Colorado 2023 2023 Regular Session

Colorado Senate Bill SB167 Introduced / Bill

Filed 02/21/2023

                    First Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
INTRODUCED
 
 
LLS NO. 23-0840.01 Christy Chase x2008
SENATE BILL 23-167
Senate Committees House Committees
Health & Human Services
A BILL FOR AN ACT
C
ONCERNING THE REGULATION OF CERTIFIED MIDWIVES BY THE STATE101
BOARD OF NURSING.102
Bill Summary
(Note:  This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov
.)
Starting July 1, 2024, the bill authorizes individuals who have a
midwife certification from the American Midwifery Certification Board,
pay the required fee, and submit to a criminal history record check to
obtain a license from the state board of nursing (board) to practice as a
certified midwife in the state. A certified midwife licensed by the board
may apply for and obtain provisional and full prescriptive authority upon
SENATE SPONSORSHIP
Winter F. and Will, 
HOUSE SPONSORSHIP
Gonzales-Gutierrez, 
Shading denotes HOUSE amendment.  Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law. satisfying the requirements specified in the bill. Certified midwives are
subject to regulation by the board to the same extent that the board
regulates the practice of nursing, including grounds for discipline and
disciplinary actions.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 12-255-102, amend2
(1) as follows:3
12-255-102.  Legislative declaration. (1)  The general assembly4
hereby declares it to be the policy of this state that, in order to safeguard5
the life, health, property, and public welfare of the people of this state and6
in order to protect the people of this state from the unauthorized,7
unqualified, and improper application of services by individuals in the8
practice of nursing 
AND THE PRACTICE AS A CERTIFIED MIDWIFE , it is9
necessary that a proper regulatory authority be established. The general10
assembly further declares it to be the policy of this state to regulate the11
practice of nursing 
AND THE PRACTICE AS A CERTIFIED MIDWIFE through12
a state agency with the power to enforce this article 255.13
SECTION 2. In Colorado Revised Statutes, 12-255-104, amend14
(4.5) and (13); and add (3.2) and (7.5) as follows:15
12-255-104.  Definitions. As used in this article 255, unless the16
context otherwise requires:17
(3.2)  "C
ERTIFIED MIDWIFE" MEANS AN INDIVIDUAL WHO MEETS18
THE QUALIFICATIONS FOR PRACTICE AS A CERTIFIED MIDWIFE, AS SPECIFIED19
IN THIS PART 1 AND BY THE AMERICAN MIDWIFERY CERTIFICATION20
B
OARD, OR ITS SUCCESSOR ENTITY, AND WHO IS CURRENTLY LICENSED BY21
THE BOARD. ONLY AN INDIVIDUAL WHO HOLDS A LICENSE TO PRACTICE AS22
A CERTIFIED MIDWIFE IN THIS STATE PURSUANT TO THIS PART 1 HAS THE23
SB23-167-2- RIGHT TO USE THE TITLE "CERTIFIED MIDWIFE" AND ITS ABBREVIATION1
"C.M."2
(4.5) (a)  "Delegation of patient care" means aspects of patient care3
that are consistent with a plan of patient care prescribed by a licensed4
health care provider within the scope of the provider's practice and that5
may be delegated to a registered nurse or licensed practical nurse within6
the scope of the nurse's practice. "Delegation of patient care" includes7
aspects of patient care that may be delegated by a licensed health care8
provider within the scope of the provider's practice and within the9
provider's professional judgment to a licensed or an unlicensed health10
care provider within the scope of that provider's practice. Nothing in this11
subsection (4.5) limits or expands the scope of practice of any nurse 
OR12
CERTIFIED MIDWIFE licensed pursuant to this article 255.13
(b)  For purposes of
 AS USED IN this subsection (4.5), "plan of14
patient care" means a written plan, verbal order, standing order, or15
protocol, whether patient specific or not, that authorizes specific or16
discretionary nursing 
OR CERTIFIED MIDWIFE action and that may include17
the administration of medication.18
(7.5)  "P
RACTICE AS A CERTIFIED MIDWIFE " MEANS THE19
PERFORMANCE OF SERVICES REQUIRING THE EDUCATION , TRAINING, AND20
SKILLS SPECIFIED BY THE AMERICAN MIDWIFERY CERTIFICATION BOARD,21
OR ITS SUCCESSOR ENTITY, FOR MIDWIFE CERTIFICATION FROM THAT22
ENTITY.23
(13)  "Unauthorized practice", for purposes of this part 1, means:24
(a)  The practice of practical nursing or the practice of professional25
nursing by any person
 INDIVIDUAL:26
(a) (I)  Who has not been issued a license under this part 1;27
SB23-167
-3- (b) (II)  Who is not practicing in this state pursuant to section1
24-60-3802; or2
(c) (III)  Whose license has been suspended or revoked or has3
expired; 
OR4
(b)  T
HE PRACTICE AS A CERTIFIED MIDWIFE BY ANY INDIVIDUAL5
WHO HAS NOT BEEN ISSUED A LICENSE UNDER THIS PART 1 OR WHOSE6
LICENSE HAS BEEN SUSPENDED OR REVOKED OR HAS EXPIRED .7
SECTION 3. In Colorado Revised Statutes, 12-255-105, amend8
(1)(a) introductory portion, (1)(a)(II) introductory portion, and9
(1)(a)(II)(D); and add (1)(a)(II.5) as follows:10
12-255-105.  State board of nursing created - removal of board11
members - meetings of board. (1) (a)  There is created the state board12
of nursing in the division, which is a type 1 entity, as defined in section13
24-1-105. The board consists of eleven
 TWELVE members who are14
residents of this state, appointed by the governor as follows:15
(II)  Seven members of the board shall be WHO ARE licensed16
professional nurses, who are actively employed in their respective nursing17
professions, and WHO ARE licensed in this state, The professional nurse18
members shall AND WHO have been employed for at least three years in19
their respective categories. Members shall be as follows:20
(D)  One member shall be WHO IS registered as an advanced21
practice registered nurse pursuant to section 12-255-111; 
EXCEPT THAT22
THE MEMBER APPOINTED PURSUANT TO THIS SUBSECTION (1)(a)(II)(D)23
MUST NOT BE A CERTIFIED NURSE MIDWIFE ;24
(II.5)  O
NE MEMBER OF THE BOARD WHO IS A CERTIFIED MIDWIFE25
OR AN ADVANCED PRACTICE REGISTERED NURSE WHO IS A CERTIFIED26
NURSE MIDWIFE;27
SB23-167
-4- SECTION 4. In Colorado Revised Statutes, 12-255-107, amend1
(1)(b)(I)(A), (1)(b)(I)(B), and (1)(h) as follows:2
12-255-107.  Powers and duties of the board - rules - definition.3
(1)  The board has the following powers and duties:4
(b) (I) (A)  To examine, license, certify, reactivate, and renew5
licenses or certifications of qualified applicants, and to grant to the6
applicants temporary licenses and permits, to engage in the practice of7
practical nursing and professional nursing, 
THE PRACTICE AS A CERTIFIED8
MIDWIFE, or the practice of a nurse aide, as applicable, in this state within9
the limitations imposed by this article 255. Licenses and certifications10
issued pursuant to this article 255 are subject to the renewal, expiration,11
reinstatement, and delinquency fee provisions specified in section12
12-20-202 (1) and (2).13
(B)  The director may increase fees to obtain or renew a14
professional nurse license, or
 AN advanced practice registered nurse15
authority, 
OR A CERTIFIED MIDWIFE LICENSE under this part 1 consistent16
with section 12-30-105 (4) to fund the division's costs in administering17
and staffing the nurse-physician advisory task force for Colorado health18
care created in section 12-30-105 (1).19
(h)  To investigate and conduct hearings upon charges for the20
discipline of nurses, 
CERTIFIED MIDWIVES, and nurse aides in accordance21
with article 4 of title 24 and section 12-20-403 and to impose disciplinary22
sanctions as provided in this article 255 and section 12-20-404;23
SECTION 5. In Colorado Revised Statutes, add 12-255-111.5 as24
follows:25
12-255-111.5.  Requirements for certified midwife licensure -26
license by endorsement - questionnaire - fees. (1)  O
N AND AFTER JULY27
SB23-167
-5- 1, 2024, THE BOARD SHALL ISSUE A LICENSE TO ENGAGE IN THE PRACTICE1
AS A CERTIFIED MIDWIFE TO ANY APPLICANT WHO :2
(a)  S
UBMITS AN APPLICATION CONTAINING INFORMATION THE3
BOARD MAY PRESCRIBE;4
(b)  S
UBMITS PROOF SATISFACTORY TO THE BOARD , IN THE MANNER5
AND UPON THE FORMS THE BOARD MAY REQUIRE , TO SHOW THAT THE6
APPLICANT HAS OBTAINED AND MAINTAINS IN GOOD STANDING A MIDWIFE7
