Repeal of part - sunset review

25-1-1511. Repeal of part - sunset review. This part 15 is repealed, effective September 1, 2032. Before the repeal, this part 15 is scheduled for review in accordance with section 2-3-1203. Source: L. 2022: Entire part added, (SB 22-186), ch. 488, p. 3540, � 1, effective August 10. ARTICLE 1.5 Powers and Duties of the Department of Public Health and Environment Editor's note: This article was added with relocations in 2003. Former C.R.S. section numbers are shown in editor's notes following those sections that were relocated. PART 1 GENERAL POWERS AND DUTIES 25-1.5-100.3. Definitions. As used in this article 1.5, unless the context otherwise requires: (1) Department means the department of public health and environment created in section 25-1-102 (1). Source: L. 2025: Entire section added, (SB 25-275), ch. 377, p. 2075, � 201, effective August 6. 25-1.5-101. Powers and duties of department - laboratory cash fund - office of suicide prevention - suicide prevention coordination cash fund - dispensation of payments under contracts with grantees - report - definitions. (1) The department has, in addition to all other powers and duties imposed upon it by law, the powers and duties provided in this section as follows: (a) To close theaters, schools, and other public places, and to forbid gatherings of people when necessary to protect the public health; (b) (I) To establish and enforce minimum general sanitary standards as to the quality of wastes discharged upon land and the quality of fertilizer derived from excreta of human beings or from the sludge of sewage disposal plants. (II) The phrase minimum general sanitary standards as used in this section means the minimum standards reasonably consistent with assuring adequate protection of the public health. The word standards as used in this section means standards reasonably designed to promote and protect the public health. (c) (I) To collect, compile, and tabulate reports of marriages, dissolution of marriages, declaration of invalidity of marriages, births, deaths, and morbidity and to require any person having information with regard to the same to make such reports and submit such information as the board shall by rule or regulation provide. (II) For the purposes of this paragraph (c), the board is authorized to require reporting of morbidity and mortality in accordance with the provisions of section 25-1-122. (d) To regulate the disposal, transportation, interment, and disinterment of the dead; (e) (I) To establish, maintain, and approve chemical, bacteriological, and biological laboratories, and to conduct such laboratory investigations and examinations as it may deem necessary or proper for the protection of the public health. (II) The department shall transmit all fees received by the department in connection with the laboratories established pursuant to this paragraph (e), with the exception of fees received pursuant to part 10 of article 4 of this title that are credited to the newborn screening and genetic counseling cash funds created in section 25-4-1006 (1), to the state treasurer, who shall deposit them in the laboratory cash fund, which is hereby created in the state treasury. The state treasurer shall credit all interest earned from the revenues in the fund to the fund. At the end of each fiscal year, the unencumbered balance of the fund remains in the fund. The revenues in the fund are subject to annual appropriation by the general assembly to the department to carry out its duties under this paragraph (e). (f) To make, approve, and establish standards for diagnostic tests by chemical, bacteriological, and biological laboratories, and to require such laboratories to conform thereto; and to prepare, distribute, and require the completion of forms or certificates with respect thereto; (g) To purchase, and to distribute to licensed physicians and veterinarians, with or without charge, as the board may determine upon considerations of emergency or need, such vaccines, serums, toxoids, and other approved biological or therapeutic products as may be necessary for the protection of the public health; (h) To establish and enforce sanitary standards for the operation and maintenance of orphanages, day care nurseries, foster homes, family care homes, summer camps for children, lodging houses, outdoor nature-based preschool programs, guest child care facilities and public services short-term child care facilities as defined in section 26.5-5-303, hotels, public conveyances and stations, schools, factories, workshops, industrial and labor camps, recreational resorts and camps, swimming pools, public baths, mobile home parks, and other buildings, centers, and places used for public gatherings; (i) (I) (A) To establish sanitary standards and make sanitary, sewerage, and health inspections and examinations for charitable, penal, and other public institutions. (B) As used in this subsection (1)(i), penal institution means any local detention center, correctional facility, holding facility, secure residential treatment center, prison, camp, or other facility in which persons are or may be lawfully held in custody, including any public or private facility in Colorado that houses or detains noncitizens for purposes of civil immigration proceedings, including any facility that houses or detains minors, on behalf of the federal office of refugee resettlement or the United States immigration and customs enforcement agency. (C) With respect to the state institutions under the department of human services specified in section 27-90-104 or under the department of corrections specified in section 17-1-104.3 (1)(b), such inspections and examinations must be made at least once each year and additional unannounced inspections may be conducted after the annual inspection. Reports on such inspections of institutions under control of the department of human services or the department of corrections must be made to the executive director of the appropriate department for appropriate action, if