C.R.S. Section 25-4-2403
Department of public health and environment

  • powers and duties
  • immunization tracking system
  • rules
  • definitions

(1)

In order to expand the immunization registry and increase access to immunizations, the department may address:

(a)

Mechanisms for:

(I)

Maximizing federal funds to purchase, distribute, and deliver vaccines for individuals in Colorado; and

(II)

Statewide purchase, distribution, and prioritization of vaccines, including childhood immunizations and the seasonal influenza vaccine;

(b)

Methods to reduce the administrative burden of providing immunizations to individuals in Colorado by reviewing current immunization activities and strategies and epidemiological data related to vaccine-preventable diseases and identifying opportunities to implement best practices for immunizations throughout Colorado using innovative strategies that are population-specific, culturally sensitive, and inclusive; address safety issues; and enhance current services;

(c)

Options for Colorado to more effectively purchase, distribute, and deliver vaccines to insured, underinsured, and uninsured individuals;

(d)

The pursuit of private and public partnerships for funding for the immunization registry infrastructure;

(e)

Options for the most effective and cost-effective use of funds that may be available to the department of public health and environment to address vaccine delivery in the state; and

(f)

The ability of the department of health care policy and financing to purchase vaccines recommended by ACIP through a purchasing system, if developed pursuant to this subsection (1) and subsection (1.3) of this section, for children who are enrolled in the children’s basic health plan created in article 8 of title 25.5, C.R.S.

(1.3)

Intentionally left blank —Ed.

(a)

The department shall convene a task force of interested stakeholders to consider the issues identified in subsection (1) of this section. The task force must consist of at least the following persons or groups:

(I)

Primary care providers, including essential community providers, pediatricians, family physicians, mid-level providers, and practice managers;

(II)

Pharmacists from both independent and chain pharmacies;

(III)

Local public health providers;

(IV)

Child health advocates;

(V)

Health insurers and other persons who pay for health-care services;

(VI)

A representative from a Colorado-based innovative vaccine company;

(VII)

Pharmaceutical manufacturers; and

(VIII)

Representatives from the departments of public health and environment and health care policy and financing.

(b)

The task force shall make recommendations to the department and the board on the financing, ordering, and delivery of childhood immunizations, including through any of the following methods:

(I)

A public-private model of vaccine purchase and delivery;

(II)

Just-in-time delivery;

(III)

Inventory management, including vaccine choices, combination vaccines, and equivalent vaccines;

(IV)

Outbreak response;

(V)

Linkage between the immunization tracking system established pursuant to subsection (2) of this section and vaccine inventory;

(VI)

Vaccine shortage response;

(VII)

Preservation of vaccine delivery in a medical home model of care;

(VIII)

Mechanisms for local public health entities to bill health insurance carriers; and

(IX)

Continuation and preservation of current models of vaccine purchase, financing, and delivery and the ability of health-care providers to use those current models or any new models that may be developed pursuant to this subsection (1.3) and subsection (1) of this section.

(c)

The board may adopt rules as necessary to implement the recommendations of the task force.

(d)

No health-care provider is compelled to participate in a vaccine purchasing system, if such system is developed pursuant to this section.

(2)

To enable the gathering of epidemiological information and investigation and control of communicable diseases, the department of public health and environment shall maintain a comprehensive immunization tracking system with immunization information gathered by state and local public health officials from the following sources:

(a)

Practitioners;

(b)

Clinics;

(c)

Schools;

(d)

Parents, legal guardians, or persons authorized to consent to immunization pursuant to section 25-4-1704;

(e)

Individuals;

(f)

Managed care organizations or health insurance plans in which an individual is enrolled as a member or insured, if such managed care organization or health insurer reimburses or otherwise financially provides coverage for immunizations;

(g)

Hospitals;

(h)

The department of health care policy and financing with respect to individuals who are eligible for coverage under the “Colorado Medical Assistance Act”, articles 4, 5, and 6 of title 25.5, C.R.S.; and

(i)

Persons and entities that have contracted with the state pursuant to paragraph (d) of subsection (9) of this section.

(2.5)

Intentionally left blank —Ed.

(a)

A practitioner who is a licensed physician, a physician assistant authorized pursuant to section 12-240-107 (6), an advanced practice registered nurse, or a person authorized pursuant to title 12 to administer immunizations within his or her scope of practice shall submit immunization, medical exemption, or nonmedical exemption data to the tracking system.

