of, or the individual standing in loco parentis to, the patient.
(f) Regulator means:
(I) For licensed health-care providers described in subsections (6)(c)(I) and (6)(c)(II) of this section, the Colorado medical board created in section 12-240-105;
(II) For licensed health-care providers described in subsection (6)(c)(III) of this section, the state board of nursing created in section 12-255-105; and
(III) For licensed health-care providers described in subsection (6)(c)(IV) of this section, the director of the division of professions and occupations in the department of regulatory agencies.
(g) Student means an individual currently enrolled in:
(I) An approved medical college, as defined in section 12-240-104 (3);
(II) An approved education program, as defined in section 12-255-104 (2), for professional nursing; or
(III) A training program approved by the director of the division of professions and occupations in the department of regulatory agencies, as described in section 12-225-104 (4)(c).
(h) Trainee means an individual enrolled in or otherwise participating in training, practical experience, practicum, or any other experiential or clinical program that is required pursuant to article 225, 240, or 255 of title 12 for the individual to become a licensed health-care provider.
(i) Whistleblower means an individual who has knowledge of an alleged violation of this section.
Source: L. 2023: Entire section added, (HB 23-1077), ch. 262, p. 1557, � 2, effective January 1, 2024.
25-3-131. Maternal health-care services - discontinuation - required notifications - definitions - repeal. (1) Except as provided in subsection (3) of this section, at least ninety days before a hospital providing maternal health-care services or a birth center may discontinue such services, the facility shall provide notice to:
(a) The department of public health and environment responsible for licensing health facilities pursuant to section 25-3-101;
(b) The primary care office, created in section 25-1.5-403;
(c) The governor;
(d) All patients receiving maternal health-care services at the facility as of the date of the notice;
(e) All health-care providers that provide maternal health-care services for the facility as of the date of the notice; and
(f) The general public.
(2) The notice required in subsection (1) of this section must include:
(a) A description of the maternal health-care services being discontinued;
(b) The rate the maternal health-care services had been provided at in the previous year;
(c) The number and type of health-care providers impacted;
(d) The proposed plan for transitioning patients to new health-care providers; and
(e) The proposed plan for transitioning the health-care providers to new positions.
(3) (a) In the event of an emergency, a facility shall provide the notice required in subsection (1) of this section on the day a definitive plan for alternative patient care has been arranged or within seven days after the emergency has been identified, whichever is earlier.
(b) This subsection (3) does not apply in the event of an emergency covered by rules promulgated by the department of public health and environment if such emergency affects the physical space of the facility and necessitates the removal of clients, employees, or contractors from the facility.
(4) As used in this section:
(a) Emergency means a sudden and unforeseen circumstance or financial impediment that would inhibit a hospital's ability to safely and effectively operate a maternal health-care service.
(b) Maternal health-care services means health-care services provided to an individual regarding care related to the individual's pregnancy, childbirth, and postpartum period.
(5) This section is repealed, effective July 1, 2027.
Source: L. 2024: Entire section added, (HB 24-1262), ch. 393, p. 2711, � 5, effective June 4.
Cross references: For the legislative declaration in HB 24-1262, see section 1 of chapter 393, Session Laws of Colorado 2024.
25-3-132. Rural and frontier hospital capital needs study - task force - creation - report - legislative declaration - definitions - repeal. (1) The general assembly finds and declares that:
(a) Many of Colorado's rural and frontier hospitals operate in outdated facilities, and some facilities have not had any meaningful upgrades for decades;
(b) These hospitals struggle with the increased maintenance costs necessary to keep facilities operational and are falling behind in being able to provide care that is consistent with current standards; and
(c) An informal study conducted by Colorado Rural Futures, a group of chief executive officers of Colorado rural and frontier hospitals, identified approximately five hundred million dollars in needed upgrades for facilities of hospitals that were responsive to the informal study, but the capital needs of rural and frontier hospitals throughout the state could require an investment of as much as one billion dollars.
(2) As used in this section, unless the context otherwise requires:
(a) Frontier area means a county in the state that has a population density of six or fewer individuals per one square mile.