any. (D) With respect to any facility that houses or detains noncitizens for purposes of civil immigration proceedings, such inspections and examinations must be made annually, and additional unannounced inspections may be conducted after the annual inspection. (E) Repealed. (II) Notwithstanding the provisions of subparagraph (I) of this paragraph (i), the standards adopted pursuant to subparagraph (I) of this paragraph (i) with regard to space requirements, furnishing requirements, required special use areas or special management housing, and environmental condition requirements, including but not limited to standards pertaining to light, ventilation, temperature, and noise level, shall not apply to any penal institution operated by or under contract with a county or municipality if the penal institution begins operations on or after August 30, 1999, and if the governing body of the jurisdiction operating the penal institution has adopted standards pertaining to such issues for the penal institution pursuant to section 30-11-104 (1), C.R.S., or section 31-15-711.5, C.R.S., whichever is applicable. (j) (I) To: (A) Collect, compile, and tabulate public health information from data sources and data provided to the department, to the extent permissible under applicable federal and state data privacy laws, rules, and regulations and federal contracts, including information concerning race, ethnicity, disability, sexual orientation, and gender identity; except that nothing in this section requires any individual to provide information relating to the individual's race, ethnicity, disability, sexual orientation, or gender identity; (B) Establish a process for, and provide technical assistance relating to, the collection, compilation, and tabulation of public health information described in subsection (1)(j)(I)(A) of this section; and (C) Disseminate public health information; (II) To provide poison control services, for the fiscal year beginning July 1, 2002, and fiscal years thereafter, on a statewide basis and to provide for the dissemination of information concerning the care and treatment of individuals exposed to poisonous substances pursuant to article 32 of this title; (k) To establish and enforce standards for exposure to toxic materials in the gaseous, liquid, or solid phase that may be deemed necessary for the protection of public health; (l) To establish and enforce standards for exposure to environmental conditions, including radiation, that may be deemed necessary for the protection of the public health; (m) (I) To accept and expend on behalf of and in the name of the state, gifts, donations, and grants for any purpose connected with the work and programs of the department. (II) Any such property so given shall be held by the state treasurer, but the department shall have the power to direct the disposition of any property so given for any purpose consistent with the terms and conditions under which such gift was created. (n) To carry out the policies of the state as set forth in part 1 of article 6 of this title with respect to family planning; (o) To carry out the policies of this state relating to the Colorado Health Care Coverage Act as set forth in parts 1 and 4 of article 16 of title 10, C.R.S.; (p) To compile and maintain current information necessary to enable the department to answer any inquiry concerning the proper action to take to counteract, eliminate, or minimize the public health hazards of a hazardous substance incident involving any specific kind of hazardous substance. To make such information available and to facilitate the reporting of hazardous substance incidents, the department shall establish, maintain, and publicize an environmental emergency telephone service that shall be available to the public twenty-four hours each day. With respect to the powers and duties specified in this paragraph (p), the department shall have no rule-making authority and shall avail itself of all available private resources. As used in this paragraph (p), the terms hazardous substance and hazardous substance incident shall have the meanings ascribed to them in section 29-22-101, C.R.S. The department shall coordinate its activities pursuant to this section with the Colorado state patrol. (q) (I) To establish and maintain a statewide cancer registry providing for compilation and analysis of appropriate information regarding incidence, diagnosis, treatment, and end results and any other data designed to provide more effective cancer control for the citizens of Colorado. (II) For the purposes of this paragraph (q), the board is authorized to require reports relating to cancer in accordance with the provisions of section 25-1-122 and to have access to medical records relating to cancer in accordance with the provisions of section 25-1-122. (r) To operate and maintain a program for children with disabilities to provide and expedite provision of health-care services to children who have congenital birth defects or who are the victims of burns or trauma or children who have acquired disabilities; (s) To annually enter into an agreement with a qualified person to perform necessary hazardous substance incident response actions when such actions are beyond the ability of the local and state response capabilities. Such response actions may include, but are not limited to, containment, clean-up, and disposal of a hazardous substance. Nothing in this article shall prevent the attorney general's office from pursuing cost recovery against responsible persons. (t) To operate special health programs for migrant and seasonal farm workers and their dependent family members and to accept and employ federal and other moneys appropriated to implement such programs; (u) To carry out the duties prescribed in article 11.5 of title 16, C.R.S., relating to substance abuse in the criminal justice system; (v) To establish and maintain a statewide gulf war syndrome registry pursuant to part 19 of article 4 of this title providing for compilation and analysis of information