(1) (a) A health-care provider or facility, if consulted by a patient who is a minor, shall perform, at the minor's request, a diagnostic examination for a sexually transmitted infection. The health-care provider or facility shall treat the minor for a sexually transmitted infection, if necessary; discuss, administer, dispense, or prescribe preventive measures or medications, where applicable; and include appropriate therapies and prescriptions.
(b) If a minor requests a diagnostic examination, care, prevention services, or treatment for a sexually transmitted infection, the health-care provider who provides such services is not civilly or criminally liable for performing the service, but the immunity from liability does not apply to any negligent act or omission by the health-care provider.
(2) The consent of a parent or legal guardian is not a prerequisite for a minor to receive a consultation, an examination, preventive care, or treatment for sexually transmitted infections. For the purposes of this section, health care provided to a minor is confidential, and information related to that care must not be divulged to any person other than the minor; except that the reporting required pursuant to the Child Protection Act of 1987, part 3 of article 3 of title 19, still applies. If the minor is thirteen years of age or younger, the health-care provider may involve the minor's parent or legal guardian. A health-care provider shall counsel the minor on the importance of bringing the minor's parent or legal guardian into the minor's confidence regarding the consultation, exam, or treatment.
Source: L. 2016: Entire part R&RE, (SB 16-146), ch. 230, p. 902, � 1, effective July 1. L. 2021: (1)(a) and (2) amended, (SB 21-016), ch. 428, p. 2835, � 2, effective July 6.
Editor's note: This section is similar to former � 25-4-402 as it existed prior to 2016.
25-4-410. Patient consent - rights of patients, victims, and pregnant women. (1) (a) Except as provided in paragraph (b) of this subsection (1), a health-care provider, hospital, clinic, laboratory, or other private or public institution shall not test, or cause by any means to have tested, any specimen of a patient for a sexually transmitted infection without the knowledge and consent of the patient, which is satisfied as follows:
(I) The patient signs a general consent form for treatment;
(II) The patient is provided with a verbal consultation about sexually transmitted infections, testing, and reporting requirements; and
(III) The patient is provided with the opportunity to opt out of testing, following the verbal consultation.
(b) Knowledge and consent for testing need not be given in the following circumstances:
(I) When a public safety worker, emergency or other health-care provider, first responder, victim of crime, or a staff member of a correctional facility, the state department, or a local public health agency is exposed to blood or other bodily fluids under circumstances that pose an evidence-based risk of transmission of a sexually transmitted infection;
(II) When a patient's medical condition is such that knowledge and consent cannot be obtained;
(III) When the testing is done as part of a seroprevalence survey, but only if all personal identifiers are removed from the specimens prior to the laboratory testing;
(IV) When the patient to be tested is sentenced to and in the custody of the department of corrections or is committed to the Colorado mental health institute at Pueblo and confined to the forensic ward or the minimum or maximum security ward of the institute; and
(V) Notwithstanding the provisions of section 25-4-201, when a pregnant woman presents in labor in a hospital, and the results of syphilis and HIV tests are not on record, a rapid test will be performed to determine whether to provide prophylaxis to prevent transmission of sexually transmitted infections to the infant.
(c) A health-care provider shall notify a patient who was tested for a sexually transmitted infection without his or her knowledge and consent pursuant to section 25-4-408. The notification must be prompt, personal, and confidential and inform the individual that a test sample was taken and that the results of the test may be obtained upon his or her request.
(2) It is the duty of every health-care provider in the state who, during the course of an examination, discovers the existence of a sexually transmitted infection, or who treats a patient for such an infection, to inform the person of the interpretations of laboratory results and counsel the person on measures for preventing transmission to others; prophylaxis and treatment of infections until cured, where possible; treatment to prevent progression of such infections; and the necessity of regular medical evaluations. Such information and laboratory test results are considered medical information and are protected from unauthorized disclosure.
(3) A pregnant woman seeking prenatal care must be informed that syphilis and HIV testing are part of standard prenatal testing and given the opportunity to decline such tests pursuant to section 25-4-201. A pregnant woman must be informed that test results inform the decision as to whether to provide prophylaxis and prevent transmission of a sexually transmitted infection to her infant.
(4) When an adult or minor has been exposed to blood or other bodily fluids as a result of a sexual offense involving sexual penetration, as defined in section 18-3-401 (6), C.R.S., for which there is an evidence-based reason to believe that the sexual offense may have resulted in exposure to a sexually transmitted infection, the state department or local public health agency, within their respective jurisdictions, shall assist in the evaluation and treatment of any involved person by:
(a) Accessing information on the incident and any persons involved to determine whether a potential exposure to a sexually transmitted infection occurred;
(b) When potential for exposure has been confirmed by the state department or a local public health agency, examining and testing any involved person to determine whether or not an involved person has been infected;
(c) Communicating relevant information and laboratory test results on the involved person to his or her attending health-care provider or directly to the involved person if the confidentiality of the information and test results are acknowledged by the recipient and adequately protected, as determined by the state department or local public health agency; and
(d) Providing immediate counseling to any involved person on the potential health risks and available post-exposure treatment.
Source: L. 2016: Entire part R&RE, (SB 16-146), ch. 230, p. 903, � 1, effective July 1.
Editor's note: Subsection (2) is similar to former � 25-4-408 as it existed prior to 2016.
25-4-411. Confidential counseling and testing sites - legislative declaration. (1) Confidential HIV counseling and testing services are the preferred screening services for the detection of a possible infection. However, the state department shall, consistent with generally accepted practices for the protection of the public health and safety, conduct an anonymous HIV counseling and testing program at selected sites. The state department may operate sites or separately contract through local public health agencies to conduct HIV testing in conjunction with counseling and testing sites, subject to maintaining standards for performance as set by rule of the state board pursuant to section 25-4-404.