CERTIFICATION FROM THE AMERICAN MIDWIFERY CERTIFICATION BOARD8
OR ITS SUCCESSOR ENTITY;9
(c)  P
AYS THE REQUIRED FEE; AND10
(d)  S
UBMITS TO A CRIMINAL HISTORY RECORD CHECK IN THE FORM11
AND MANNER AS DESCRIBED IN SUBSECTION (2) OF THIS SECTION.12
(2) (a)  I
N ADDITION TO THE REQUIREMENTS OF SUBSECTION (1) OF13
THIS SECTION, EACH APPLICANT MUST HAVE THE APPLICANT 'S14
FINGERPRINTS TAKEN BY A LOCAL LAW ENFORCEMENT AGENCY OR ANY15
THIRD PARTY APPROVED BY THE COLORADO BUREAU OF INVESTIGATION16
FOR THE PURPOSE OF OBTAINING A FINGERPRINT-BASED CRIMINAL HISTORY17
RECORD CHECK. IF AN APPROVED THIRD PARTY TAKES THE APPLICANT 'S18
FINGERPRINTS, THE FINGERPRINTS MAY BE ELECTRONICALLY CAPTURED19
USING COLORADO BUREAU OF INVESTIGATION -APPROVED LIVESCAN20
EQUIPMENT. THIRD-PARTY VENDORS SHALL NOT KEEP THE APPLICANT 'S21
INFORMATION FOR MORE THAN THIRTY DAYS UNLESS REQUESTED TO DO SO22
BY THE APPLICANT. THE APPLICANT SHALL SUBMIT PAYMENT BY CERTIFIED23
CHECK OR MONEY ORDER FOR THE FINGERPRINTS AND FOR THE ACTUAL24
COSTS OF THE RECORD CHECK AT THE TIME THE FINGERPRINTS ARE25
SUBMITTED TO THE COLORADO BUREAU OF INVESTIGATION . UPON RECEIPT26
OF FINGERPRINTS AND RECEIPT OF THE PAYMENT FOR COSTS , THE27
SB23-167
-6- COLORADO BUREAU OF INVESTIGATION SHALL CONDUCT A STATE AND1
NATIONAL FINGERPRINT-BASED CRIMINAL HISTORY RECORD CHECK2
UTILIZING RECORDS OF THE COLORADO BUREAU OF INVESTIGATION AND3
THE FEDERAL BUREAU OF INVESTIGATION AND SHALL FORWARD THE4
RESULTS OF THE CRIMINAL HISTORY RECORD CHECK TO THE DIRECTOR .5
(b)  W
HEN THE RESULTS OF A FINGERPRINT -BASED CRIMINAL6
HISTORY RECORD CHECK OF AN APPLICANT PERFORMED PURSUANT TO THIS7
SUBSECTION (2) REVEAL A RECORD OF ARREST WITHOUT A DISPOSITION ,8
THE BOARD SHALL REQUIRE THAT APPLICANT TO SUBMIT TO A9
NAME-BASED JUDICIAL RECORD CHECK, AS DEFINED IN SECTION 22-2-119.310
(6)(d).11
(3)  T
HE BOARD MAY ISSUE A LICENSE BY ENDORSEMENT TO12
ENGAGE IN THE PRACTICE AS A CERTIFIED MIDWIFE IN THIS STATE TO AN13
APPLICANT WHO SATISFIES THE REQUIREMENTS OF THE OCCUPATIONAL14
CREDENTIAL PORTABILITY PROGRAM .15
(4) (a) (I)  T
HE BOARD SHALL DESIGN A QUESTIONNAIRE TO BE SENT16
TO ALL LICENSEES WHO APPLY FOR LICENSE RENEWAL . EACH APPLICANT17
FOR LICENSE RENEWAL SHALL COMPLETE THE BOARD -DESIGNED18
QUESTIONNAIRE. THE PURPOSE OF THE QUESTIONNAIRE IS TO DETERMINE19
WHETHER A LICENSEE HAS ACTED IN VIOLATION OF THIS PART 1 OR HAS20
BEEN DISCIPLINED FOR ANY ACTION THAT MIGHT BE CONSIDERED A21
VIOLATION OF THIS PART 1 OR THAT MIGHT MAKE THE LICENSEE UNFIT TO22
PRACTICE AS A CERTIFIED MIDWIFE WITH REASONABLE CARE AND SAFETY .23
T
HE BOARD SHALL INCLUDE ON THE QUESTIONNAIRE A QUESTION24
REGARDING WHETHER THE LICENSEE HAS COMPLIED WITH SECTION25
12-30-111
 AND IS IN COMPLIANCE WITH SECTION 12-280-403 (2)(a).26
(II)  I
F AN APPLICANT FAILS TO ANSWER THE QUESTIONNAIRE27
SB23-167
-7- ACCURATELY, THE FAILURE CONSTITUTES GROUNDS FOR DISCIPLINE UNDER1
SECTION 12-255-120 (1)(v).2
(III)  T
HE BOARD MAY INCLUDE THE COST OF DEVELOPING AND3
REVIEWING THE QUESTIONNAIRE IN THE FEE PAID UNDER SUBSECTION4
(1)(c) 
OF THIS SECTION.5
(IV)  T
HE BOARD MAY DENY AN APPLICATION FOR LICENSE6
RENEWAL THAT DOES NOT ACCOMPANY AN ACCURATELY COMPLETED7
QUESTIONNAIRE.8
(b)  O
N AND AFTER JULY 1, 2024, AS A CONDITION OF RENEWAL OF9
A LICENSE, EACH LICENSEE SHALL ATTEST THAT THE LICENSEE IS IN10
COMPLIANCE WITH SECTION 12-280-403 (2)(a) AND THAT THE LICENSEE IS11
AWARE OF THE PENALTIES FOR NONCOMPLIANCE WITH THAT SECTION .12
(5)  A
 CERTIFIED MIDWIFE WHO SATISFIES THE REQUIREMENTS OF13
SECTION 12-255-112 MAY BE GRANTED PRESCRIPTIVE AUTHORITY AS A14
FUNCTION IN ADDITION TO THOSE FUNCTIONS DESCRIBED IN SECTION15
12-255-104
 (7.5).16
SECTION 6. In Colorado Revised Statutes, 12-255-112, amend17
(1), (3), (4)(b) introductory portion, (4)(b)(I)(A), (4)(b)(I)(D),18
(4)(b)(I)(E), (4)(b)(III), (4)(b)(IV), (4)(d), (5), (6), (7), (9), (10), (11), and19
(12); repeal (4)(f); and add (4)(a.5) and (4)(b)(V) as follows:20
12-255-112.  Prescriptive authority - advanced practice21
registered nurses - certified midwives - limits on prescriptions - rules22
- financial benefit for prescribing prohibited. (1)  The board may23
authorize 
THE FOLLOWING LICENSEES TO PRESCRIBE CONTROLLED24
SUBSTANCES OR PRESCRIPTION DRUGS , AS THOSE TERMS ARE DEFINED IN25
SECTION 12-280-103:26
(a)  An advanced practice registered nurse who is listed on the27
SB23-167
-8- advanced practice registry, WHO has a license in good standing without1
disciplinary sanctions issued pursuant to section 12-255-110, and 
WHO2
has fulfilled 
THE REQUIREMENTS OF THIS SECTION AND requirements3
established by the board pursuant to this section; to prescribe controlled
4
substances or prescription drugs as defined in section 12-280-103. OR5
(b)  A
 CERTIFIED MIDWIFE WHO HAS A LICENSE ISSUED PURSUANT6
TO SECTION 12-255-111.5 THAT IS IN GOOD STANDING WITHOUT7
DISCIPLINARY SANCTIONS AND WHO HAS FULFILLED THE REQUIREMENTS8
OF THIS SECTION AND REQUIREMENTS ESTABLISHED BY THE BOARD9
PURSUANT TO THIS SECTION.10
(3) (a)  An advanced practice registered nurse 
OR A CERTIFIED11
MIDWIFE may be granted authority to prescribe prescription drugs and12
controlled substances to provide treatment to clients within the role and13
population focus of the advanced practice registered nurse 
OR CERTIFIED14
MIDWIFE, AS APPLICABLE.15
(b) (I)  An advanced practice registered nurse 
OR A CERTIFIED16
MIDWIFE who has been granted authority to prescribe prescription drugs17
and controlled substances under this part 1 may advise the nurse's 
OR18
CERTIFIED MIDWIFE'S patients of their option to have the symptom or19
purpose for which a prescription is being issued included on the20
prescription order.21
(II)  A nurse's 
OR CERTIFIED MIDWIFE'S failure to advise a patient22
under subsection (3)(b)(I) of this section is neither:23
(A)  Grounds for any disciplinary action against the nurse's 
OR24
CERTIFIED MIDWIFE'S professional license issued under this part 1; nor25
(B)  Grounds for any civil action against a nurse 
OR CERTIFIED26
MIDWIFE in a negligence or tort action; nor27
SB23-167
-9- (C)  Evidence in any civil action against a nurse OR CERTIFIED1
MIDWIFE.2
(4) (a.5)  A
 CERTIFIED MIDWIFE APPLYING FOR PRESCRIPTIVE3
AUTHORITY SHALL PROVIDE EVIDENCE TO THE BOARD THAT THE CERTIFIED4
MIDWIFE HAS OBTAINED AND MAINTAINS :5
(I)  A
 MIDWIFE CERTIFICATION IN GOOD STANDING FROM THE6
A
MERICAN MIDWIFERY CERTIFICATION BOARD OR ITS SUCCESSOR ENTITY;7
AND8
(II)  P
ROFESSIONAL LIABILITY INSURANCE AS REQUIRED BY SECTION9
12-255-113.10
(b)  Upon satisfaction of the requirements set forth in subsection
11
(4)(a) of this section, The board may grant provisional prescriptive12
authority to an advanced practice registered nurse, 
UPON SATISFACTION OF13
THE REQUIREMENTS SET FORTH IN SUBSECTION (4)(a) OF THIS SECTION, OR14
TO A CERTIFIED MIDWIFE, UPON SATISFACTION OF THE REQUIREMENTS SET15
FORTH IN SUBSECTION (4)(a.5) OF THIS SECTION. The provisional16
prescriptive authority that is granted is limited to those patients and17
medications appropriate to the advanced practice registered nurse's 
OR18
CERTIFIED MIDWIFE'S role and population focus. In order to retain19
provisional prescriptive authority and obtain and retain full prescriptive20
authority pursuant to this subsection (4) for patients and medications21
appropriate for the advanced practice registered nurse's 
OR CERTIFIED22
MIDWIFE'S role and population focus, an advanced practice registered23
nurse 
OR A CERTIFIED MIDWIFE shall satisfy the following requirements:24
(I) (A)  Once the provisional prescriptive authority is granted, the25
advanced practice registered nurse 
OR CERTIFIED MIDWIFE must obtain26
seven hundred fifty hours of documented experience in a mutually27
SB23-167
-10- structured prescribing mentorship either with a physician or with an1
advanced practice registered nurse 
OR A CERTIFIED MIDWIFE who has full2
prescriptive authority and experience in prescribing medications. The3
mentor must be practicing in Colorado and have education, training,4
experience, and an active practice that corresponds with the role and5
population focus of the advanced practice registered nurse 
OR CERTIFIED6
MIDWIFE.7