regarding incidence, diagnosis, treatment, and treatment outcomes of veterans or family members of veterans suffering from gulf war syndrome; (w) (I) To operate the office of suicide prevention, which is established in the division of prevention services in the department. The office of suicide prevention serves as the coordinator for crisis and suicide prevention programs throughout the state, including the Colorado suicide prevention plan established in section 25-1.5-112 and the crisis and suicide prevention training grant program established in section 25-1.5-113. For the purposes of this subsection (1)(w), the term comprehensive suicide prevention or suicide prevention includes the following components: (A) Strategies or approaches that seek to prevent the onset of suicidal despair, commonly known as suicide prevention; (B) Public health intervention supports, including community training, workforce development, quality improvement and provision of technical assistance to support the adoption of best suicide attempt behavior intervention and postvention practices and policies; and (C) Postvention responses to and support for individuals and communities affected by the aftermath of a suicide attempt. (II) The department is authorized to accept gifts, grants, and donations on behalf of the office of suicide prevention. The department shall transmit all such gifts, grants, and donations to the state treasurer who shall credit the same to the suicide prevention coordination cash fund, which fund is hereby created. The fund also consists of any money appropriated or transferred to the fund by the general assembly for the purposes of implementing section 25-1.5-112. Any money remaining in the suicide prevention coordination cash fund at the end of any fiscal year must remain in the fund and must not be transferred or credited to the general fund. The general assembly shall make appropriations from the suicide prevention coordination cash fund for expenditures incurred by the department or the office of suicide prevention in the performance of its duties pursuant to this subsection (1)(w) and section 25-1.5-112. (III) (A) Notwithstanding section 24-1-136 (11)(a)(I), as part of the duties of the office of suicide prevention, on or before each November 1, the office of suicide prevention shall submit to the chairs of the senate health and human services committee and the house of representatives health and human services committee, or their successor committees, and to the members of the joint budget committee, a report listing all crisis and suicide prevention programs in the state and describing the effectiveness of the office of suicide prevention in acting as the coordinator for crisis and suicide prevention programs. For the report submitted in 2013 and each year thereafter, the office of suicide prevention shall include any findings and recommendations it has to improve crisis and suicide prevention in the state. For the report submitted in 2024 and each year thereafter, the office of suicide prevention shall include a summary of the report pursuant to section 25-1.5-113.5 (5)(b). (B) (Deleted by amendment, L. 2012.) (IV) The department and the office of suicide prevention may collaborate with the school safety resource center and with each facility licensed or certified pursuant to section 25-1.5-103 in order to coordinate services related to crisis and suicide prevention, as that term is defined in this subsection (1)(w), including relevant training and other services as part of the Colorado suicide prevention plan established in section 25-1.5-112. When a facility treats a person who has attempted suicide or exhibits a suicidal gesture, the facility may provide oral and written information or educational materials to the person or, in the case of a minor, to parents, relatives, or other responsible persons to whom the minor will be released, prior to the person's release, regarding warning signs of depression, risk factors of suicide, methods of preventing suicide, available resources for comprehensive suicide prevention, and any other information concerning suicide awareness, and prevention. The facility shall also provide oral and written information or educational materials to the person or, in the case of a minor, to parents, relatives, or other responsible persons to whom the minor will be released, prior to the person's release, concerning the after-effects of a suicide attempt. The department and the office of suicide prevention may work with facilities and the Colorado suicide prevention plan to determine whether and where gaps exist in comprehensive suicide prevention programs and services, including gaps that may be present in: (A) The comprehensive suicide prevention information and materials being used and distributed in facilities throughout the state; (B) Comprehensive suicide prevention resources available to persons who attempt suicide or exhibit a suicidal gesture and, when the person is a minor, to parents, relatives, and other responsible persons to whom a minor is released; and (C) The process for referring persons who attempt suicide or exhibit a suicidal gesture to comprehensive suicide prevention services and programs or other appropriate health-care providers for treatment. (V) The department and the office of suicide prevention shall prepare written information for primary care offices and providers throughout the state. The information must be region-specific concerning how to recognize and respond to a suicidal patient and include separate written information for providers and information that may be shared with patients. (x) To implement the state dental loan repayment program created in article 23 of this title; (y) To coordinate with the United States secretary of the interior and the United States secretary of agriculture to develop resource management plans consistent with this article for federal lands pursuant to 16 U.S.C. sec. 530, 16 U.S.C. sec. 1604, and 43 U.S.C. sec. 1712; (z) To perform the duties specified in