The act prohibits a licensed physician or physician assistant; licensed medical resident, intern, or fellow; licensed professional nurse; advanced practice registered nurse; registered direct-entry midwife; or medical, nursing, or direct-entry midwife student or trainee (licensee, student, or trainee) from performing, and prohibits a licensed health-care facility from permitting a licensee, student, or trainee to perform, an intimate examination on a sedated or unconscious patient unless the patient has given specific informed consent to an intimate examination. Additionally, a student or trainee may perform an intimate examination on a sedated or unconscious patient for educational or training purposes only if: The examination is related to the planned procedure to be performed on the patient; 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 The student or trainee is under the direct supervision of the supervising licensee. The informed consent requirement does not apply in an emergency situation in which an intimate examination on a sedated or unconscious patient is medically necessary for the life or well-being of the patient or if the licensee has previously obtained the patient's consent to health care that includes an intimate examination about which the patient has been informed. The act outlines the requirements for obtaining the patient's informed consent. Failure to comply with the requirements of the act, or retaliating against a person who complains about a violation of the act, constitutes unprofessional conduct, is grounds for discipline, and subjects the licensee, student, or trainee to discipline by the regulator that regulates the particular health-care profession. A licensed health-care facility that fails to comply with the requirements of the act is subject to sanctions imposed by the department of public health and environment. Additionally, a patient who is subjected to an intimate examination in violation of the requirements of the act may file a civil action for damages, which action is not a medical malpractice action, and the statutory cap on noneconomic damages in civil actions applies to an award to a patient for noneconomic damages. For the 2023-24 state fiscal year, the act appropriates $32,915 from the general fund to the department of public health and environment for use by the health facilities and emergency medical services division to implement the act. APPROVED by Governor May 25, 2023 EFFECTIVE January 1, 2024 NOTE: This act was passed without a safety clause. (Note: This summary applies to this bill as enacted.)
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Effective January 1, 2024, the act requires each newly constructed building and each building with qualifying restroom renovations that is wholly or partly owned by a state department, state agency, state institution of higher education, county, city and county, or municipality (public entity) to: Provide a non-gendered restroom facility or a multi-stall non-gendered facility on each floor where restrooms are available in a newly constructed building and wherever a restroom is accessible to the public in a building in which a restroom is being renovated; Ensure that all single-stall restrooms are not gender specific restrooms; Allow for the use of multi-stall restrooms by any gender if certain facility features are met under the International Plumbing Code and the Colorado Fuel Gas Code; Provide at least one safe, sanitary, and convenient baby diaper changing station that is accessible to the public on each floor where there is a public restroom in a newly constructed building and wherever a restroom is accessible to the public in a building in which a restroom is being renovated, in each gender-specific restroom if only gender-specific restrooms are available, and in each non-gendered single-stall or multi-stall restroom or provide such a changing station in an easily accessible location with equivalent privacy and amenities as a restroom; Ensure that each baby diaper changing station is cleaned with the same frequency as the restroom in which it is located, or restrooms on the same floor or in the space if it is not within a restroom, and maintained, repaired, and replaced as necessary to ensure safety and ease of use. Beginning July 1, 2024, but no later than July 1, 2026, a building that is wholly or partially owned or leased by a public entity must ensure that signage for the building or the portion of the building leased or owned by the public entity complies with the following signage requirements, subject to available appropriations: Include signage indicating the presence of a baby diaper changing station with a pictogram that is void of gender in all restrooms with baby diaper changing stations, include signage with a pictogram void of gender in all non-gendered restrooms, and include signage with a pictogram void of gender in all single-stalled restrooms; and Indicate in the central building directory, if such a directory exists, the location of any baby diaper changing station and of any non-gendered restroom with a pictogram void of gender. The act requires the department of personnel to complete a survey that determines the number and locations of signs needed to comply with the act signage requirements and requires the survey be provided to the general assembly and the capital development committee. The requirements of the act pertaining to baby diaper changing stations and providing a non-gendered single-stall restroom or a non-gendered multi-stall restroom in specified locations do not apply: To the extent that compliance with a requirement would result in failure to comply with applicable building standards governing the right of access for individuals with disabilities; To a project that has already progressed through the design review process, budgeting, and final approval by the governing body that has final approval over capital construction project expenditures as of the effective date of the act, or to a building designated as a certified historic structure. Beginning on July 1, 2025, the act requires a building that is wholly or partially owned by a public entity that is a newly constructed building that is accessible to employees or enrolled students, or a building undergoing a qualifying restroom renovation to: Provide a non-gendered single-stall restroom or a non-gendered multi-stall restroom; Ensure that any single-stall restroom is not a gender-specific restroom; and Allow for the use of a multi-stall restroom by any gender if certain facility features are met pursuant to the International Plumbing Code or the Colorado Fuel Gas Code as adopted by the state plumbing board. The act clarifies that an employee with a designated workplace in a public building may undertake the complaint process for alleged discriminatory or unfair practices including the failure to comply with providing the required amenities to all genders, as required, with the Colorado civil rights division charged with the enforcement of the Colorado anti-discrimination act. For the 2023-24 state fiscal year, $450,000 is appropriated from the general fund to the department of personnel for use by the office of the state architect. To implement the act, the office may use $400,000 for statewide planning services and $50,000 for a restroom survey of state-owned buildings. APPROVED by Governor May 24, 2023 EFFECTIVE August 7, 2023 NOTE: This act was passed without a safety clause and takes effect 90 days after sine die. (Note: This summary applies to this bill as enacted.)