(b) Rural and frontier hospital means a hospital that is licensed as a general or critical access hospital by the department and that operates in a rural area or a frontier area.
(c) Rural area means an area listed as eligible for rural health funding by the federal office of rural health policy.
(d) Study means the study required pursuant to this section.
(e) Task force means the rural and frontier hospital capital needs study task force created in subsection (4)(a) of this section.
(3) Subject to oversight by the task force, the department shall study or shall contract for a study to evaluate the capital needs of Colorado rural and frontier hospitals. The study must:
(a) Objectively measure the number of studied facilities that are not code compliant in accordance with the current and relevant edition of the Facility Guidelines Institute Guidelines for Design and Construction of Health Care Facilities;
(b) Identify the age of core facilities and additions that have been made to such buildings;
(c) Evaluate the estimated project cost, including construction costs and relevant planning, design, and engineering costs, per square foot to renovate or replace facilities identified as having capital needs;
(d) Make a reasonable estimate of the total cost of capital needs per facility and the aggregate total cost of capital needs for all facilities identified in the study; and
(e) Review or evaluate any other matters concerning capital needs of rural and frontier hospitals that are requested by the task force.
(4) (a) (I) There is created the rural and frontier hospital capital needs study task force for the purposes of developing and approving the parameters of the study and overseeing the study and the report of the results of the study.
(II) In addition to the purpose of the task force set forth in subsection (4)(a)(I) of this section, the task force may facilitate contracting with a private sector consulting company to assist with data compilation, research, and outreach to rural and frontier hospitals. The task force may establish the frequency that the task force wants the company to report back to the task force.
(b) (I) Subject to subsection (4)(b)(II) of this section, no later than two months after sufficient funding has been secured in accordance with subsection (6)(a) of this section, members shall be appointed to the task force as follows:
(A) The governor shall appoint three members; and
(B) The president of the senate, the speaker of the house of representatives, the minority leader of the senate, and the minority leader of the house of representatives shall appoint one member each.
(II) The composition of members appointed to the task force must be as follows:
(A) Three members who work in rural or frontier hospitals;
(B) One member who works as an architect professional;
(C) One member who works as a construction contractor professional;
(D) One member who represents hospitals; and
(E) One member of the general public who lives in a rural area or frontier area.
(c) The task force shall hold its first meeting within two months of all appointments being made to the task force pursuant to subsection (4)(b) of this section and meet at least quarterly after its first meeting until the report required by subsection (5) of this section is completed and may meet more frequently before that date if needed. Meetings of the task force may be in person or online.
(5) Not later than eighteen months after the date that the task force holds its first meeting, the department shall complete the study and compile the results of the study into a report. The department shall present the report to the house of representatives health and human services committee and the senate health and human services committee, or their successor committees.
(6) (a) It is the intent of the general assembly that the implementation of this section be funded entirely by gifts, grants, and donations; that gifts, grants, and donations will be received throughout the course of the study; and that, in accordance with section 24-75-1305, no additional general fund money be appropriated for the implementation of this section. The department and the task force may seek, accept, and expend gifts, grants, or donations from private or public sources to implement this section. The department shall not implement this section unless it receives an amount of gifts, grants, and donations that it deems necessary to implement this section.
(b) The study is contingent on money being available to carry out the study. If money is not available for the task force, the department, or any other entity to carry out its duties required pursuant to this section, the task force, the department, or the entity is not required to carry out the duties. A contract with a third-party entity that will provide services related to the study must be contingent on money being available for that purpose.
(7) This section is repealed, effective July 1, 2027.
Source: L. 2025: Entire section added, (HB 25-1223), ch. 439, p. 2527, � 1, effective August 6.
25-3-133. Emergency medical condition - emergency medical services - transfer - discharge - nonliability - enforcement - definitions. (1) Requirements. A facility shall provide emergency medical services to a person who presents to the facility when the person requests or a request is made on the person's behalf for emergency medical services. In the absence of a request, a facility shall provide emergency medical services to a person if a prudent layperson would believe, based on the person's appearance or behavior, that the person is in need of emergency medical services.