(D)  Upon successful completion of the mentorship period, the8
mentor shall provide the mentor's signature and attestation to verify that9
the advanced practice registered nurse 
OR CERTIFIED MIDWIFE has10
successfully completed the mentorship within the required period after the11
provisional prescriptive authority was granted.12
(E)  If an advanced practice registered nurse 
OR A CERTIFIED13
MIDWIFE with provisional prescriptive authority fails to complete the14
mentorship required by this subsection (4)(b)(I) within three years or15
otherwise fails to demonstrate competence as determined by the board,16
the advanced practice registered nurse's 
OR CERTIFIED MIDWIFE'S17
provisional prescriptive authority expires for failure to comply with the18
statutory requirements.19
(III)  The advanced practice registered nurse 
OR CERTIFIED20
MIDWIFE shall maintain professional liability insurance as required by21
section 12-255-113.22
(IV)  The advanced practice registered nurse 
OR CERTIFIED23
MIDWIFE shall maintain national certification, as specified in subsection24
(4)(a)(III) 
OR (4)(a.5)(I) of this section, unless the board grants an25
exception.26
(V)  T
HE CERTIFIED MIDWIFE MUST COMPLETE AT LEAST THREE27
SB23-167
-11- YEARS OF CLINICAL WORK EXPERIENCE AS A CERTIFIED MIDWIFE .1
(d)  In order to obtain provisional prescriptive authority and obtain2
and retain full prescriptive authority in this state, an advanced practice3
registered nurse 
OR A CERTIFIED MIDWIFE from another state must meet4
the requirements of this section or substantially equivalent requirements,5
as determined by the board.6
(f)  Once an advanced practice registered nurse obtains full
7
prescriptive authority pursuant to this subsection (4), the advanced8
practice registered nurse is not required to maintain or update an9
articulated plan as described in subsection (4)(b)(II) or (4)(c)(I) of this10
section.11
(5)  An advanced practice registered nurse 
OR A CERTIFIED12
MIDWIFE who obtains prescriptive authority pursuant to this section shall13
be assigned a specific identifier by the state board of nursing. This14
identifier shall be available to the Colorado medical board and the state15
board of pharmacy. The state board of nursing shall establish a16
mechanism to assure that the prescriptive authority of an advanced17
practice registered nurse 
OR A CERTIFIED MIDWIFE may be readily verified.18
(6)  An advanced practice registered nurse 
OR A CERTIFIED19
MIDWIFE with prescriptive authority pursuant to this section is subject to20
the limitations on prescriptions specified in section 12-30-109.21
(7) (a)  The scope of practice for an advanced practice registered22
nurse 
OR A CERTIFIED MIDWIFE may be determined by the board in23
accordance with this part 1.24
(b)  The board may consider information provided by nursing,25
medical, 
MIDWIFERY, or other health professional organizations,26
associations, or regulatory boards.27
SB23-167
-12- (c) (I)  Prescriptive authority by an advanced practice registered1
nurse shall be OR A CERTIFIED MIDWIFE IS limited to those patients2
appropriate to the nurse's 
OR CERTIFIED MIDWIFE'S scope of practice.3
Prescriptive authority may be limited or withdrawn and the advanced4
practice registered nurse 
OR CERTIFIED MIDWIFE may be subject to further5
disciplinary action in accordance with this part 1 if the nurse 
OR6
CERTIFIED MIDWIFE has prescribed outside the nurse's OR CERTIFIED7
MIDWIFE'S scope of practice or for other than a therapeutic purpose.8
(II)  Nothing in this section shall be construed to require a9
registered nurse 
OR CERTIFIED MIDWIFE to obtain prescriptive authority to10
deliver anesthesia care.11
(9)  Nothing in this section shall be construed to permit dispensing12
or distribution, as defined in section 12-280-103 (14) and (15), by an13
advanced practice registered nurse 
OR A CERTIFIED MIDWIFE, except for14
samples, under article 280 of this title 12 and the federal "Prescription15
Drug Marketing Act of 1987", Pub.L. 100-293, as amended.16
(10)  An advanced practice registered nurse registered pursuant to17
section 12-255-111 
OR A CERTIFIED MIDWIFE is not required to apply for18
or obtain prescriptive authority.19
(11)  Nothing in this section shall limit
 LIMITS:20
(a)  The practice of nursing by any nurse, including advanced21
practice registered nurses; 
OR22
(b)  T
HE PRACTICE AS A CERTIFIED MIDWIFE BY ANY CERTIFIED23
MIDWIFE.24
(12)  An advanced practice registered nurse 
OR A CERTIFIED25
MIDWIFE shall not accept any direct or indirect benefit from a26
pharmaceutical manufacturer or pharmaceutical representative for27
SB23-167
-13- prescribing a specific medication to a patient. For the purposes of this1
section, a direct or indirect benefit does not include a benefit offered to2
an advanced practice registered nurse 
OR CERTIFIED MIDWIFE regardless3
of whether the specific medication is being prescribed.4
SECTION 7. In Colorado Revised Statutes, amend 12-255-1135
as follows:6
12-255-113.  Professional liability insurance required -7
advanced practice registered nurses and certified midwives in8
independent practice - rules. (1)  It is unlawful for any advanced9
practice registered nurse 
OR CERTIFIED MIDWIFE engaged in an10
independent practice of professional nursing 
OR AS A CERTIFIED MIDWIFE11
to practice within the state of Colorado unless the advanced practice12
registered nurse 
OR CERTIFIED MIDWIFE purchases and maintains or is13
covered by professional liability insurance in an amount not less than five14
hundred thousand dollars per claim with an aggregate liability for all15
claims during the year of one million five hundred thousand dollars.16
(2)  Professional liability insurance required by this section shall
17
MUST cover all acts within the scope of practice of an advanced practice18
registered nurse 
OR CERTIFIED MIDWIFE as defined
 DESCRIBED in this part19
1.20
(3)  Notwithstanding the requirements of subsection (1) of this21
section, the board, by rule, may exempt or establish lesser liability22
insurance requirements for advanced practice registered nurses 
OR23
CERTIFIED MIDWIVES.24
(4)  Nothing in this section shall be construed to confer liability on25
an employer for the acts of an advanced practice registered nurse 
OR A26
CERTIFIED MIDWIFE that are outside the scope of employment or to negate27
SB23-167
-14- the applicability of the "Colorado Governmental Immunity Act", article1
10 of title 24.2
SECTION 8. In Colorado Revised Statutes, amend 12-255-1153
as follows:4
12-255-115.  Volunteer licensure - fees - questionnaire. (1)  The5
board may issue a license to a volunteer nurse 
OR CERTIFIED MIDWIFE who6
meets the requirements set forth in this section.7
(2)  A volunteer nursing 
OR CERTIFIED MIDWIFE license shall only8
be issued to an applicant who:9
(a)  Currently holds a license to practice nursing, either as a10
practical nurse or as a professional nurse, 
OR TO PRACTICE AS A CERTIFIED11
MIDWIFE, and the license is due to expire unless renewed; or12
(b)  Is not currently engaged in the practice of nursing 
OR AS A13
CERTIFIED MIDWIFE either full-time or part-time and has, prior to ceasing14
practice, maintained full licensure in good standing in any state or15
territory of the United States.16
(3) (a)  A volunteer nursing license shall permit the nurse to17
engage in volunteer nursing tasks within the scope of the nurse's license.18
(b)  A
 VOLUNTEER CERTIFIED MIDWIFE LICENSE SHALL PERMIT THE19
CERTIFIED MIDWIFE TO ENGAGE AS A VOLUNTEER IN THE PRACTICE AS A20
CERTIFIED MIDWIFE WITHIN THE SCOPE OF THE CERTIFIED MIDWIFE 'S21
LICENSE.22
(4)  An applicant for a volunteer nursing 
OR CERTIFIED MIDWIFE23
license shall submit to the board an application containing the information24
the board may prescribe, a copy of the applicant's most recent nursing 
OR25
CERTIFIED MIDWIFE license, and a statement signed under penalty of26
perjury in which the applicant agrees not to receive compensation for any27
SB23-167
-15- nursing tasks OR TASKS AS A CERTIFIED MIDWIFE that are performed while1
in possession of the license.2
(5)  A person who possesses a volunteer nursing 
OR CERTIFIED3