(b)

Notwithstanding subsection (2.5)(a) of this section, a practitioner who is a licensed physician, a physician assistant authorized pursuant to section 12-240-107 (6), an advanced practice registered nurse, or a person authorized pursuant to title 12 to administer immunizations within his or her scope of practice is not subject to a regulatory sanction for failing to submit immunization, medical exemption, or nonmedical exemption data to the immunization tracking system.

(3)

Records in the immunization tracking system shall be strictly confidential and shall not be released, shared with any agency or institution, or made public upon subpoena, search warrant, discovery proceedings, or otherwise, except under the following circumstances:

(a)

Medical and epidemiological information may be released in a manner such that no individual person can be identified.

(b)

Immunization records and epidemiological information may be released to the extent necessary for the treatment, control, investigation, and prevention of vaccine-preventable diseases; except that every effort shall be made to limit disclosure of personal identifying information to the minimum amount necessary to accomplish the public health purpose.

(c)

Immunization records and epidemiological information may be released to the individual who is the subject of the record, to a parent of a minor individual, to a guardian or person authorized to consent to immunization under section 25-4-1704, to the physician, clinic, hospital, or licensed health-care practitioner treating the person who is the subject of an immunization record, to a school in which such person is enrolled, or any entity or person described in paragraph (f), (h), or (i) of subsection (2) of this section.

(4)

An officer, employee, or agent of the department of public health and environment or a county, district, or municipal public health agency shall not be examined in any judicial, executive, legislative, or other proceeding as to the existence or content of any individual’s report obtained by such department without consent of the individual or the individual’s parent or guardian. However, this subsection (4) shall not apply to individuals who are under isolation, quarantine, or other restrictive action taken pursuant to section 25-1.5-102 (1)(c).

(5)

Intentionally left blank —Ed.

(a)

An officer, employee, or agent of the department of public health and environment or any other person who violates this section by releasing or making public confidential immunization records or epidemiological information in the immunization tracking system or by otherwise breaching the confidentiality requirements of this section or releasing such information without authorization commits a class 2 misdemeanor and, upon conviction thereof, shall be punished as provided in section 18-1.3-501 (1). The unauthorized release of each record shall constitute a separate offense.

(b)

A natural person who, in exchange for money or any other thing of value, violates this section by wrongfully releasing or making public confidential immunization records or epidemiological information in the immunization tracking system or by otherwise breaching the confidentiality requirements of this section or releasing such information without authorization commits a class 2 misdemeanor and, upon conviction thereof, shall be punished as provided in section 18-1.3-501 (1).

(c)

A business entity who, in exchange for money or any other thing of value, violates this section by wrongfully releasing or making public confidential immunization records or epidemiological information in the immunization tracking system or by otherwise breaching the confidentiality requirements of this section or releasing such information without authorization shall be assessed a civil penalty of ten thousand dollars per sale of information per subject of such information.

(6)

Intentionally left blank —Ed.

(a)

The department of public health and environment or the department’s contractor may directly contact the individual who is the subject of immunization records or the individual’s parent or legal guardian for the purpose of notifying the individual, parent, or legal guardian if immunizations are due or overdue as indicated by the advisory committee on immunization practices of the United States department of health and human services or the American academy of pediatrics. The department or the department’s contractor shall contact the individual, parent, or legal guardian if it is necessary to control an outbreak of or prevent the spread of a vaccine-preventable disease pursuant to section 25-1.5-102 (1)(a) or 25-4-908.

(b)

A notice given to an individual or a parent or legal guardian of an individual under eighteen years of age pursuant to this subsection (6) shall also inform the individual, parent, or legal guardian of the option to refuse an immunization on the grounds of medical, religious, or personal belief considerations pursuant to section 25-4-903.

(7)

An individual or a parent or legal guardian who consents to the immunization of an infant, a child, or a student pursuant to part 9 or 17 of this article 4 or this part 24 may exclude immunization information from the immunization tracking system. The individual, parent, or legal guardian may remove such immunization information from the immunization tracking system at any time. The department of public health and environment shall ensure that the process to exclude immunization information from the system is readily available and not burdensome. The physician, licensed health-care practitioner, clinic, hospital, or county, district, or municipal public health agency shall inform the individual, parent, or legal guardian of the option to exclude such information from such system and the potential benefits of inclusion in such system. In addition, the physician, licensed health-care practitioner, clinic, hospital, or county, district, or municipal public health agency shall inform such parent or legal guardian of a minor individual of the option to refuse an immunization on the grounds of medical, religious, or personal belief considerations pursuant to section 25-4-903. Neither refusing an immunization on the grounds of medical, religious, or personal belief considerations pursuant to section 25-4-903 nor opting to exclude immunization notification information from the immunization tracking system by itself constitutes child abuse or neglect by a parent or legal guardian for the purposes of part 3 of article 3 of title 19.