The act requires that, on or before January 1, 2024, the commissioner of agriculture adopt rules requiring neonicotinoid pesticides to be designated as limited-use pesticides and authorizing only licensed dealers to sell them. Products containing neonicotinoid active ingredients used in academic research are exempted from the limited-use pesticide designation, as are the following products that contain neonicotinoid active ingredients and for which the product label includes an intended use as: A pet care product; A veterinary product; An indoor pest control product; A personal care product used for preventing, destroying, repelling, or mitigating lice; A product used in structural insulation; A preserved wood product or product used in the manufacturing of wood preservatives; A bait product; or An insect strip. APPROVED by Governor May 17, 2023 EFFECTIVE August 7, 2023 NOTE: This act was passed without a safety clause and takes effect 90 days after sine die.(Note: This summary applies to this bill as enacted.)
Under current law, a unit owners' association (association) of a common interest community may not prohibit the use of xeriscape, nonvegetative turf grass, or drought-tolerant vegetative landscapes to provide ground covering to property for which a unit owner is responsible. There is, however, an exception authorizing an association to adopt and enforce design or aesthetic guidelines or rules that apply to nonvegetative turf grass and drought-tolerant vegetative landscapes or to regulate the type, number, and placement of drought-tolerant plantings and hardscapes that may be installed on a unit owner's property, on a limited common element, or on other property for which the unit owner is responsible. The act states that an association's guidelines or rules must: Not prohibit the use of nonvegetative turf grass in the backyard of a unit owner's property; Not unreasonably require the use of hardscape on more than 20% of the landscaping area of a unit owner's property; Allow a unit owner an option that consists of at least 80% drought-tolerant plantings; and Not prohibit vegetable gardens in the front, back, or side yard of a unit owner's property. The act requires an association to develop at least 3 garden designs that are preapproved by the association for installation in front yards within the common interest community. To receive preapproval, a garden design must adhere to the principles of water-wise landscaping or be part of a water conservation program operated by a local water provider. A unit owner who is affected by an association's violation of the act's requirements may, after providing the association notice of and a 45-day period to cure the violation, bring a civil action to restrain further violation and to recover up to $500 or actual damages, whichever is greater. The act's provisions apply only to a unit that is a single-family detached home and do not apply to: A unit that is a single-family attached home that shares one or more walls with another unit; or A condominium. APPROVED by Governor May 17, 2023 EFFECTIVE August 7, 2023 NOTE: This act was passed without a safety clause and takes effect 90 days after sine die. (Note: This summary applies to this bill as enacted.)
The act directs the Colorado state forest service (state forest service) to consult with other entities to develop educational materials relating to career opportunities in forestry and wildfire mitigation for distribution to high school guidance counselors to provide to high school students. The act creates the timber, forest health, and wildfire mitigation industries workforce development program (development program) in the state forest service to provide partial reimbursement to timber businesses and forest health or wildfire mitigation entities for the costs of hiring interns. The act requires the state treasurer, on June 30, 2023, and on June 30 each year thereafter, to transfer $1,000,000 from the general fund to the wildfire mitigation capacity development fund for allowable uses of the fund. The act authorizes the expansion of existing forestry programs, including wildfire mitigation programs, and the creation of new forestry programs at public institutions of higher education (public institutions) to include state institutions of higher education, local district colleges, and area technical colleges. The commission on higher education (commission) shall determine which public institutions receive funding for expanded or new forestry programs, prioritizing public institutions that can provide a trained workforce expeditiously. The act provides for the acquisition of a harvesting simulator to train students, which may be shared among the forestry programs. The act includes funding for the forestry programs. The act directs the state board for community colleges and occupational education (community college board) to administer the recruitment of wildland fire prevention and mitigation educators program (recruiting program) to increase the number of qualified educators at community colleges, area technical colleges, and local district colleges that deliver a wildfire prevention and mitigation program or course. For the 2023-24 state fiscal year: The act appropriates $15,000 to the healthy forests vibrant communities cash fund from the general fund; and The act appropriates $1,545,034 to the department of higher education from the general fund, including: $114,384 for the Colorado state forest service at Colorado state university; $1,180,650 for use by the commission for new and expanded forestry programs; and $250,000 for the college opportunity program to be used for fee-for-service contracts for the community college board state system colleges for the recruiting program. APPROVED by Governor May 12, 2023 EFFECTIVE May 12, 2023(Note: This summary applies to this bill as enacted.)
