As used in this part 17, unless the context otherwise requires:
(1) Board of health means the state board of health.
(2) Department means the state department of public health and environment.
(3) Infant means any child up to twenty-four months of age or any child eligible for vaccination and enrolled under the Colorado Medical Assistance Act, articles 4, 5, and 6 of title 25.5, C.R.S.
(3.5) Minor means any child under eighteen years of age.
(4) Practitioner means a duly licensed physician or other person who is permitted and otherwise qualified to administer vaccines under the laws of this state.
(5) Vaccine means such vaccines as are determined by the board of health to be necessary to conform to recognized standard medical practices. Such term includes, but is not limited to, the following vaccines:
(a) Diphtheria-tetanus-pertussis (DTP);
(b) Polio: Oral polio vaccine (OPV) or inactivated polio vaccine (IPV);
(c) Measles-mumps-rubella (MMR);
(d) Haemophilus influenzae type B conjugate vaccines (HIB).
Source: L. 92: Entire part added, p. 1308, � 1, effective July 1. L. 94: (2) amended, p. 2776, � 474, effective July 1. L. 96: (3.5) added, p. 583, � 2, effective July 1. L. 2006: (3) amended, p. 2015, � 90, effective July 1.
Cross references: For the legislative declaration contained in the 1994 act amending subsection (2), see section 1 of chapter 345, Session Laws of Colorado 1994.
25-4-1704. Infant immunization program - delegation of authority to immunize minor. (1) There is hereby created in the department an infant immunization program which is established to immunize infants against vaccine preventable disease. Such program shall be implemented on and after January 1, 1993.
(2) Every parent, legal guardian, or person vested with legal custody or decision-making responsibility for the medical care of a minor, or person otherwise responsible for the care of an infant residing in this state, shall be responsible for having such infant vaccinated in compliance with the schedule of immunization established by the board of health; except that, failure to vaccinate a child in accordance with this subsection (2) shall not constitute sufficient grounds for any insurance company to deny a claim submitted on behalf of a child who develops a vaccine preventable disease.
(2.5) (a) Subject to the provisions of this subsection (2.5), a parent, legal guardian, person vested with legal custody of a minor or decision-making responsibility for the medical care of a minor, or such other adult person responsible for the care of a minor in this state, other than any employee of a licensed child care center in which the minor is enrolled, may delegate, verbally or in writing, that person's authority to consent to the immunization of a minor to a stepparent, an adult relative of first or second degree of kinship, or an adult child care provider who has care and control of the minor. Any immunization administered pursuant to a delegation of authority under this subsection (2.5) shall be administered only at a health-care clinic, hospital, office of a private practitioner, or county public health clinic.
(b) If a parent, legal guardian, person vested with legal custody of a minor or decision-making responsibility for the medial care of a minor, or other adult person responsible for the care of a minor in this state verbally delegates his or her authority to consent to the immunization of a minor under this subsection (2.5), the person to whom such authority is thereby delegated shall confirm the verbal delegation in writing and shall verbally relay any relevant health history to the administering practitioner. The practitioner administering the vaccination shall include the written confirmation in the minor's medical record. If a parent, legal guardian, person vested with legal custody of a minor or decision-making responsibility for the medical care of a minor, or other adult person responsible for the care of a minor in this state delegates his or her authority to consent to the immunization of a minor under this subsection (2.5) in writing, such writing shall include the relevant health history, and the practitioner administering the vaccination shall include a copy of the written delegation of authority in the minor's medical record.
(c) A person who consents to the immunization of a minor pursuant to a delegation of authority under this subsection (2.5) shall provide the practitioner with sufficient and accurate health information about the minor for whom the consent is given and, if necessary, sufficient and accurate health information about the minor's family to enable the practitioner to assess adequately the risks and benefits inherent in the proposed immunization and to determine whether the immunization is advisable.
(d) A person may not consent to the immunization of a minor pursuant to this subsection (2.5) if:
(I) The person has actual knowledge that the parent, legal guardian, person vested with legal custody of a minor or decision-making responsibility for the medical care of a minor, or other adult person responsible for the care of a minor in this state has expressly refused to give consent to the immunization; or
(II) The parent, legal guardian, person vested with legal custody of a minor or decision-making responsibility for the medical care of a minor, or other adult person responsible for the care of a minor in this state has told the person that the person may not consent to the immunization of the minor or, in the case of a written authorization, has withdrawn the authorization in writing.
(3) In addition to the immunization obligations set forth in section 25-4-905, relating to the immunization of indigent children, and except as provided in subsection (4) of this section, the department shall provide at public expense, subject to available appropriations, systematic immunizations to those infants that are not exempt from such immunization pursuant to paragraph (a) or (b) of subsection (4) of this section. The manner and frequency of vaccine administration shall conform to recognized standards of medical practice which are necessary for the protection of public health.
(4) An infant shall be exempted from receiving the required immunizations:
(a) Upon submitting certification from a licensed physician or advanced practice registered nurse that the physical condition of the infant is such that one or more specified immunizations would endanger the infant's life or health; or
(b) Upon submitting a statement signed by one parent or guardian that such parent or guardian adheres to a religious belief whose teachings are opposed to immunizations, or that such parent or guardian has a personal belief that is opposed to immunization.