MIDWIFE license is immune from civil liability for actions performed4
within the scope of the nursing 
OR CERTIFIED MIDWIFE license unless it is5
established that injury or death was caused by gross negligence or the6
willful and wanton misconduct of the licensee. The immunity provided7
in this subsection (5) applies only to the licensee and does not affect the8
liability of any other individual or entity. Nothing in this subsection (5)9
limits the ability of the board to take disciplinary action against a licensee.10
(6)  The fee for a volunteer nursing 
OR CERTIFIED MIDWIFE license,11
including assessments for legal defense, peer assistance, and other12
programs for which licenses are assessed, must not exceed fifty percent13
of the license renewal fee, including all assessments, established by the14
board for an active nursing 
OR CERTIFIED MIDWIFE license.15
(7)  The board shall design a questionnaire to be sent to all16
volunteer nurses 
AND CERTIFIED MIDWIVES who apply for license renewal.17
Each applicant for license renewal shall complete the board-designed18
questionnaire. The purpose of the questionnaire is to determine whether19
a licensee has acted in violation of this part 1 or has been disciplined for20
any action that might be considered a violation of this part 1 or might21
make the licensee unfit to practice nursing 
OR AS A CERTIFIED MIDWIFE22
with reasonable care and safety. If an applicant fails to answer the23
questionnaire accurately, the failure constitutes grounds for discipline24
under section 12-255-120 (1)(v). The board may include the cost of25
developing and reviewing the questionnaire in the fee paid under26
subsection (6) of this section. The board may deny an application for27
SB23-167
-16- license renewal that does not accompany an accurately completed1
questionnaire.2
(8) (a)  The board shall deny an application for the reactivation of3
a practical or professional nurse license for a volunteer nurse if the board4
determines that the nurse requesting reactivation has not actively5
volunteered as a nurse for the two-year period immediately preceding the6
filing of the application for license reactivation or has not otherwise7
demonstrated continued competency to return to the active practice of8
nursing in a manner approved by the board.9
(b)  T
HE BOARD SHALL DENY AN APPLICATION FOR THE10
REACTIVATION OF A CERTIFIED MIDWIFE LICENSE FOR A VOLUNTEER11
CERTIFIED MIDWIFE IF THE BOARD DETERMINES THAT THE CERTIFIED12
MIDWIFE REQUESTING REACTIVATION HAS NOT ACTIVELY VOLUNTEERED13
AS A CERTIFIED MIDWIFE FOR THE TWO -YEAR PERIOD IMMEDIATELY14
PRECEDING THE FILING OF THE APPLICATION FOR LICENSE REACTIVATION15
OR HAS NOT OTHERWISE DEMONSTRATED CONTINUED COMPETENCY TO16
RETURN TO THE ACTIVE PRACTICE AS A CERTIFIED MIDWIFE IN A MANNER17
APPROVED BY THE BOARD.18
SECTION 9. In Colorado Revised Statutes, 12-255-117, amend19
(5) as follows:20
12-255-117.  Temporary licenses and permits. (5)  The board21
shall summarily withdraw a temporary license or permit issued pursuant22
to this section if the board determines that the 
TEMPORARY license OR23
PERMIT holder fails to meet the requirements of this section or section24
12-255-109, 12-255-110, 12-255-111.5, or 12-255-114. The holder of a25
temporary license or permit summarily withdrawn has the right to a26
hearing that shall be conducted pursuant to article 4 of title 24 and section27
SB23-167
-17- 12-20-403 by the board or by an administrative law judge at the board's1
discretion.2
SECTION 10. In Colorado Revised Statutes, 12-255-119, amend3
(1)(a), (3)(a)(I) introductory portion, (3)(a)(I)(B), (3)(a)(I)(C), (3)(a)(II),4
(3)(a)(III), (3)(b), (3)(c)(III), (4)(a), (4)(c)(III), (4)(c)(IV) introductory5
portion, (4)(c)(IV)(C), (4)(e), (6), (7), (8)(a), (8)(b), (8)(d), and (10) as6
follows:7
12-255-119.  Disciplinary procedures of the board - inquiry8
and hearings panels - mental and physical examinations - definitions9
- rules. (1) (a)  The president of the board shall divide the other ten10
members of the board into two panels of five members each. Members11
representing the three different categories of membership (licensed12
practical nurses, professional nurses, 
CERTIFIED MIDWIVES, and persons13
not licensed, employed, or in any way connected with, or with any14
financial interest in, any health-care facility, agency, or insurer) shall be15
divided between the two panels as equally as possible.16
(3) (a) (I)  For the purposes of
 AS USED IN this section:17
(B)  "License" includes licensure for a practical nurse or18
professional nurse, 
LICENSURE FOR A CERTIFIED MIDWIFE, and licensure19
for a psychiatric technician.20
(C)  "Nurse", "licensee", or "respondent" includes a practical21
nurse, a professional nurse, 
A CERTIFIED MIDWIFE, and a psychiatric22
technician as described in section 12-295-103 (4).23
(II)  Written complaints relating to the conduct of a nurse licensed24
or authorized to practice nursing in this state 
OR RELATING TO THE25
CONDUCT OF A CERTIFIED MIDWIFE LICENSED OR AUTHORIZED TO26
PRACTICE AS A CERTIFIED MIDWIFE IN THIS STATE may be made by any27
SB23-167
-18- person or may be initiated by an inquiry panel of the board on its own1
motion. U
NLESS THE BOARD DETERMINES THE COMPLAINT TO BE WITHOUT2
MERIT OF INVESTIGATION, THE BOARD SHALL GIVE NOTICE OF THE3
COMPLAINT TO the nurse OR CERTIFIED MIDWIFE complained of, shall be
4
given notice, unless the board determines the complaint to be without5
merit of investigation, by first-class mail, and SHALL STATE IN the notice6
shall state the nature of the complaint and shall state that the failure to7
respond in a materially factual and timely manner constitutes grounds for8
discipline. The nurse 
OR CERTIFIED MIDWIFE complained of shall be given9
thirty days to answer or explain in writing the matters described in such
10
THE complaint. Upon receipt of the nurse's OR CERTIFIED MIDWIFE'S11
answer or at the conclusion of thirty days, whichever occurs first, the12
inquiry panel may take further action as set forth in subsection (3)(a)(III)13
of this section.14
(III)  Upon receipt of the nurse's 
OR CERTIFIED MIDWIFE'S answer15
or the conclusion of thirty days, the inquiry panel may conduct a further16
investigation that may be made by one or more members of the inquiry17
panel; 
IN THE CASE OF A COMPLAINT AGAINST A NURSE , one or more18
nurses who are not members of the board; 
IN THE CASE OF A COMPLAINT19
AGAINST A CERTIFIED MIDWIFE, ONE OR MORE CERTIFIED MIDWIVES OR20
CERTIFIED NURSE MIDWIVES WHO ARE NOT MEMBERS OF THE BOARD ; a21
member of the staff of the board; a professional investigator; or any other22
person or organization as the inquiry panel directs. The investigation shall
23
MUST be entirely informal.24
(b)  The board shall cause an investigation to be made when the25
board is informed of:26
(I)  Disciplinary action taken by an employer of a nurse 
OR27
SB23-167
-19- CERTIFIED MIDWIFE against the nurse OR CERTIFIED MIDWIFE or1
resignation in lieu of a disciplinary action for conduct that constitutes2
grounds for discipline under section 12-255-120 or 12-295-111. The3
employer shall report the disciplinary action or resignation to the board.4
(II)  An instance of a malpractice settlement or judgment against5
a nurse 
OR CERTIFIED MIDWIFE;6
(III)  A nurse 
OR CERTIFIED MIDWIFE who has not timely renewed7
his or her
 THE NURSE'S OR CERTIFIED MIDWIFE'S license and the nurse OR8
CERTIFIED MIDWIFE is actively engaged in the practice of nursing OR AS9
A CERTIFIED MIDWIFE.10
(c)  On completion of an investigation, the inquiry panel shall11
make a finding that:12
(III)  An instance of conduct occurred that does not warrant formal13
action by the board and that should be dismissed, but that indications of14
possible conduct by the nurse 
OR CERTIFIED MIDWIFE were noted that15
could lead to serious consequences if not corrected. In such a case, the16
board shall send a confidential letter of concern in accordance with17
section 12-20-404 (5) to the nurse 
OR CERTIFIED MIDWIFE against whom18
the complaint was made.19
(4) (a)  All formal complaints shall be heard and determined in20
accordance with subsection (4)(b) of this section and section 24-4-105.21