part 6 of article 10 of title 30, C.R.S., relating to the Colorado coroners standards and training board; (aa) To determine if there is a shortage of drugs critical to the public safety of the people of Colorado and declare an emergency for the purpose of preventing the practice of unfair drug pricing as prohibited by section 6-1-714, C.R.S.; (bb) To include on its public website home page a link to forms containing advanced directives regarding a person's acceptance or rejection of life-sustaining medical or surgical treatment, which forms are available to be downloaded electronically; (cc) To carry out the health survey for birthing parents and reporting requirements set forth in part 7 of this article 1.5. (2) (a) Notwithstanding any provision of this title 25, in contracting with any grantee for the provision of any service for the purposes of this title 25, the department may dispense up to twenty-five percent of the total value of the payments under the contract to the grantee immediately upon the execution or renewal of the contract. (b) As used in this subsection (2), grantee means a person that: (I) Is awarded a grant pursuant to a grant program that is managed or overseen by the department; (II) Pursuant to the conditions of the awarded grant, is a party to a contract with the department; (III) Is classified as a nonprofit organization or a charitable organization by the federal internal revenue service and has submitted written proof of such classification to the department; and (IV) Satisfies any criteria established by the department for the purpose of implementing this subsection (2). Source: L. 2003: Entire article added with relocations, p. 676, � 2, effective July 1; (1)(y) added, p. 1035, � 7, effective April 17; (1)(z) added, p. 1830, � 2, effective August 6. L. 2005: (1)(aa) added, p. 372, � 1, effective April 22. L. 2007: (1)(h) amended, p. 866, � 4, effective May 14. L. 2010: (1)(i)(I) amended, (SB 10-175), ch. 188, p. 798, � 58, effective April 29; (1)(bb) added, (HB 10-1050), ch. 80, p. 271, � 2, effective August 11. L. 2011: (1)(e) amended, (SB 11-161), ch. 12, p. 34, � 1, effective March 9. L. 2012: (1)(w)(III) amended and (1)(w)(IV) added, (HB 12-1140), ch. 173, p. 619, � 1, effective May 11. L. 2015: (1)(m)(I) amended, (SB 15-247), ch. 165, p. 505, � 3, effective May 8. L. 2016: (1)(h) amended, (SB 16-189), ch. 210, p. 769, � 58, effective June 6; (1)(w)(I), (1)(w)(II), and IP(1)(w)(IV) amended, (SB 16-147), ch. 364, p. 1521, � 3, effective June 10. L. 2017: (1)(w)(III)(A) amended, (SB 17-056), ch. 33, p. 92, � 1, effective March 16. L. 2018: (1)(w)(I), (1)(w)(II), (1)(w)(III)(A), and IP(1)(w)(IV) amended, (SB 18-272), ch. 333, p. 2005, � 4, effective August 8. L. 2020: (1)(i)(I) amended, (HB 20-1409), ch. 275, p. 1349, � 1, effective July 11. L. 2021: (1)(w)(I) and (1)(w)(IV) amended and (1)(w)(V) added, (HB 21-1119), ch. 49, p. 207, � 4, effective September 7; (2) added, (HB 21-1247), ch. 219, p. 1154, � 1, effective September 7. L. 2022: (1)(j)(I) amended, (HB 22-1157), ch. 321, p. 2271, � 1, effective June 2; (1)(cc) added, (HB 22-1289), ch. 399, p. 2837, � 7, effective June 7; (1)(h) amended, (HB 22-1295), ch. 123, p. 845, � 68, effective July 1. L. 2024: (1)(w)(III)(A) amended, (SB 24-007), ch. 401, p. 2761, � 3, effective June 5; (1)(h) amended, (SB 24-078), ch. 441, p. 3087, � 4, effective August 7. Editor's note: (1) This section is similar to former � 25-1-107 (1)(c), (1)(e), (1)(f), (1)(g), (1)(h), (1)(i), (1)(j), (1)(m), (1)(n), (1)(q), (1)(s), (1)(t), (1)(u), (1)(v), (1)(w), (1)(y), (1)(z), (1)(aa), (1)(bb), (1)(cc), (1)(ff), (1)(hh), (1)(ii), and (1)(kk) as they existed prior to 2003. (2) Subsection (1)(i)(I)(E) provided for the repeal of subsection (1)(i)(I)(E), effective July 1, 2021. (See L. 2020, p. 1349.) Cross references: For the legislative declaration contained in the 2003 act enacting (1)(y), see section 1 of chapter 145, Session Laws of Colorado 2003. For the legislative declaration in SB 18-272, see section 1 of chapter 333, Session Laws of Colorado 2018. For the legislative declaration in HB 21-1119, see section 1 of chapter 49, Session Laws of Colorado 2021. For the legislative declaration in HB 22-1289, see section 1 of chapter 399, Session Laws of Colorado 2022. For the legislative declaration in SB 24-007, see section 1 of chapter 401, Session Laws of Colorado 2024. For the legislative declaration in SB 24-078, see section 1 of chapter 441, Session Laws of Colorado 2024. 25-1.5-102. Epidemic and communicable diseases - powers and duties of department - rules - definitions. (1) The department has, in addition to all other powers and duties imposed upon it by law, the powers and duties provided in this section as follows: (a) (I) To investigate and control the causes of epidemic and communicable diseases affecting the public health. (II) For the purposes of this paragraph (a), the board shall determine, by rule and regulation, those epidemic and communicable diseases and conditions that are dangerous to the public health. The board is authorized to require reports relating to such designated diseases in accordance with the provisions of section 25-1-122 and to have access to medical records relating to such designated diseases in accordance with the provisions of section 25-1-122. (III) For the purposes of this paragraph (a), epidemic diseases means cases of an illness or condition, communicable or noncommunicable, in excess of normal expectancy, compared to the usual frequency of the illness or condition in the same area, among the specified population, at the same season of the year. A single case of a disease long absent from a population may require immediate investigation. (IV) For the purposes of this paragraph (a), communicable diseases means an illness due to a specific infectious agent or its toxic products that arises through transmission of that agent or its products from an infected person, animal, or reservoir to a susceptible host, either directly or indirectly through an intermediate