Source: L. 92: Entire part added, p. 1308, � 1, effective July 1. L. 96: (2.5) added, p. 583, � 3, effective July 1. L. 98: (2), (2.5)(a), (2.5)(b), and (2.5)(d) amended, p. 1412, � 79, effective February 1, 1999. L. 2008: (4)(a) amended, p. 133, � 19, effective January 1, 2009.
25-4-1705. Department of public health and environment - powers and duties - rules. (1) The department shall negotiate for the purchase of and shall purchase vaccines to achieve the purposes of this part 17.
(2) The department shall secure and maintain such facilities as may be necessary for the safe and adequate preservation and storage of such vaccines.
(3) The department shall distribute such vaccines, in accordance with rules promulgated by the board of health, without purchase, shipping, handling, or other charges to practitioners who agree not to impose a charge for such vaccine on the infant recipient, the child's parent or guardian, third-party payer, or any other person; except that a practitioner may charge a reasonable administrative fee in connection with the administration of a vaccine. The board of health shall determine the amount of such administrative fee that a practitioner may charge.
(4) The department shall collect epidemiological information and shall establish a system for recording such information pursuant to rules and regulations adopted by the board of health.
(5) The board of health, in consultation with the medical services board in the state department of health care policy and financing, and such other persons, agencies, or organizations that the board of health deems advisable, shall formulate, adopt, and promulgate rules governing the implementation and operation of the infant immunization program. Such rules shall address the following:
(a) The purchase, storage, and distribution of the vaccines by the department;
(b) Requirements that providers, hospitals, and health-care clinics must meet before entering into a contract with the department, making such provider, hospital, or clinic an agent of the department for the purposes of the infant immunization program;
(c) Which vaccines shall be required to be administered;
(d) The route and frequency of the vaccine's administration;
(e) (Deleted by amendment, L. 2007, p. 655, � 3, effective April 26, 2007.)
(f) The issuance of immunization records to parents or guardians;
(g) The assessment of the vaccination status of infants;
(h) The dissemination of information about the operation of the infant immunization program, including the requirement that such information be distributed by hospitals to parents of newborns.
(6) The department is authorized to accept any gifts or grants or awards of funds from the federal government or private sources for the implementation and operation of the infant immunization program.
(7) The department is authorized to enter into contracts which are necessary for the implementation and operation of the infant immunization program.
(8) County, district, or municipal public health agencies and the department shall use the birth certificate of any infant to enroll such infant in an immunization tracking system established in section 25-4-2403. Such use of the infant's birth certificate shall be considered an official duty of county, district, and municipal public health agencies and the department.
(9) (a) (Deleted by amendment, L. 2003, p. 2198, � 1, effective August 6, 2003.)
(b) The department or any person who contracts with the department pursuant to subsection (7) of this section may establish a purchase system as described in section 25-4-2403 for the procurement of vaccines for privately insured persons under federal government contracts.
(10) Physicians, licensed health-care practitioners, clinics, schools, licensed child care providers, hospitals, managed care organizations or health insurers in which a student, as defined in section 25-4-901 (3), or an infant is enrolled as a member or insured, persons that have contracted with the department pursuant to subsection (7) of this section, and public health officials may release any immunization records in their possession, whether or not such records are in the immunization tracking system established in section 25-4-2403, to the persons or entities specified in section 25-4-2403 (1) to provide an accurate and complete immunization record for the child in order to verify compliance with state immunization law.
Source: L. 92: Entire part added, p. 1309, � 1, effective July 1. L. 94: IP(5), (5)(b), and (5)(e)(IV) amended, p. 2776, � 475, effective July 1. L. 98: (5)(e) amended, p. 20, � 3, effective August 5. L. 2001: IP(5) and (5)(e) amended and (9) and (10) added, p. 825, � 4, effective August 8. L. 2002: (5)(e)(III)(A) and (5)(e)(III)(B) amended, p. 1536, � 266, effective October 1. L. 2003: (5)(e)(II)(D) and (5)(e)(IV) amended, p. 710, � 42, effective July 1; (9) amended, p. 2198, � 1, effective August 6. L. 2005: (5)(e)(IV) and (5)(e)(V) amended and (5)(e)(VI) added, p. 419, � 1, effective April 29. L. 2007: (5)(e), (8), and (10) amended, p. 655, � 3, effective April 26. L. 2010: (8) amended, (HB 10-1422), ch. 419, p. 2101, � 111, effective August 11. L. 2013: (9)(b) amended, (SB 13-222), ch. 350, p. 2030, � 2, effective May 28.
Cross references: For the legislative declaration contained in the 1994 act amending the introductory portion to subsection (5) and subsections (5)(b) and (5)(e)(IV), see section 1 of chapter 345, Session Laws of Colorado 1994. For the legislative declaration contained in the 2002 act amending this section, see section 1 of chapter 318, Session Laws of Colorado 2002. For the legislative declaration in the 2013 act amending subsection (9)(b), see section 1 of chapter 350, Session Laws of Colorado 2013.