In 2021, the general assembly enacted Senate Bill 21-175, concerning the Colorado prescription drug affordability review board, which created the prescription drug affordability review board (board) in the division of insurance (division) and an affordability review process whereby the board may review costs associated with, and establish upper payment limits for, certain prescription drugs. The 2023 act makes certain changes concerning the board. Section 1 clarifies which actions taken by the board are "board activities", as this term is used elsewhere. Section 2 states that staff members and contractors of the division must disclose any conflict of interest related to a prescription drug for which the board is conducting an affordability review or establishing an upper payment limit. Such a disclosure remains confidential if it relates to a personal association. The board, upon review of a disclosure, may direct the staff member or contractor of the division to recuse themselves. Section 3 allows the chair of the board to cancel or postpone a board meeting for good cause. Section 4 makes certain changes to the procedure by which the board identifies prescription drugs that may be subjected to an affordability review, which changes take effect January 1, 2025, and requires the board to report on its public web page certain information regarding its considerations. Under current law, the board may not establish an upper payment limit for more than 12 prescription drugs per calendar year for 3 years, beginning April 1, 2022. Section 5 lets the board establish an upper payment limit for up to 18 prescription drugs per calendar year if the board determines that there is a need and has sufficient staff support. Section 6 establishes that an upper payment limit for a prescription drug is not a final agency action that is subject to judicial review until the board promulgates a rule establishing the upper payment limit. Sections 6 and 7 remove certain language concerning a process for appealing decisions of the board. Sections 8 and 9 extend the repeal and associated sunset review of the board from September 1, 2026, to September 1, 2031. Section 10 establishes that a denial of a request for benefits for a prescription drug that is unavailable in the state because a manufacturer has withdrawn the prescription drug from sale or distribution within the state is an "adverse determination" for which an individual may request an independent external review. APPROVED by Governor May 10, 2023 PORTIONS EFFECTIVE August 7, 2023 PORTIONS EFFECTIVE January 1, 2025 NOTE: This act was passed without a safety clause and takes effect 90 days after sine die; except that, section 4 of the act takes effect January 1, 2025. (Note: This summary applies to this bill as enacted.)
The act requires the department of public health and environment (department), by August 1, 2024, and in consultation with stakeholders, to identify reproductive health-care services, LGBTQ health-care services, and end-of-life health-care services (identified health-care services) that, for nonmedical reasons, are not generally available at a specified health-care facility (covered entity) or that are subject to significant restriction at a covered entity. The department shall develop a simple service availability form (form) to be filled out by each covered entity for the purpose of conveying to patients and to the public information about identified health-care services that are subject to denial of care at the covered entity. The act defines: "Covered entity" as a hospital, community clinic, maternity hospital, freestanding emergency department, or rehabilitation hospital, but "covered entity" does not include a health-care professional or a hospital, community clinic, or other facility owned or operated by the state; "Denial of care", in part, as refusal to provide health-care services for nonmedical reasons; "Nonmedical reasons", in part, as nonclinical criteria, rules, or policies that restrict health-care professionals at a covered entity from providing health-care services that the health-care professional is authorized to provide and that the covered is licensed to provide; and Reproductive health-care services, LGBTQ health-care services, and end-of-life health-care services. The act includes requirements for the content and format of the form and requires each covered entity to submit a completed form to the department and to update the form within 30-days after a change in the availability of the identified health-care services. Beginning on or before October 1, 2024, the department shall maintain on its public-facing website a list of covered entities and the form for the covered entity. The department shall review and update the service availability form at least biennially in consultation with stakeholders. A covered entity shall provide patients with the current service availability form during scheduling for identified health-care services and at the time federal privacy laws are provided to patients before health-care services are initiated, and shall maintain a record of the patient's receipt of the form. A covered entity that fails to comply with the act is subject to a fine not exceeding $1,000 for each day the covered entity is in violation of the act. The state board of health shall adopt rules to implement the act. For the 2023-24 state fiscal year, the act appropriates $64,627 from the general fund to the department for use by the health facilities and emergency medical services division to implement the act. APPROVED by Governor May 10, 2023 EFFECTIVE August 7, 2023 NOTE: This act was passed without a safety clause and takes effect 90 days after sine die. (Note: This summary applies to this bill as enacted.)