plant or animal host, vector, or the inanimate environment. (b) (I) To investigate and monitor the spread of disease that is considered part of an emergency epidemic, as defined in section 24-33.5-703 (4), to determine the extent of environmental contamination resulting from the emergency epidemic, and to rapidly provide epidemiological and environmental information to the state board of health. (II) Except as otherwise directed by executive order of the governor, the department shall exercise its powers and duties to control epidemic and communicable diseases and protect the public health as set out in this section. (III) The department may accept and expend federal funds, gifts, grants, and donations for the purposes of an emergency epidemic or preparation for an emergency epidemic. (IV) When a public safety worker, emergency medical service provider, peace officer, or staff member of a detention facility has been exposed to blood or other bodily fluid which there is a reason to believe may be infectious with hepatitis C, the state department and county, district, and municipal public health agencies within their respective jurisdictions shall assist in evaluation and treatment of any involved persons by: (A) Accessing information on the incident and any persons involved to determine whether a potential exposure to hepatitis C occurred; (B) Examining and testing such involved persons to determine hepatitis C infection when the fact of an exposure has been established by the state department or county, district, or municipal public health agency; (C) Communicating relevant information and laboratory test results on the involved persons to such persons' attending physicians or directly to the involved persons if the confidentiality of such information and test results is acknowledged by the recipients and adequately protected, as determined by the state department or county, district, or municipal public health agency; and (D) Providing counseling to the involved persons on the potential health risks resulting from exposure and the available methods of treatment. (V) The employer of an exposed person shall ensure that relevant information and laboratory test results on the involved person are kept confidential. Such information and laboratory results are considered medical information and protected from unauthorized disclosure. (VI) For purposes of this paragraph (b), public safety worker includes, but is not limited to, law enforcement officers, peace officers, and firefighters. (c) To establish, maintain, and enforce isolation and quarantine, and, in pursuance thereof and for this purpose only, to exercise such physical control over property and the persons of the people within this state as the department may find necessary for the protection of the public health; (d) To abate nuisances when necessary for the purpose of eliminating sources of epidemic and communicable diseases affecting the public health. (e) Repealed. (2) Notwithstanding any other provision of law to the contrary, the department shall administer the provisions of this section regardless of an individual's race, religion, gender, ethnicity, national origin, or immigration status. Source: L. 2003: Entire article added with relocations, p. 680, � 2, effective July 1; IP(1)(b)(IV) amended, p. 1617, � 23, effective August 6. L. 2006, 1st Ex. Sess.: (2) added, p. 25, � 2, effective July 31. L. 2010: IP(1)(b)(IV), (1)(b)(IV)(B), and (1)(b)(IV)(C) amended, (HB 10-1422), ch. 419, p. 2091, � 86, effective August 11. L. 2013: (1)(b)(I) amended, (HB 13-1300), ch. 316, p. 1687, � 72, effective August 7. L. 2018: (1)(b)(I) amended, (HB 18-1394), ch. 234, p. 1473, � 20, effective August 8. L. 2022: (1)(e) added, (SB 22-226), ch. 179, p. 1192, � 10, effective May 18. L. 2023: (1)(e) amended, (HB 23-1246), ch. 199, p. 1019, � 7, effective May 16. L. 2024: (1)(e) amended, (HB 24-1465), ch. 257, p. 1684, � 7, effective May 24; (1)(e) amended, (HB 24-1466), ch. 429, p. 2941, � 27, effective June 5. L. 2025: (1)(b)(I) amended, (HB 25-1027), ch. 65, p. 274, � 9, effective April 10; (1)(e) repealed, (SB 25-312), ch. 301, p. 1538, � 19, effective May 30. Editor's note: (1) This section is similar to former � 25-1-107 (1)(a), (1)(a.5), (1)(b), and (1)(d) as they existed prior to 2003. (2) Amendments to subsection (1)(b)(IV) by House Bill 03-1266 and Senate Bill 03-002 were harmonized. (3) Amendments to subsection (1)(e) by HB 24-1465 and HB 24-1466 were harmonized. Cross references: For the legislative declaration in SB 22-226, see section 1 of chapter 179, Session Laws of Colorado 2022. For the legislative declaration in HB 23-1246, see section 1 of chapter 199, Session Laws of Colorado 2023. For the legislative declaration in HB 24-1466, see section 1 of chapter 429, Session Laws of Colorado 2024. 25-1.5-103. Health facilities - powers and duties of department - rules - limitations on rules - definitions - repeal. (1) The department has, in addition to all other powers and duties imposed upon it by law, the powers and duties provided in this section as follows: (a) (I) (A) To annually license and to establish and enforce standards for the operation of general hospitals, hospital units as defined in section 25-3-101 (2), freestanding emergency departments as defined in section 25-1.5-114, critical access hospitals as defined in section 25-1.5-114.5, psychiatric hospitals, community clinics, rehabilitation hospitals, convalescent centers, facilities for persons with intellectual and developmental disabilities, nursing care facilities, hospice care, assisted living residences, dialysis treatment clinics, ambulatory surgical centers, birthing centers, home care agencies, and other facilities of a like nature, except those wholly owned and operated by a governmental unit or agency. (A.5) Repealed. (B) In establishing and enforcing such standards and in addition to the required announced inspections, the department shall, within available appropriations, make additional inspections without prior notice to the health