(8)

A person licensed to practice medicine pursuant to article 240 of title 12; a person licensed to practice nursing or as a certified midwife pursuant to part 1 of article 255 of title 12; any other licensed health-care practitioner as defined in section 25-4-1703; providers of county nursing services; staff members of health-care clinics, hospitals, and offices of private practitioners; county, district, and municipal public health agencies; and all persons and entities listed in subsection (2) of this section are authorized to report to the immunization tracking system and to use the reminder and recall process established by the immunization tracking system.

(9)

The department of public health and environment may:

(a)

Issue immunization records to individuals, parents, or guardians authorized to consent to immunizations;

(b)

Assess the vaccination status of individuals;

(c)

Accept any gifts or grants or awards of funds from the federal government or private sources for the implementation and operation of the immunization tracking system, which shall be credited to the immunization fund created in section 25-4-1708; and

(d)

Enter into contracts that are necessary for the implementation and operation of the immunization tracking system. A person who enters into a contract pursuant to this paragraph (d) shall only use the information gathered from the immunization tracking system in accordance with this part 24 and shall be subject to all applicable state and federal laws regarding the confidentiality of information.

(10)

County, district, and municipal public health agencies and the department of public health and environment shall use the birth certificate of any person to enroll the person in an immunization tracking system. The use of the birth certificate shall be considered an official duty of local health departments and the department of public health and environment.

(11)

Physicians, licensed health-care practitioners, clinics, schools, licensed child care providers, hospitals, managed care organizations or health insurance plans in which an individual is enrolled as a member or insured, persons that have contracted with the department of public health and environment pursuant to paragraph (d) of subsection (9) 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, to the persons or entities specified in subsection (2) of this section to provide treatment for such individual or to provide an accurate and complete immunization record for the individual.

(12)

The department of public health and environment shall disseminate information about the immunization tracking system, including providing notification pursuant to subsection (7) of this section to birthing hospitals. The hospitals shall provide the notices to the parents of newborns.

(13)

As used in this section:

(a)

“ACIP” means the advisory committee on immunization practices to the centers for disease control and prevention in the federal department of health and human services, or its successor entity.

(b)

“Board” means the state board of health created in section 25-1-103.

(c)

“Department” means the department of public health and environment created in section 25-1-102.

(d)

“Equivalent vaccines” means two or more vaccines that:

(I)

Protect a recipient of the vaccine against the same infection;

(II)

Have similar safety and efficacy profiles; and

(III)

Are recommended for comparable populations by the federal centers for disease control and prevention.

Source: Section 25-4-2403 — Department of public health and environment - powers and duties - immunization tracking system - rules - definitions, https://leg.­colorado.­gov/sites/default/files/images/olls/crs2023-title-25.­pdf (accessed Oct. 20, 2023).