(2) Central log required. For each person who presents to a facility and requests emergency medical services or a request is made on the person's behalf for emergency medical services, the facility shall input into a central log whether the person refused treatment, was denied treatment, whether no treatment was required, or whether the person was transferred, admitted and treated, stabilized and transferred, or discharged.
(3) Nondiscrimination. A facility is a place of public accommodation subject to part 6 of article 34 of title 24 and shall not deny emergency medical services or discriminate in providing emergency medical services to a patient for a discriminatory or unlawful reason as described in part 6 of article 34 of title 24.
(4) Provider protections. (a) A facility shall not penalize or take any adverse action against a health-care provider for refusing to transfer a patient with an emergency medical condition that has not been stabilized.
(b) This subsection (4) does not alter or limit the rights and protections afforded to a person pursuant to section 24-34-402 (1).
(5) Financial inquiry. A facility shall not delay providing emergency medical services to a person in order to inquire about the person's ability to pay for emergency medical services.
(6) Appropriate transfer. If a patient has received an appropriate medical screening examination as described in subsection (10)(c)(I)(A) of this section and the examining health-care provider determines that an emergency medical condition exists and the condition has not been stabilized, the facility shall not transfer the patient unless all of the following conditions are met:
(a) The patient is provided medical treatment within the facility's capacity that minimizes the risks to the patient's health;
(b) The receiving facility has the space and qualified personnel available for treating the patient and has agreed to accept transfer of the patient and to provide appropriate medical treatment;
(c) The transfer is effected through qualified personnel and transportation equipment, including the use of necessary and medically appropriate life support measures during the transfer;
(d) The transferring facility sends all medical records or copies of the medical records, related to the patient's emergency medical condition that the patient presented to the facility for, that are available at the time of the transfer, including medical records or copies of the medical records, related to observations of signs and symptoms; preliminary diagnosis; treatment provided to the patient; test results; the informed written request or certification provided pursuant to subsection (6)(e) of this section or a copy of the request or certification; and, if relevant, the name and address of any on-call physician who refused or failed to appear at the facility within a reasonable amount of time to provide the patient with necessary stabilizing treatment;
(e) (I) After being informed of the facility's obligations pursuant to this section and the risk of transfer, the patient or the patient's representative requests the transfer in writing;
(II) A physician has signed a certification that includes a summary of the risks and benefits of transferring the patient and a statement that, based upon the information available at the time of the transfer, the medical benefits reasonably expected from the provision of appropriate medical treatment at another facility outweigh the increased risks to the patient from being transferred; or
(III) If a physician is not physically present in the facility at the time a patient is transferred, the examining health-care provider has signed a certification that includes the information described in subsection (6)(e)(II) of this section and the physician, after consulting with the examining health-care provider, agrees with the certification and subsequently countersigns the certification.
(7) Appropriate discharge (a) If a patient has received an appropriate medical screening examination as described in subsection (10)(c)(I)(A) of this section and the examining health-care provider determines that an emergency medical condition exists, the facility shall not discharge the patient unless the patient's emergency medical condition has been stabilized.
(b) If a patient has not been stabilized, discharging the patient is only permitted if:
(I) After being informed of the facility's obligations pursuant to this section and the risk of discharge, the patient or the patient's representative requests a discharge in writing; or
(II) The facility offers the patient further medical examination and treatment and informs the patient or the patient's representative of the risks and benefits of the examination and treatment but the patient or the patient's representative does not consent to the medical examination and treatment. The patient's medical record must contain a description of the examination and, if applicable, the treatment and a statement that the patient or the patient's representative refused. The facility shall take all reasonable steps to secure the patient's written informed refusal, which must indicate the patient has been informed of the risks and benefits of the examination and treatment, if applicable.