facility, subject to sub-subparagraph (C) of this subparagraph (I). Such inspections shall be made only during the hours of 7 a.m. to 7 p.m. (C) The department shall extend the survey cycle or conduct a tiered inspection or survey of a health facility licensed for at least three years and against which no enforcement activity has been taken, no patterns of deficient practices exist, as documented in the inspection and survey reports issued by the department, and no substantiated complaint resulting in the discovery of significant deficiencies that may negatively affect the life, health, or safety of consumers of the health facility has been received within the three years prior to the date of the inspection. The department may expand the scope of the inspection or survey to an extended or full survey if the department finds deficient practice during the tiered inspection or survey. The department, by rule, shall establish a schedule for an extended survey cycle or a tiered inspection or survey system designed, at a minimum, to: Reduce the time needed for and costs of licensure inspections for both the department and the licensed health facility; reduce the number, frequency, and duration of on-site inspections; reduce the scope of data and information that health facilities are required to submit or provide to the department in connection with the licensure inspection; reduce the amount and scope of duplicative data, reports, and information required to complete the licensure inspection; and be based on a sample of the facility size. Nothing in this subsection (1)(a)(I)(C) limits the ability of the department to conduct a periodic inspection or survey that is required to meet its obligations as a state survey agency on behalf of the federal centers for medicare and medicaid services or the department of health care policy and financing to assure that the health facility meets the requirements for participation in the medicare and medicaid programs or limits the ability of the department to enter, survey, and investigate hospitals pursuant to section 25-3-128. (D) In connection with the renewal of licenses issued pursuant to this subparagraph (I), the department shall institute a performance incentive system pursuant to section 25-3-105 (1)(a)(I)(C). (E) The department shall not cite as a deficiency in a report resulting from a survey or inspection of a licensed health facility any deficiency from an isolated event identified by the department that can be effectively remedied during the survey or inspection of the health facility, unless the deficiency caused harm or a potential for harm, created a life- or limb-threatening emergency, or was due to abuse or neglect. (F) Sections 24-4-104, C.R.S., and 25-3-102 govern the issuance, suspension, renewal, revocation, annulment, or modification of licenses. All licenses issued by the department must contain the date of issue and cover a twelve-month period. Nothing contained in this paragraph (a) prevents the department from adopting and enforcing, with respect to projects for which federal assistance has been obtained or is requested, higher standards as may be required by applicable federal laws or regulations of federal agencies responsible for the administration of applicable federal laws. (II) To establish and enforce standards for the operation and maintenance of the health facilities named in subparagraph (I) of this paragraph (a), wholly owned and operated by the state or any of its political subdivisions, and no such facility shall be operated or maintained without an annual certificate of compliance; (b) To suspend, revoke, or refuse to renew any license issued to a health facility pursuant to subparagraph (I) or (II) of paragraph (a) of this subsection (1) if such health facility has committed abuse of health insurance pursuant to section 18-13-119, C.R.S., or if such health facility has advertised through newspapers, magazines, circulars, direct mail, directories, radio, television, or otherwise that it will perform any act prohibited by section 18-13-119 (3), C.R.S., unless the health facility is exempted from section 18-13-119 (5), C.R.S.; (c) Repealed. (d) (I) To ensure that each hospital that provides nonemergent perinatal care services is complying with the requirements specified in section 25-52-106.5, including participating in at least one maternal or infant health quality improvement initiative and submitting outcome data to the perinatal quality collaborative defined in section 25-52-103 (3). (II) This subsection (1)(d) is repealed, effective September 1, 2029. (2) As used in this section, unless the context otherwise requires: (a) and (a.3) Repealed. (a.5) Community clinic has the same meaning as set forth in section 25-3-101 and does not include: (I) A federally qualified health center, as defined in the federal Social Security Act, 42 U.S.C. sec. 1395x (aa)(4); (II) A rural health clinic as defined in section 1861 (aa)(2) of the federal Social Security Act, 42 U.S.C. sec. 1395x (aa)(2); or (III) A freestanding emergency department, as defined in and required to be licensed under section 25-1.5-114. (b) Repealed. (b.5) Enforcement activity means the imposition of remedies such as civil money penalties; appointment of a receiver or temporary manager; conditional licensure; suspension or revocation of a license; a directed plan of correction; intermediate restrictions or conditions, including retaining a consultant, department monitoring, or providing additional training to employees, owners, or operators; or any other remedy provided by state or federal law or as authorized by federal survey, certification, and enforcement regulations and agreements for violations of federal or state law. (c) Facility for persons with developmental disabilities means a facility specially designed for the active treatment and habilitation of persons with intellectual and developmental disabilities or a community residential home, as defined in section 25.5-10-202, C.R.S., which is licensed and certified