Except as provided in subsection (1) of this section, all formal hearings22
shall be conducted by the hearings panel. The nurse 
OR CERTIFIED23
MIDWIFE may be present in person or represented by counsel, or both, if24
so desired, to offer evidence and be heard in the nurse's 
OR CERTIFIED25
MIDWIFE'S own defense. At formal hearings, the witnesses shall be sworn26
and a complete record shall be made of all proceedings and testimony.27
SB23-167
-20- (c) (III)  If the hearings panel finds the charges proven and orders1
that discipline be imposed, it shall also determine the extent of the2
discipline, which may be in the form of a letter of admonition regarding3
a license or suspension for a definite or indefinite period, revocation, or4
nonrenewal of a license to practice. In addition to any other discipline that5
may be imposed pursuant to this section, the hearings panel may impose6
a fine of no less than two hundred fifty dollars but no more than one7
thousand dollars per violation on any nurse 
OR CERTIFIED MIDWIFE who8
violates this part 1 or any rule adopted pursuant to this part 1. The board9
shall adopt rules establishing a fine structure and the circumstances under10
which fines may be imposed.11
(IV)  In determining appropriate disciplinary action, the hearings12
panel shall first consider sanctions that are necessary to protect the public.13
Only after the panel has considered such sanctions shall it consider and14
order requirements designed to rehabilitate the nurse 
OR CERTIFIED15
MIDWIFE. If discipline other than revocation of a license to practice is16
imposed, the hearings panel may also order that the nurse 
OR CERTIFIED17
MIDWIFE be granted probation and allowed to continue to practice during18
the period of the probation. The hearings panel may also include in any19
disciplinary order that allows the nurse 
OR CERTIFIED MIDWIFE to continue20
to practice such conditions as the panel may deem appropriate to assure21
that the nurse 
OR CERTIFIED MIDWIFE is physically, mentally, and22
otherwise qualified to practice nursing 
OR AS A CERTIFIED MIDWIFE in23
accordance with generally accepted standards of practice, including any24
of the following:25
(C)  The review or supervision of the respondent's practice of26
nursing 
OR AS A CERTIFIED MIDWIFE as may be necessary to determine the27
SB23-167
-21- quality of the respondent's practice of nursing OR AS A CERTIFIED MIDWIFE1
and to correct deficiencies therein IN THE RESPONDENT'S PRACTICE; or2
(e)  The two-year waiting period specified in section 12-20-404 (3)3
applies to any person whose license to practice nursing, 
PRACTICE AS A4
CERTIFIED MIDWIFE, or PRACTICE any other health-care occupation is5
revoked by any other legally qualified board.6
(6)  Upon the expiration of any term of suspension, the license7
shall be reinstated by the board if the board is furnished with evidence8
that the nurse 
OR CERTIFIED MIDWIFE has complied with all terms of the9
suspension. If the evidence shows the nurse 
OR CERTIFIED MIDWIFE has10
not complied with all terms of the suspension, the board may revoke or11
continue the suspension of the license at a hearing, notice of which and12
the procedure at which shall be as provided in this section.13
(7)  In case any nurse 
OR CERTIFIED MIDWIFE is determined to be14
mentally incompetent or insane by a court of competent jurisdiction and15
a court enters, pursuant to part 3 or 4 of article 14 of title 15 or section16
27-65-110 (4) or 27-65-127, an order specifically finding that the mental17
incompetency or insanity is of such a degree that the nurse 
OR CERTIFIED18
MIDWIFE is incapable of continuing the practice of nursing OR AS A19
CERTIFIED MIDWIFE, the board shall automatically suspend the nurse's OR20
CERTIFIED MIDWIFE'S license, and, notwithstanding any provision of this21
part 1 to the contrary, the suspension must continue until the nurse 
OR22
CERTIFIED MIDWIFE is found by the court to be competent to continue the23
practice of nursing 
OR THE PRACTICE AS A CERTIFIED MIDWIFE , AS24
APPLICABLE.25
(8) (a)  If the board has reasonable cause to believe that a nurse is26
unable to practice nursing, 
OR A CERTIFIED MIDWIFE IS UNABLE TO27
SB23-167
-22- PRACTICE AS A CERTIFIED MIDWIFE, with reasonable skill and safety to1
patients because of a condition described in section 12-255-120 (1)(i) or2
(1)(j) or section 12-295-111 (1)(i) or (1)(j), it THE BOARD may require the3
nurse 
OR CERTIFIED MIDWIFE to submit to mental or physical examinations4
by a physician or other licensed health-care professional designated by the5
board. If a nurse 
OR CERTIFIED MIDWIFE fails to submit to the mental or6
physical examinations, the board may suspend the nurse's 
OR CERTIFIED7
MIDWIFE'S license until the required examinations are conducted.8
(b) (I)  Every nurse 
OR CERTIFIED MIDWIFE shall be deemed, by so9
practicing or by applying for renewal registration of the nurse's 
OR10
CERTIFIED MIDWIFE'S license, to have consented to submit to mental or11
physical examinations when directed in writing by the board. Further, the12
nurse 
OR CERTIFIED MIDWIFE shall be deemed to have waived all13
objections to the admissibility of the examining physician's or other14
licensed health-care professional's testimony or examination reports on15
the ground of privileged communication. Subject to applicable federal16
law, the nurse 
OR CERTIFIED MIDWIFE shall be deemed to have waived all17
objections to the production of medical records to the board from18
health-care providers that may be necessary for the evaluations described19
in subsection (8)(a) of this section.20
(II)  Nothing in this section shall prevent the
 PREVENTS A nurse OR21
CERTIFIED MIDWIFE from submitting to the board testimony or22
examination reports of a physician or other licensed health-care23
professional designated by the nurse 
OR CERTIFIED MIDWIFE to a condition24
described in subsection (8)(a) of this section that may be considered by25
the board in conjunction with, but not in lieu of, testimony and26
examination reports of the physician or licensed health-care professional27
SB23-167
-23- designated by the board.1
(d)  The board may require that a nurse 
OR CERTIFIED MIDWIFE2
submit medical records for review in conjunction with an examination3
made pursuant to subsection (8)(a) of this section; except that the records4
shall
 remain confidential, and shall be reviewed by the board MAY5
REVIEW THE RECORDS only to the extent necessary to conduct an6
investigation.7
(10)  A physician or other licensed health-care professional who,8
at the request of the board, examines a nurse shall be OR CERTIFIED9
MIDWIFE IS immune from suit for damages by the nurse OR CERTIFIED10
MIDWIFE examined if the examining physician or examining licensed11
health-care professional conducted the examination and made findings or12
a diagnosis in good faith.13
SECTION 11. In Colorado Revised Statutes, 12-255-120, amend14
(1)(d), (1)(f), (1)(g), (1)(j)(I), (1)(j)(II), (1)(l), (1)(n), (1)(v), (1)(w),15
(1)(x), (1)(y), (1)(dd), (1)(ee), and (1)(ff) as follows:16
12-255-120.  Grounds for discipline - definitions. (1)  "Grounds17
for discipline", as used in this part 1, means any action by any person18
who:19
(d)  Has had a license to practice nursing, 
PRACTICE AS A CERTIFIED20
MIDWIFE, or PRACTICE any other health-care occupation suspended or21
revoked in any jurisdiction. A certified copy of the order of suspension or22
revocation shall be
 IS prima facie evidence of the suspension or23
revocation.24
(f)  Has practiced nursing 
OR AS A CERTIFIED MIDWIFE in a manner25
that fails to meet generally accepted standards for the nursing
 practice OF26
NURSING OR AS A CERTIFIED MIDWIFE, AS APPLICABLE;27
SB23-167
-24- (g)  Has violated any order or rule of the board pertaining to1
nursing practice, 
PRACTICE AS A CERTIFIED MIDWIFE, or licensure;2
(j)  Has failed to:3
(I)  Notify the board, as required by section 12-30-108 (1), of a4
physical illness, physical condition, or behavioral health, mental health,5
or substance use disorder that affects the person's ability to practice6
nursing 
OR AS A CERTIFIED MIDWIFE with reasonable skill and safety to7