25‑4‑101
Premises sanitation - food defined 25‑4‑102
Sanitary regulations 25‑4‑103
Construction requirements 25‑4‑104
Protection from dirt 25‑4‑105
Toilet rooms and lavatories 25‑4‑106
Nuisances - petty offense 25‑4‑107
Rooms not used for sleeping 25‑4‑108
Work by persons with contagious diseases - forbidden 25‑4‑109
Enforcement 25‑4‑110
Prosecutions - disposition of fines 25‑4‑111
Penalty 25‑4‑112
Rules 25‑4‑201
Pregnant woman to take blood test 25‑4‑203
Birth certificate - blood test 25‑4‑204
Penalty 25‑4‑205
District attorneys to prosecute 25‑4‑301
Inflammation of eyes 25‑4‑401
Legislative declaration 25‑4‑402
Definitions 25‑4‑403
Eligibility - nondiscrimination 25‑4‑404
Rules 25‑4‑405
Reporting requirements - immunity 25‑4‑406
Reports - confidentiality 25‑4‑407
Reporting requirements - research exemption 25‑4‑408
Infection control - duties 25‑4‑409
Minors - treatment - consent 25‑4‑410
Patient consent - rights of patients, victims, and pregnant women 25‑4‑411
Confidential counseling and testing sites - legislative declaration 25‑4‑412
Public safety - public health procedures - orders for compliance - petitions - hearings 25‑4‑413
Emergency public health procedures - injunctions 25‑4‑414
Penalties 25‑4‑500.3
Definitions 25‑4‑501
Tuberculosis declared to be an infectious and communicable disease 25‑4‑502
Tuberculosis to be reported 25‑4‑506
Investigation and examination of suspected or known tuberculosis cases 25‑4‑507
Isolation order - enforcement - court review 25‑4‑508
Inspection of records 25‑4‑509
Violations - penalty 25‑4‑510
Jurisdiction 25‑4‑511
Duties of board of health and department - confidentiality of records - rules 25‑4‑512
Nondiscrimination in the provision of general services 25‑4‑513
Funding 25‑4‑601
Definitions 25‑4‑602
Notice to health department or officer if animal affected or suspected of being affected by rabies 25‑4‑603
Report of person bitten by animal to health department or health officer 25‑4‑604
Animal attacking or biting person to be confined - examination 25‑4‑605
Animals bitten by animals known or suspected of having rabies to be confined 25‑4‑606
Animals to be confined to prevent spread of rabies 25‑4‑607
Order of board of health requiring inoculation of animals - veterinarian waiver of order 25‑4‑608
Notice of order requiring inoculation of animals 25‑4‑609
Effect of order requiring inoculation of animals 25‑4‑610
Uninoculated animals not to run at large - impounding and disposition of animals 25‑4‑611
Report to state department 25‑4‑612
Enforcement of part 6 25‑4‑613
Liability for accident or subsequent disease from inoculation 25‑4‑614
Penalties 25‑4‑615
Further municipal restrictions not prohibited 25‑4‑701
Definitions 25‑4‑702
Board to establish rules - department to administer 25‑4‑709
Quarantine 25‑4‑710
Right of entry - inspections 25‑4‑712
Unlawful acts 25‑4‑713
Penalty for violations 25‑4‑901
Definitions 25‑4‑902
Immunization prior to attending school - standardized immunization information 25‑4‑902.5
Immunization prior to attending a college or university - tuberculosis screening process development 25‑4‑903
Exemptions from immunization - rules 25‑4‑904
Rules - immunization rules - rule-making authority of state board of health 25‑4‑904.5
Annual alignment evaluation 25‑4‑905
Immunization of indigent children 25‑4‑906
Certificate of immunization - forms 25‑4‑907
Noncompliance 25‑4‑908
When exemption from immunization not recognized 25‑4‑909
Vaccine-related injury or death - limitations on liability 25‑4‑910
Immunization data collection 25‑4‑911
Vaccinated children standard - legislative declaration 25‑4‑912
Confidentiality 25‑4‑1001
Short title 25‑4‑1002
Legislative declaration 25‑4‑1002.5
Definitions 25‑4‑1003
Powers and duties of executive director - newborn screening programs - genetic counseling and education programs - rules 25‑4‑1004
Newborn screening - rules 25‑4‑1004.3
Newborn heart defect screening - pulse oximetry - rules - definition 25‑4‑1004.5
Follow-up testing and treatment - second screening - fee - rules 25‑4‑1004.7
Newborn hearing screening - advisory committee - report - rules 25‑4‑1005
Exceptions 25‑4‑1006
Cash funds 25‑4‑1201
Powers and duties of executive director 25‑4‑1202
Streptococcus cash fund 25‑4‑1301
Legislative declaration 25‑4‑1302
Definitions 25‑4‑1303
Labeling - product modules - take-home containers 25‑4‑1304