pursuant to section 25.5-10-214, C.R.S. (d) Hospice care means an entity that administers services to a terminally ill person utilizing palliative care or treatment. (3) (a) In the exercise of its powers pursuant to this section, the department shall not promulgate any rule, regulation, or standard relating to nursing personnel for rural nursing care facilities, rural intermediate care facilities, and other rural facilities of a like nature more stringent than the applicable federal standards and regulations. (b) For purposes of this subsection (3), rural means: (I) A county of less than fifteen thousand population; or (II) A municipality of less than fifteen thousand population which is located ten miles or more from a municipality of over fifteen thousand population; or (III) The unincorporated part of a county ten miles or more from a municipality of fifteen thousand population or more. (c) A nursing care facility which is not rural as defined in paragraph (b) of this subsection (3) shall meet the licensing requirements of the department for nursing care facilities. However, if a registered nurse hired pursuant to department regulations is temporarily unavailable, a nursing care facility may use a licensed practical nurse in place of a registered nurse if such licensed practical nurse is a current employee of the nursing care facility. (3.5) Repealed. (4) In the exercise of its powers, the department shall not promulgate any rule, regulation, or standard that limits or interferes with the ability of an individual to enter into a contract with a private pay facility concerning the programs or services provided at the private pay facility. For the purposes of this subsection (4), private pay facility means a skilled nursing facility or intermediate care facility subject to the requirements of section 25-1-120 or an assisted living residence licensed pursuant to section 25-27-105 that is not publicly funded or is not certified to provide services that are reimbursed from state or federal assistance funds. (5) (a) This subsection (5) applies to construction, including substantial renovation, and ongoing compliance with article 33.5 of title 24, C.R.S., of a health-care facility building or structure on or after July 1, 2013. All health facility buildings and structures shall be constructed in conformity with the standards adopted by the director of the division of fire prevention and control in the department of public safety. (b) Except as provided in paragraph (c) of this subsection (5) but notwithstanding any other provision of law to the contrary, the department shall not issue or renew any license under this article unless the department has received a certificate of compliance from the division of fire prevention and control certifying that the building or structure of the health facility is in conformity with the standards adopted by the director of the division of fire prevention and control. (c) The department has no authority to establish or enforce standards relating to building or fire codes. All functions, personnel, and property of the department as of June 30, 2013, that are principally directed to the administration, inspection, and enforcement of any building or fire codes or standards shall be transferred to the health facility construction and inspection section of the division of fire prevention and control pursuant to section 24-33.5-1201 (5), C.R.S. (d) Notwithstanding any provision of law to the contrary, all health facilities seeking certification pursuant to the federal insurance or assistance provided by Title XIX of the federal Social Security Act, as amended and commonly known as medicaid, or the federal insurance or assistance provided by Title XVIII of the federal Social Security Act, as amended and commonly known as medicare, or any successor code adopted or promulgated by the appropriate federal authorities, shall continue to meet such certification requirements. (e) Nothing in this subsection (5) divests the department of the authority to perform health survey work or prevents the department from accessing related funds. (6) (a) The department shall collaborate with the department of education, the department of health care policy and financing, and the department of human services to develop an interagency resource guide pursuant to section 22-2-410 to assist facilities to become licensed or authorized as approved facility schools and to recommend changes related to the interagency resource guide to the department's statute, rule, or administrative procedures. (b) The department shall prominently post the interagency resource guide created pursuant to subsection (6)(a) of this section on the department's website. Source: L. 2003: Entire article added with relocations, p. 682, � 2, effective July 1. L. 2006: (1)(a)(I), (1)(c)(I), (2), and (2)(b) amended, pp. 1389, 1404, �� 21, 63, effective August 7. L. 2008: (3.5) added, p. 1947, � 1, effective June 2; (1)(a)(I) amended, p. 2232, � 1, effective August 5. L. 2010: (3.5)(a)(I) amended, (SB 10-175), ch. 188, p. 798, � 59, effective April 29. L. 2011: (2)(a.5) added, (HB 11-1101), ch. 94, p. 277, � 1, effective April 8; (2)(a.5) amended, (HB 11-1323), ch. 265, p. 1198, � 1, effective June 2. L. 2012: (1)(a)(I), (1)(c), and IP(2)(a.5) amended and (2)(b.5) added, (HB 12-1294), ch. 252, p. 1251, � 2, effective June 4; (5) added, (HB 12-1268), ch. 234, p. 1024, � 1, effective July 1, 2013. L. 2013: (5)(a) amended, (HB 13-1300), ch. 316, p. 1687, � 73, effective August 7; (1)(a)(I)(A) and (2)(c) amended, (HB 13-1314), ch. 323, p. 1806, � 37, effective March 1, 2014. L. 2017: (2)(b) amended, (SB 17-242), ch. 263, p. 1323, � 184, effective May 25. L. 2019: (1)(a)(I)(A) and (2)(a.5)(II) amended and (2)(a.5)(III) added, (HB 19-1010), ch. 324, p. 2997, � 2, effective August 2; (3.5) amended, (HB 19-1060), ch. 10, p. 40, � 3, effective August 2; (1)(a)(I)(A) and (1)(c) amended and (2)(a.3) added, (HB 19-1237), ch. 413, p. 3639, � 8, effective July 1, 2021. L. 2020: (2)(a.5)(I) amended, (SB 