patients or that may endanger the health or safety of individuals under the8
person's care;9
(II)  Act within the limitations created by a physical illness,10
physical condition, or behavioral health, mental health, or substance use11
disorder that renders the person unable to practice nursing 
OR AS A12
CERTIFIED MIDWIFE with reasonable skill and safety to patients or that may13
endanger the health or safety of individuals under the person's care; or14
(l)  Has engaged in any conduct that would constitute a crime as15
defined in title 18 and that relates to the person's employment as a16
practical or professional nurse 
OR AS A CERTIFIED MIDWIFE. In conjunction17
with any disciplinary proceeding pertaining to this subsection (1)(l), the18
board shall be governed by the provisions of sections 12-20-202 (5) and19
24-5-101.20
(n)  Has engaged in any of the following activities and practices:21
(I)  Willful and repeated ordering or performance, without clinical22
justification, of demonstrably unnecessary laboratory tests or studies;23
(II)  The administration, without clinical justification, of treatment24
that is demonstrably unnecessary;25
(III)  The failure to obtain consultations or perform referrals when26
failing to do so is not consistent with the standard of care for the27
SB23-167
-25- profession; or1
(IV)  Ordering or performing, without clinical justification, any2
service, X ray, or treatment that is contrary to recognized standards of the3
practice of nursing 
OR AS A CERTIFIED MIDWIFE as interpreted by the4
board;5
(v)  Has failed to accurately complete and submit to the board the6
designated questionnaire upon renewal of a license pursuant to section7
12-255-110 (3), 12-255-111.5 (4), 12-255-114 (3), or 12-255-115 (7);8
(w) (I)  Represents himself or herself
 ONESELF to an individual or9
to the general public by use of any word or abbreviation to indicate or10
induce others to believe that he or she is a licensed practical or11
professional nurse unless the person is actually licensed as a practical12
nurse or professional nurse, respectively; or13
(II)  Uses the title "nurse", "registered nurse", "R.N.", "practical14
nurse", "trained practical nurse", "licensed vocational nurse", "licensed15
practical nurse", or "L.P.N." unless the person is licensed by the board 
AS16
A PROFESSIONAL OR PRACTICAL NURSE , AS APPLICABLE;17
(III)  R
EPRESENTS ONESELF TO AN INDIVIDUAL OR TO THE GENERAL18
PUBLIC BY USE OF ANY WORD OR A BBREVIATION TO INDICATE OR INDUCE19
OTHERS TO BELIEVE THAT THE PERSON IS A CERTIFIED MIDWIFE UNLESS20
THE PERSON IS ACTUALLY LICENSED AS A CERTIFIED MIDWIFE ; OR21
(IV)  U
SES THE TITLE "CERTIFIED MIDWIFE" OR THE ABBREVIATION22
"C.M."
 UNLESS THE PERSON IS LICENSED BY THE BOARD AS A CERTIFIED23
MIDWIFE;24
(x)  Practices as a practical or professional nurse 
OR AS A25
CERTIFIED MIDWIFE during a period when the person's license has been26
suspended, revoked, or placed on inactive status pursuant to section27
SB23-167
-26- 12-255-122;1
(y)  Sells or fraudulently obtains or furnishes a license to practice2
as a nurse 
OR CERTIFIED MIDWIFE or aids or abets therein
 IN SUCH ACT;3
(dd)  Has failed to notify the board, in writing and within thirty4
days after a judgment or settlement is entered, of a final judgment by a5
court of competent jurisdiction against the licensee for malpractice of6
nursing 
OR AS A CERTIFIED MIDWIFE or a settlement by the licensee in7
response to charges or allegations of malpractice of nursing 
OR AS A8
CERTIFIED MIDWIFE and, in the case of a judgment, has failed to include9
in the notice the name of the court, the case number, and the names of all10
parties to the action;11
(ee)  Fails to report to the board, within thirty days after an adverse12
action, that an adverse action has been taken against the person by another13
licensing agency in another state or jurisdiction, a peer review body, a14
health-care institution, a professional, or
 nursing, OR CERTIFIED MIDWIFE15
society or association, a governmental agency, a law enforcement agency,16
or a court for acts or conduct that would constitute grounds for17
disciplinary or adverse action as described in this article 255;18
(ff)  Fails to report to the board, within thirty days, the surrender19
of a license or other authorization to practice nursing 
OR AS A CERTIFIED20
MIDWIFE in another state or jurisdiction or the surrender of membership21
on any nursing 
OR CERTIFIED MIDWIFE staff or in any nursing, CERTIFIED22
MIDWIFE, or professional association or society while under investigation23
by any of those authorities or bodies for acts or conduct similar to acts or24
conduct that would constitute grounds for action as described in this25
article 255;26
SECTION 12. In Colorado Revised Statutes, 12-255-121, amend27
SB23-167
-27- (1)(a), (1)(b)(I), (2), and (6)(a) as follows:1
12-255-121.  Withholding or denial of license - hearing -2
definitions. (1) (a)  The board is empowered to determine summarily3
whether:4
(I)  An applicant for a license or a temporary license to practice as5
a nurse 
OR AS A CERTIFIED MIDWIFE possesses the qualifications required6
by this part 1; whether
7
(II)  There is probable cause to believe that an applicant for a8
license or temporary license has done any of the acts set forth in section9
12-255-120 as grounds for discipline; or whether10
(III)  The applicant for a license or temporary license has had a11
license to practice nursing, 
PRACTICE AS A CERTIFIED MIDWIFE , or12
PRACTICE any other health-care occupation revoked by any legally13
authorized board.14
(b)  As used in this section:15
(I)  "Applicant" includes a nurse 
OR CERTIFIED MIDWIFE seeking16
reinstatement or reactivation of a license pursuant to section 12-255-122,17
but does not include a renewal applicant.18
(2) (a) (I)  If the board determines that an applicant does not19
possess the qualifications for licensure required by this part 1, that20
probable cause exists to believe that an applicant for a license or21
temporary license has done any of the acts set forth in section22
12-255-120, or that an applicant for a license or temporary license has had23
a nursing, 
CERTIFIED MIDWIFE, or other health-care occupation license24
revoked by another legally authorized board, the board may withhold or25
deny the applicant a license under this part 1.26
(II)  The board may deny a license or temporary license to practice27
SB23-167
-28- as a nurse OR AS A CERTIFIED MIDWIFE to any applicant during the time the1
applicant's license is under suspension in another state.2
(III)  The board may deny a license or may grant a license subject3
to terms of probation if the board determines that an applicant for a4
license has not actively practiced practical or professional nursing, 
HAS5
NOT ACTIVELY PRACTICED AS A CERTIFIED MIDWIFE , or has not otherwise6
maintained continued competency, as determined by the board, during the7
two years immediately preceding the application for licensure under this8
part 1.9
(b)  If the board denies a license to an applicant pursuant to10
subsection (2)(a) of this section, the provisions of section 24-4-104 (9)11
apply. Upon the denial, the board shall provide the applicant with a12
statement in writing setting forth the following:13
(I)  The basis of the board's determination that the applicant:14
(A)  Does not possess the qualifications required by this part 1;15
(B)  Has had a nursing, 
CERTIFIED MIDWIFE, or other health-care16
occupation license revoked or suspended by another legally authorized17
board; or18
(C)  Has not actively practiced practical or professional nursing,19
HAS NOT ACTIVELY PRACTICED AS A CERTIFIED MIDWIFE , or has not20
maintained continued competency during the previous two years; or21
(II)  The factual basis for probable cause that the applicant has22
done any of the acts set forth in section 12-255-120.23
(c) (I)  If the board denies a 
NURSING license to an applicant on the24
grounds that the applicant's nursing or other health-care occupation25
license was revoked by another legally authorized board, the board may26
require the applicant to pass a written examination as provided in section27