Bulk food protection 25‑4‑1305
Bulk food display 25‑4‑1306
Dispensing utensils 25‑4‑1307
Materials 25‑4‑1308
Food-contact surfaces 25‑4‑1309
Non-food-contact surfaces 25‑4‑1310
Accessibility 25‑4‑1311
Equipment sanitization 25‑4‑1312
Violation - penalty 25‑4‑1313
Rules and regulations 25‑4‑1314
Limitation 25‑4‑1401
Drug assistance program - program fund - HIV medications rebate fund - created - legislative declaration - no entitlement created 25‑4‑1402
Definitions 25‑4‑1403
Colorado HIV and AIDS prevention grant program 25‑4‑1404
Grant program - rules - conflict of interest 25‑4‑1405
AIDS and HIV prevention fund - administration - limitation 25‑4‑1501
Legislative declaration 25‑4‑1502
Definitions 25‑4‑1503
Fund created 25‑4‑1504
Allocation of fund 25‑4‑1505
Powers and duties of department and advisory board 25‑4‑1601
Legislative declaration 25‑4‑1602
Definitions 25‑4‑1603
Licensing, certification, and food protection agency 25‑4‑1604
Powers and duties of department - rules 25‑4‑1605
Submission of plans for approval - required 25‑4‑1606
Licensure - exception 25‑4‑1607
Fees 25‑4‑1607.5
Retail food establishment regulation - fees - investigations - stakeholder process 25‑4‑1607.7
Health inspection results - development of a uniform system - communication to the public 25‑4‑1607.9
Department targets - audits - reporting 25‑4‑1608
Food protection cash fund - creation 25‑4‑1609.5
Grievance process 25‑4‑1610
Unlawful acts 25‑4‑1611.5
Violations - penalties - review 25‑4‑1612
Judicial review 25‑4‑1614
Home kitchens - exemption - food inspection - short title - definitions - rules 25‑4‑1615
Pet dogs in retail food establishments - prohibited - exceptions 25‑4‑1616
Food donations to nonprofit organizations encouraged 25‑4‑1617
Animal shares and meat sales by farmers and ranchers - short title - definitions 25‑4‑1701
Short title 25‑4‑1702
Legislative declaration 25‑4‑1703
Definitions 25‑4‑1704
Infant immunization program - delegation of authority to immunize minor 25‑4‑1705
Department of public health and environment - powers and duties - rules 25‑4‑1706
Infant immunization program - eligibility 25‑4‑1707
Moneys targeted for medical assistance for infants - reimbursement 25‑4‑1708
Fund created 25‑4‑1709
Limitations on liability 25‑4‑1801
Short title 25‑4‑1802
Legislative declaration 25‑4‑1803
Definitions 25‑4‑1804
Department designated as certifying and inspecting agency 25‑4‑1805
Powers and duties of department - rules 25‑4‑1806
Shellfish dealers - certificate required - application - fees 25‑4‑1807
Record-keeping requirements 25‑4‑1808
Unlawful acts 25‑4‑1809
Inspections - investigations - access - subpoena 25‑4‑1810
Enforcement 25‑4‑1811
Disciplinary actions - denial of certification 25‑4‑1812
Civil penalties 25‑4‑1813
Criminal penalties 25‑4‑1901
Short title 25‑4‑1902
Definitions 25‑4‑1903
Gulf war syndrome registry - creation - reporting 25‑4‑1905
Confidentiality of information collected 25‑4‑1906
Gulf war syndrome registry fund 25‑4‑2001
Short title 25‑4‑2002
Legislative declaration 25‑4‑2003
Definitions 25‑4‑2004
Powers and duties of executive director - hepatitis C program 25‑4‑2005
Hepatitis C testing - recommendations - definitions 25‑4‑2101
Powers and duties of department - rules 25‑4‑2102
Penalties for violations 25‑4‑2103
Parental consent for minors 25‑4‑2201
Legislative declaration 25‑4‑2202
Definitions 25‑4‑2203
Health disparities and community grant program - rules 25‑4‑2204
Office of health equity - creation 25‑4‑2205
Powers and duties of the office of health equity - rules - working group 25‑4‑2206
Health equity commission - creation - repeal 25‑4‑2208
Necessary document program - report - definition 25‑4‑2209
Culturally relevant and affirming health-care training - health-care providers - grants - definitions 25‑4‑2301
Colorado immunization fund - supplemental tobacco litigation settlement moneys account - creation 25‑4‑2401
Short title 25‑4‑2402
Legislative declaration 25‑4‑2403
Department of public health and environment - powers and duties - immunization tracking system - rules - definitions 25‑4‑2404
Vaccines - access to the public - definitions 25‑4‑2501
Short title 25‑4‑2502
Definitions 25‑4‑2503
Cervical cancer immunization program - rules 25‑4‑2504
Public awareness campaign - fund
Green check means up to date. Up to date

Current through Fall 2024

§ 25-4-2403’s source at colorado​.gov