20-136), ch. 70, p. 287, � 21, effective September 14. L. 2022: (1)(a)(I)(C) amended, (HB 22-1401), ch. 178, p. 1180, � 2, effective May 18; (1)(a)(I)(A.5) added and (3.5) repealed, (HB 22-1278), ch. 222, pp. 1583, 1506, �� 211, 52, effective July 1; IP(2) and (2)(a.3)(I) amended, (HB 22-1295), ch. 123, p. 845, � 69, effective July 1; (1)(a)(I)(A) amended (HB 22-1278), ch. 222, p. 1591, � 226, effective July 1, 2024; (2)(a)(II), (2)(a.3)(II), and (2)(b)(II) added by revision, (HB 22-1278), ch. 222, pp. 1591, 1605, �� 226, 263(1)(b). L. 2023: (6) added, (SB 23-219), ch. 88, p. 333, � 12, effective April 20; (1)(a)(I)(A.5), (2)(a.3)(II), and (2)(b)(II) amended and (1)(c)(III) added, (HB 23-1236), ch. 206, p. 1052, � 7, effective May 16. L. 2024: (1)(d) added, (SB 24-175), ch. 433, p. 3035, � 2, effective June 5; (1)(a)(I)(A) amended, (SB 24-121), ch. 439, p. 3065, � 1, effective August 7. Editor's note: (1) This section is similar to former � 25-1-107 (1)(l), (3), and (4) as they existed prior to 2003. (2) Amendments to subsection (2) in sections 21 and 63 of House Bill 06-1277 were harmonized. As a result of the harmonization, subsection (2)(a) in section 63 of House Bill 06-1277 was renumbered as subsection (2)(b). (3) Amendments to subsection (1)(a)(I)(A) by HB 19-1010 and HB 19-1237 were harmonized, effective July 1, 2021. (4) Subsection (2)(a.3)(I) was amended in HB 22-1295. Those amendments were superseded by the repeal of subsection (2.3)(a) in SB 22-1278, effective July 1, 2024. (5) Subsection (2)(a)(II) provided for the repeal of subsection (2)(a), effective July 1, 2024. (See L. 2022, pp. 1591, 1605.) (6) Subsections (1)(a)(I)(A.5), (1)(c)(III), (2)(a.3)(II), and (2)(b)(II) provided for the repeal of subsections (1)(a)(I)(A.5), (1)(c), (2)(a.3), and (2)(b), respectively, effective January 1, 2025. (See L. 2023, p. 1052.) Cross references: For the legislative declaration in the 2012 act amending subsections (1)(a)(I) and (1)(c) and the introductory portion to subsection (2)(a.5) and adding subsection (2)(b.5), see section 1 of chapter 252, Session Laws of Colorado 2012. For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017. For the legislative declaration in HB 19-1060, see section 1 of chapter 10, Session Laws of Colorado 2019. For the legislative declaration in SB 20-136, see section 1 of chapter 70, Session Laws of Colorado 2020. 25-1.5-104. Regulation of standards relating to food - powers and duties of department. (1) The department has, in addition to all other powers and duties imposed upon it by law, the powers and duties provided in this section as follows: (a) To impound any vegetables and other edible crops and meat and animal products intended for and unfit for human consumption, and, upon five days' notice and after affording reasonable opportunity for a hearing to the interested parties, to condemn and destroy the same if deemed necessary for the protection of the public health; (b) (I) To promulgate and enforce rules, regulations, and standards for the grading, labeling, classification, and composition of milk, milk products, and dairy products, including imitation dairy products; to establish minimum general sanitary standards of quality of all milk, milk products, dairy products, and imitation dairy products sold for human consumption in this state; to inspect and supervise, in dairy plants or dairy farms and in other establishments handling any milk, milk products, dairy products, or imitation dairy products, the sanitation of production, processing, and distribution of all milk, milk products, dairy products, and imitation dairy products sold for human consumption in this state and, to this end, to take samples of milk, milk products, dairy products, and imitation dairy products for bacteriological, chemical, and other analyses; and to enforce the standards for milk, milk products, dairy products, and imitation dairy products in processing plants, dairy farms, and other facilities and establishments handling, transporting, or selling such products; to certify persons licensed by the department under the provisions of section 25-5.5-107 as duly qualified persons for the purpose of collecting raw milk samples for official analyses in accordance with minimum qualifications established by the department; to issue, for the fees established by law, licenses and temporary permits to operate milk plants, dairy plants, receiving stations, dairy farms, and other facilities manufacturing any milk, milk products, dairy products, or imitation dairy products for human consumption. (II) The phrase minimum general sanitary standards as used in this section means the minimum standards reasonably consistent with assuring adequate protection of the public health. The word standards as used in this section means standards reasonably designed to promote and protect the public health. (c) To promulgate and enforce rules and regulations for the labeling and sale of oleomargarine and for the governing of milk- or cream-weighing-and-testing operations; (d) To approve all oils used in reading tests of samples of cream and milk; (e) To examine and license persons to sample or test milk, cream, or other dairy products for the purpose of determining the value of such products or to instruct other persons in the sampling and testing of such products and to cancel licenses issued by the department on account of incompetency or any violation of the provisions of the dairy laws or the rules and regulations promulgated by the board; (f) To license manufacturers of oleomargarine; (g) To establish and enforce sanitary standards for the operation of slaughtering, packing, canning, and rendering establishments and stores, shops, and vehicles wherein meat and animal products intended for human consumption may be offered for sale or transported, but this shall not be construed to authorize any state officer or employee to interfere with regulations or inspections made by anyone acting under the laws of the United States. Source: L. 2003: Entire article added w