SB23-167
-29- 12-255-109 as a prerequisite to licensure. The applicant shall not be1
allowed to take the written examination until at least two years after the2
revocation of the nursing or other health-care occupation license.3
(II)  I
F THE BOARD DENIES A CERTIFIED MIDWIFE LICENSE TO AN4
APPLICANT ON THE GROUNDS THAT THE APPLICANT 'S CERTIFIED MIDWIFE5
LICENSE WAS REVOKED BY ANOTHER LEGALLY AUTHORIZED BOARD , THE6
BOARD MAY REQUIRE THE APPLICANT TO OBTAIN RECERTIFICATION FROM7
THE AMERICAN MIDWIFERY CERTIFICATION BOARD, OR ITS SUCCESSOR8
ENTITY, AS A PREREQUISITE TO LICENSURE. THE APPLICANT SHALL NOT BE9
ALLOWED TO OBTAIN LICENSURE PURSUANT TO THIS SUBSECTION (2)(c)(II)10
UNTIL AT LEAST TWO YEARS AFTER THE APPLICANT 'S CERTIFIED MIDWIFE11
LICENSE WAS REVOKED.12
(6) (a)  At the hearing, the applicant shall have
 HAS the burden of13
proof to show that:14
(I)  The applicant possesses the qualifications required for15
licensure under this part 1;16
(II)  The applicant's nursing, 
CERTIFIED MIDWIFE, or other17
health-care occupation license was not revoked by another legally18
authorized board; or19
(III)  The applicant has actively practiced practical or professional20
nursing, 
HAS ACTIVELY PRACTICED AS A CERTIFIED MIDWIFE , or has21
maintained continued competency during the two years prior to22
application for a license under this part 1.23
SECTION 13. In Colorado Revised Statutes, 12-255-122, amend24
(1), (2), (3), (5), (6)(a), and (6)(b)(II) as follows:25
12-255-122.  Inactive license status - reactivation. (1)  A nurse26
OR CERTIFIED MIDWIFE licensed pursuant to section 12-255-110,27
SB23-167
-30- 12-255-111.5, or 12-255-114 may request that the board place his or her1
THE NURSE'S OR CERTIFIED MIDWIFE'S license on inactive status. The2
request shall be made in the form and manner designated by the board.3
(2)  A nurse 
OR CERTIFIED MIDWIFE requesting inactive license4
status shall provide an affidavit or other document required by the board5
certifying that, immediately upon the conferral of inactive status, the6
nurse shall
 WILL not practice nursing, OR THE CERTIFIED MIDWIFE WILL7
NOT PRACTICE AS A CERTIFIED MIDWIFE, in the state unless and until the8
nurse's 
OR CERTIFIED MIDWIFE'S license is reactivated pursuant to9
subsection (6) of this section.10
(3)  Upon receiving the documentation pursuant to subsection (2)11
of this section, the board shall approve a request for inactive license12
status. However, the board may deny the request if the board has probable13
cause to believe that the requesting nurse 
OR CERTIFIED MIDWIFE has14
committed any of the acts set forth in section 12-255-120.15
(5)  A nurse 
OR CERTIFIED MIDWIFE with a license on inactive16
status is not authorized to practice nursing 
OR AS A CERTIFIED MIDWIFE,17
AS APPLICABLE, in Colorado. Any nurse practicing nursing while his or
18
her THE NURSE'S license is inactive, shall be AND ANY CERTIFIED MIDWIFE19
PRACTICING AS A CERTIFIED MIDWIFE WHILE THE CERTIFIED MIDWIFE 'S20
LICENSE IS INACTIVE, IS subject to disciplinary action pursuant to section21
12-255-119 and criminal penalties pursuant to section 12-255-125.22
(6) (a)  A nurse 
OR CERTIFIED MIDWIFE with a license on inactive23
status who wishes to resume the practice of nursing 
OR AS A CERTIFIED24
MIDWIFE, AS APPLICABLE, shall file an application in the form and manner25
designated by the board and pay the license reactivation fees established26
pursuant to section 12-255-107. The board shall reactivate such license27
SB23-167
-31- unless subsection (6)(b) of this section applies.1
(b)  The board shall deny an application for reactivation of an2
inactive license:3
(II)  If the board determines that the nurse 
OR CERTIFIED MIDWIFE4
requesting reactivation has not actively practiced nursing 
OR AS A5
CERTIFIED MIDWIFE in another state for the two-year period immediately6
preceding the filing of the request for reactivation or has not otherwise7
demonstrated continued competency to return to the active practice of8
nursing 
OR AS A CERTIFIED MIDWIFE in a manner approved by the board.9
SECTION 14. In Colorado Revised Statutes, 12-255-124, amend10
(1), (3), and (4) as follows:11
12-255-124.  Surrender of license. (1)  Prior to the initiation of12
an investigation or hearing, any licensee or temporary license holder may13
surrender his or her
 THE INDIVIDUAL'S license to practice nursing OR AS14
A CERTIFIED MIDWIFE.15
(3)  The board shall not issue a license or temporary license or16
permit to a former licensee or temporary license or permit holder whose17
license has been surrendered unless the licensee meets all of the18
requirements of this part 1 for a new applicant, including, 
FOR19
APPLICANTS FOR A LICENSE, TEMPORARY LICENSE, OR PERMIT TO PRACTICE20
NURSING, the passing of an examination.21
(4)  The surrender of a license in accordance with this section22
removes all rights and privileges to practice nursing 
OR AS A CERTIFIED23
MIDWIFE, AS APPLICABLE, including renewal of a license.24
SECTION 15. In Colorado Revised Statutes, amend 12-255-12525
as follows:26
12-255-125.  Unauthorized practice - penalties. (1)  It is27
SB23-167
-32- unlawful for any person to practice as a practical or professional nurse OR1
AS A CERTIFIED MIDWIFE unless licensed to practice that profession.2
(2)  Any person who practices or offers or attempts to practice3
practical or professional nursing 
OR AS A CERTIFIED MIDWIFE without an4
active license issued under this part 1 is subject to penalties pursuant to5
section 12-20-407 (1)(a).6
SECTION 16. In Colorado Revised Statutes, amend 12-255-1267
as follows:8
12-255-126.  Injunctive proceedings. The board may seek9
injunctive relief in accordance with section 12-20-406, but only to enjoin10
any person who does not possess a currently valid or active practical or11
professional nurse license, 
CERTIFIED MIDWIFE LICENSE, or nurse aide12
certification from committing any act declared to be unlawful or13
prohibited by this article 255.14
SECTION 17. In Colorado Revised Statutes, 12-255-127, amend15
(1)(b), (1)(c), (1)(d), (1)(e), (1)(f), (1)(g), (1)(p), (1)(q), (2), and (3) as16
follows:17
12-255-127.  Exclusions. (1)  This part 1 does not prohibit:18
(b)  Domestic administration of family remedies or care of the sick19
by domestic servants, housekeepers, companions, or household aides of20
any type, whether employed regularly or because of an emergency of21
illness, but who shall not in any way assume to practice practical or22
professional nursing 
OR AS A CERTIFIED MIDWIFE;23
(c)  Nursing 
OR MIDWIFERY assistance in the case of an emergency;24
(d)  The practice of nursing 
OR AS A CERTIFIED MIDWIFE in this25
state by any legally qualified nurse 
OR CERTIFIED MIDWIFE of another state26
whose engagement requires the nurse 
OR CERTIFIED MIDWIFE to27
SB23-167
-33- accompany and care for a patient temporarily residing in this state, during1
the period of one engagement, not to exceed six months in length, if the2
person does not represent or hold himself or herself out as a practical or3
professional nurse 
OR CERTIFIED MIDWIFE licensed to practice in this state;4
(e)  The practice of any nurse 
OR CERTIFIED MIDWIFE licensed in5
this state or another state or a territory of the United States who is6
employed by the United States government or any bureau, division, or7
agency thereof
 OF THE UNITED STATES GOVERNMENT while in the8
discharge of official duties;9
(f)  The practice of nursing 
OR MIDWIFERY by students enrolled in10
an educational
 APPROVED EDUCATION program approved by the board OR11
MIDWIFERY EDUCATION PROGRAM when the practice is performed as part12
of an educational THE APPROVED EDUCATION program OR MIDWIFERY13
EDUCATION PROGRAM prior to the graduation of the student;14
(g)  The practice of nursing 
OR AS A CERTIFIED MIDWIFE by any15
nurse 
OR MIDWIFE WHO IS licensed in any other state, or
 any territory of16
the United States, or any other country 
AND IS enrolled in a baccalaureate17
or graduate program, when
 IF the practice is performed as a part of the18
program;19
(p)  The administration of medical marijuana in a nonsmokeable20
form by a licensee LICENSED NURSE in a public school or nonpublic21