(2) (a) The disclosure of a person's name, address, phone number, birth date, or other personally identifying information is not required as a condition to be tested for HIV at an anonymous testing site. Any provision of this part 4 that requires or can be construed as requiring a person seeking testing to report or disclose such information does not apply to persons seeking to be tested at an anonymous testing site created pursuant to this section.
(b) Notwithstanding the provisions of subsection (2)(a) of this section, the age, gender, or gender identity of a person seeking to be tested at a testing site may be required.
Source: L. 2016: Entire part R&RE, (SB 16-146), ch. 230, p. 905, � 1, effective July 1.
Editor's note: This section is similar to former � 25-4-1405.5 as it existed prior to 2016.
25-4-412. Public safety - public health procedures - orders for compliance - petitions - hearings. (1) An order or restrictive measure directed to a person with a sexually transmitted infection must only be used as the last resort when other measures to protect the public health have failed, including all reasonable efforts, which must be documented, to obtain the voluntary cooperation of the person who may be subject to the order or restrictive measure. The order or restrictive measure must be applied serially with the least intrusive measures used first. The state department or local public health agency has the burden of proof to show that specified grounds exist for the issuance of the order or restrictive measure and that the terms and conditions imposed are no more restrictive than necessary to protect the public health.
(2) When the executive director or the local director, within his or her respective jurisdiction, knows or has reason to believe, because of evidence-based, medical, or epidemiological information, that a person has a sexually transmitted infection and poses a credible risk to the public health, he or she may issue an order to:
(a) Require the person to be examined and tested to determine whether he or she has acquired a sexually transmitted infection;
(b) Require him or her to report to a qualified health-care provider for counseling regarding sexually transmitted infections, information on treatment, and how to avoid transmitting sexually transmitted infections to others; or
(c) Direct a person with a sexually transmitted infection to cease and desist from specific conduct that poses risks to the public health, but only if the executive director or local director has determined that clear and convincing evidence exists to believe that such person has been ordered to report for counseling or has received counseling by a qualified health-care provider and continues to demonstrate behavior that poses an evidence-based risk to the public health.
(3) (a) If a person violates a cease-and-desist order issued pursuant to paragraph (c) of subsection (2) of this section and it is shown that the person poses an evidence-based risk to the public health, the executive director or the local director may enforce the cease-and-desist order by imposing such restrictions upon the person as are necessary to prevent the specific conduct that risks the public health. Restrictions may include required participation in evaluative, therapeutic, and counseling programs.
(b) Any restriction must be in writing, setting forth the name of the person to be restricted; the initial period of time that the restrictive order is effective, not to exceed three months; the terms of the restrictions; and any other conditions necessary to protect the public health. Restrictions must be imposed in the least restrictive manner necessary to protect the public health.
(c) The executive director or local director who issues an order pursuant to this subsection (3) shall review petitions for reconsideration from the person affected by the order. Restriction orders issued by local directors shall be submitted for review and approval by the executive director.
(4) (a) (I) Upon the issuance of an order by the state department or a local public health agency pursuant to subsection (2) or (3) of this section, the state department or local public health agency shall give notice promptly, personally, and confidentially to the person who is the subject of the order. The notice must state the grounds and provisions of the order and notify the person who is the subject of the order that he or she has the right to refuse to comply with the order, that he or she has the right to be present at a judicial hearing in the district court to review the order, and that he or she may have an attorney appear on his or her behalf at the hearing. If a respondent to any such action cannot afford an attorney, one shall be appointed for him or her at the commencement of the court process.
(II) If the person who is the subject of the order refuses to comply with the order and refuses to voluntarily cooperate with the executive director or local director, the executive director or local director may petition the district court for an order of compliance with the order. The executive director or local director shall request that the county or city and county attorney, or district public health agency, file such petition in the district court. However, if the county or city and county attorney, or district public health agency, refuses to act, the executive director may file such petition and be represented by the attorney general.
(III) If an order of compliance is requested, the court shall hear the matter within fourteen days following the request. Notice of the place, date, and time of the hearing must be by personal service or, if the person who is the subject of the order is not available, mailed by prepaid certified mail, return receipt requested, at the person's last-known address. Proof of mailing by the state department or local public health agency is sufficient notice under this section. The state department or local public health agency has the burden of proof to show by clear and convincing evidence that the specified grounds exist for the issuance of the order, the need for compliance, and the terms and conditions imposed in the order are no more restrictive than necessary to protect the public health.
(IV) An officer or employee of the state department or a local public health agency must not be examined in any judicial, legislative, executive, or other proceedings as to the existence or content of any individual's report, other than the respondent in a proceeding authorized by this section, made by such department or agency pursuant to this part 4; the existence of the content of the reports received pursuant to section 25-4-405; or the result of an investigation conducted pursuant to section 25-4-408.
(V) Upon the conclusion of the hearing, the court shall issue appropriate orders affirming, modifying, or dismissing the original order.
(b) If the executive director or local director does not petition the district court for an order of compliance within thirty days after the person who is the subject of the order refuses to comply, the person may petition the district court for dismissal of the order. If the district court dismisses the order, the fact that the order was issued must be expunged from the records of the state department or the local public health agency.
(5) Any hearing conducted pursuant to this section must be closed and confidential, and any transcripts or records related to the hearing are also confidential.
Source: L. 2016: Entire part R&RE, (SB 16-146), ch. 230, p. 905, � 1, effective July 1. L. 2017: (4)(a)(IV) amended, (SB 17-294), ch. 264, p. 1408, � 85, effective May 25.
Editor's note: This section is similar to former �� 25-4-406 (1) and 25-4-1406 as they existed prior to 2016.