(8) Nonliability. A facility or health-care provider does not violate this section if:
(a) The patient is provided an appropriate medical screening examination as described in subsection (10)(c)(I)(A) of this section by a health-care provider and the examining health-care provider determines that no emergency medical condition exists and records the determination in the patient's medical record;
(b) The patient is provided an appropriate medical screening examination as described in subsection (10)(c)(I)(A) of this section by a health-care provider and the examining health-care provider determines that an emergency medical condition exists and the patient is appropriately transferred or discharged pursuant to subsection (6) or (7) of this section; or
(c) The patient is provided an appropriate medical screening examination as described in subsection (10)(c)(I)(A) of this section by a health-care provider and the examining health-care provider determines that an emergency medical condition exists and the patient is admitted in good faith to the facility as an inpatient for further stabilizing treatment.
(9) Investigation and penalty. (a) The department may investigate a facility that negligently violates this section pursuant to section 25-1.5-103 (1)(a).
(b) (I) A physician who negligently violates this section engages in unprofessional conduct and is subject to discipline pursuant to section 12-240-121.
(II) This subsection (9)(b) applies to a physician who:
(A) Signs a certification pursuant to subsection (6)(e)(II) of this section that states the medical benefits reasonably expected from appropriate medical treatment at another facility outweigh the increased risks to the patient from being transferred if the physician knew or should have known the benefits did not outweigh the risks;
(B) Misrepresents a patient's condition or other information, including a facility's obligations pursuant to this section; or
(C) Is the on-call physician and fails or refuses to present to the facility within a reasonable period of time pursuant to subsection (10)(c)(I)(B) of this section after being contacted.
(c) If a civil monetary penalty is imposed pursuant to section 12-240-121 or 25-1.5-103 , the maximum civil monetary penalty amount must be reduced by any civil monetary penalty imposed pursuant to the federal Emergency Medical Treatment and Active Labor Act, 42 U.S.C. sec. 1395dd (d), for the same violation.
(10) Definitions. As used in this section, unless the context otherwise requires:
(a) Abortion has the same meaning as set forth in section 25-6-402.
(b) (I) Emergency medical condition means:
(A) A medical condition manifesting itself by acute signs and symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in placing the health of the person in serious jeopardy, serious impairment of bodily functions, or serious dysfunction of any bodily organ or part; or
(B) With respect to a pregnant person who is having contractions, there is inadequate time to effectuate a safe transfer to another facility before delivery or that transferring the patient may pose a threat to the health or safety of the patient.
(II) Emergency medical condition includes, but is not limited to, labor, ectopic pregnancy, a complication resulting from pregnancy or pregnancy loss, and emergent hypertensive disorders when the absence of immediate medical attention could reasonably be expected to result in placing the health of the person in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.
(c) (I) Emergency medical services means:
(A) An appropriate medical screening examination within the capability of the facility, including ancillary services routinely available to the facility, to determine if an emergency medical condition exists; and
(B) When the examining health-care provider determines that an emergency medical condition exists, the medical treatment necessary to stabilize the emergency medical condition that is within the capability of the facility. If the patient's emergency medical condition requires the services of an on-call physician, the examining health-care provider shall attempt to contact the on-call physician, if applicable.
(II) Emergency medical services includes providing an abortion or sterilization procedures when a patient has an emergency medical condition and an abortion or sterilization procedures are necessary to stabilize the patient and are within the capability and capacity of the facility.
(d) Facility means an emergency department of a hospital licensed pursuant to section 25-3-101; a freestanding emergency department, as defined in section 25-1.5-114; or any other licensed health-care facility, or area of a hospital or health-care facility, that holds itself out to the public as providing emergency care.
(e) Labor means the process of childbirth beginning with the latent or early phase of labor and continuing through the delivery of the placenta. A person experiencing contractions is in labor unless a physician, a certified nurse midwife, or other qualified medical personnel, acting within the person's scope of practice as defined in the facility's medical staff bylaws and state law, certifies after a reasonable time of observation that the person is in false labor.
(f) Stabilize means to provide medical treatment that may be necessary to ensure, within reasonable medical probability, that no material deterioration of the patient's condition, serious impairment of bodily functions or dysfunction of any bodily organ or part, or threat to the patient's life is likely to result from or occur during the transfer or discharge of the patient.
Source: L. 2025: Entire section added, (SB 25-130), ch. 190, p. 841, � 1, effective May 14.