Under current law, pharmacy benefit managers (PBMs) are required to perform certain acts and are prohibited from engaging in certain acts. Specifically, PBMs are prohibited from: Requiring patients to obtain their prescription drugs through mail order; Charging pharmacies fees to adjudicate claims; Requiring pharmacies to obtain accreditations or certifications that are different than what the PBM requires of its affiliated pharmacies; Retroactively reducing a payment made to a pharmacy on a drug claim after the point of sale or reimbursing a pharmacy in an amount that is less than the amount reimbursed to its own affiliated pharmacy for the same pharmacy service; Modifying the prescription drug formulary under a health benefit plan during the plan year; With regard to audits, using specified techniques in calculating a recoupment or penalty, subjecting a pharmacy to recoupment when a clerical error is discovered, and requiring pharmacies to be audited more than once a year; Prohibiting a pharmacy or pharmacist from, or penalizing a pharmacy or pharmacist for, providing information to patients about more affordable, therapeutically equivalent alternatives to a prescribed drug; or Requiring a pharmacy or pharmacist to charge or collect a copayment from an insured patient that exceeds the total charge submitted by the pharmacy for the prescription drug. Additionally, PBMs are required to: Provide pharmacies 7 days' written notice before an audit, conduct an audit by or in consultation with a pharmacist, allow the pharmacy to supplement claims documentation, and establish an appeals process; Provide an insured individual, the insured's health-care provider, or a third party acting on behalf of the insured or provider with up-to-date and real-time cost, benefit, and coverage information under the terms of the insured's health benefit plan; and Provide contracted pharmacies with the list of sources the PBM used in determining maximum allowable cost pricing, update the information every 7 days, allow pharmacies the ability to readily review the information, follow specified requirements when placing a drug on the maximum allowable cost list, and establish an appeals process to resolve disputes. The act specifies that the commissioner of insurance (commissioner) has the power to enforce these prohibitions and requirements and impose penalties on PBMs for failing to comply with these prohibitions and requirements. The commissioner is also authorized to adopt rules as necessary to implement and enforce these prohibitions and requirements. Additionally, the act requires PBMs to register with and pay a registration fee to the commissioner and authorizes the commissioner to deny, suspend, revoke, or refuse to issue, continue, or renew a PBM registration or to issue a cease-and-desist order if the commissioner finds that a PBM has engaged in specified activities, including violating an insurance law. The PBM registration fees imposed under the act are to be used to fund the costs of the division of insurance in enforcing requirements and prohibitions on PBMs. The act appropriates $206,647 from the division of insurance cash fund to the department of regulatory agencies for use by the division of insurance for personal services and operating expenses related to implementing the act. APPROVED by Governor May 10, 2023 EFFECTIVE August 7, 2023 NOTE: This act was passed without a safety clause and takes effect 90 days after sine die. (Note: This summary applies to this bill as enacted.)
The bill requires the Colorado school of public health to analyze model legislation for implementing a publicly financed and privately delivered universal health-care payment system for Colorado that directly compensates providers. The Colorado school of public health must submit a report detailing its findings from the analysis to the general assembly by December 1, 2023. October 1, 2024. The bill also creates the statewide health-care analysis task force consisting of members appointed by the general assembly and the governor, as well as executive directors of specified state departments, the commissioner of insurance, and the chief executive officer of the Colorado health benefit exchange or any designees of the executive directors, the commissioner, and the chief executive officer. The task force is created for the purpose of advising the Colorado school of public health during the analysis. The bill also exempts the analysis conducted by the Colorado school of public health from a financial aid funding requirement. (Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.) (Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)
The act requires a public school or school district to allow a qualified student to wear and display traditional Native American regalia at a school graduation ceremony and applies to pre-kindergarten, kindergarten, primary school, and secondary school graduation ceremonies. The act requires public colleges and universities to allow a qualified student to wear and display traditional Native American regalia at a college graduation ceremony. APPROVED by Governor May 4, 2023 EFFECTIVE May 4, 2023 (Note: This summary applies to this bill as enacted.)