school pursuant to a policy adopted pursuant to section 22-1-119.322
(3)(d.5);23
(q)  The training by a licensee LICENSED NURSE of school24
personnel or volunteers on the administration of medical marijuana in a25
nonsmokeable form in a public school or nonpublic school to a student26
with a valid medical marijuana recommendation pursuant to a policy27
SB23-167
-34- adopted pursuant to section 22-1-119.3 (3)(d.5).1
(2)  This part 1 shall not be construed as applying to a person who2
nurses or cares for the sick in accordance with the practice or tenets of3
any church or religious denomination that teaches reliance upon spiritual4
means through prayer for healing, and who does not hold himself or5
herself out to the public to be a licensed practical or professional nurse 
OR6
A CERTIFIED MIDWIFE.7
(3)  Nothing in this part 1:8
(a)  Prohibits any licensee from practicing practical or professional9
nursing 
OR AS A CERTIFIED MIDWIFE independently for compensation upon10
a fee for services basis;11
(b)  Prohibits or requires the direct reimbursement for nursing 
OR12
CERTIFIED MIDWIFE services and care through qualified governmental and13
insurance programs to persons duly licensed in accordance with this part14
1; or15
(c)  Conveys to the practice of nursing 
OR THE PRACTICE AS A16
CERTIFIED MIDWIFE the performance of medical practice as regulated by17
article 240 of this title 12, 
OTHER THAN AS PERMITTED UNDER SECTION18
12-240-107 (1)(f)(I).19
SECTION 18. In Colorado Revised Statutes, amend 12-255-12820
as follows:21
12-255-128.  Prescribing opiate antagonists. An advanced22
practice registered nurse 
OR CERTIFIED MIDWIFE with prescriptive23
authority pursuant to section 12-255-112 may prescribe or dispense an24
opiate antagonist in accordance with section 12-30-110.25
SECTION 19. In Colorado Revised Statutes, 12-255-130, amend26
(1), (2)(b), (3)(a) introductory portion, (3)(c), (4), and (6) as follows:27
SB23-167
-35- 12-255-130.  Peer health assistance or alternative to discipline1
program - fund - rules. (1)  As a condition of licensure and for the2
purpose of supporting a nursing peer health assistance program FOR3
NURSES OR CERTIFIED MIDWIVES or a nurse AN alternative to discipline4
program 
FOR NURSES OR CERTIFIED MIDWIVES , every applicant for an5
initial license or to reinstate a license and any person renewing a license6
issued pursuant to this part 1 shall pay to the administering entity7
designated pursuant to subsection (3)(c) of this section a fee in an amount8
set by the board, not to exceed twenty-five dollars per year; except that9
the board may adjust the amount each January 1 to reflect changes in the10
United States department of labor's bureau of labor statistics consumer11
price index, or its successor index, for Denver-Aurora-Lakewood for12
goods paid by urban consumers.13
(2) (b)  Money in the fund shall be used to support a nursing
 peer14
health assistance program 
FOR NURSES AND CERTIFIED MIDWIVES or nurse
15
AN alternative to discipline program FOR NURSES AND CERTIFIED16
MIDWIVES in providing assistance to licensees needing help in dealing17
with physical, emotional, psychiatric, or psychological problems or18
behavioral, mental health, or substance use disorders that may be19
detrimental to their ability to practice nursing 
OR TO PRACTICE AS A20
CERTIFIED MIDWIFE.21
(3) (a)  The board shall select one or more recognized peer health22
assistance organizations or nurse
 alternative to discipline programs as23
designated providers. For purposes of selecting designated providers, the24
board shall use a competitive bidding process that encourages25
participation from interested vendors. To be eligible for designation by26
the board pursuant to this section, a peer health assistance organization or27
SB23-167
-36- nurse alternative to discipline program shall:1
(c)  The board shall designate an administering entity for a2
program established pursuant to this section. The entity shall MUST be a3
nonprofit private entity that is qualified under 26 U.S.C. sec. 501 (c)(3)4
of the federal "Internal Revenue Code of 1986", as amended, and shall be5
dedicated to providing support for charitable, benevolent, educational, or6
scientific purposes that are related to nursing 
OR MIDWIFERY, nursing OR7
MIDWIFERY education, nursing OR MIDWIFERY research and science, and8
other nursing 
OR MIDWIFERY charitable purposes.9
(4)  Notwithstanding sections 12-255-119 and 24-4-104, the board10
may immediately suspend the license of any licensee who is referred to11
a peer health assistance program or nurse
 alternative to discipline12
program by the board and who fails to attend or to complete the program.13
If the licensee objects to the suspension, he or she THE LICENSEE may14
submit a written request to the board for a formal hearing on the15
suspension within ten days after receiving notice of the suspension, and16
the board shall grant the request. In the hearing, the licensee shall bear the17
burden of proving that his or her THE INDIVIDUAL'S license should not be18
suspended.19
(6)  Nothing in this section shall be construed to create any liability20
of the board, members of the board, or the state of Colorado for the21
actions of the board in making awards to peer health assistance22
organizations or nurse alternative to discipline programs or in designating23
licensees to participate in the programs of such organizations. No civil24
action may be brought or maintained against the board, its members, or25
the state for an injury alleged to have been the result of an act or omission26
of a licensee participating in or referred to a program provided by a peer27
SB23-167
-37- health assistance organization or to a nurse AN alternative to discipline1
program. However, the state shall remain REMAINS liable under the2
provisions of the "Colorado Governmental Immunity Act", article 10 of3
title 24, if an injury alleged to have been the result of an act or omission4
of a licensee participating in or referred to a peer health assistance5
program or nurse alternative to discipline program occurred while such6
licensee was performing duties as an employee of the state.7
SECTION 20. In Colorado Revised Statutes, amend 12-255-1318
as follows:9
12-255-131.  Delegation of nursing or midwifery tasks - rules.10
(1)  Any licensed practical nurse, registered nurse, or advanced practice11
registered nurse, 
OR CERTIFIED MIDWIFE may delegate any task included12
in the nurse's 
OR CERTIFIED MIDWIFE'S licensed scope of practice, subject13
to the requirements of this section. A licensed practical nurse, registered14
nurse, or
 advanced practice registered nurse, OR CERTIFIED MIDWIFE may15
delegate nursing 
OR CERTIFIED MIDWIFE tasks to licensed, certified,16
registered, or unlicensed or unregulated assistive personnel. In no event17
may a registered nurse 
OR CERTIFIED MIDWIFE delegate to another person18
the authority to select medications if the person is not, independent of the19
delegation, authorized by law to select medications.20
(2)  Delegated tasks shall
 MUST be within the area of responsibility21
of the delegating nurse 
OR CERTIFIED MIDWIFE and shall
 MUST not require22
any delegatee to exercise the judgment required of a nurse 
OR CERTIFIED23
MIDWIFE.24
(3)  No delegation shall be made without the delegating nurse 
OR25
CERTIFIED MIDWIFE making a determination that, in his or her
 THE26
LICENSEE'S professional judgment, the delegated task can be properly and27
SB23-167
-38- safely performed by the delegatee and that the delegation is1
commensurate with the patient's safety and welfare.2
(4)  The delegating nurse shall be OR CERTIFIED MIDWIFE IS solely3
responsible for determining the required degree of supervision the4
delegatee will need, after an evaluation of the appropriate factors, which5
shall include but ARE not be limited to the following:6
(a)  The stability of the condition of the patient;7
(b)  The training and ability of the delegatee;8
(c)  The nature of the nursing 
OR CERTIFIED MIDWIFE task being9
delegated; and10
(d)  Whether the delegated task has a predictable outcome.11
(5)  An employer of a nurse 
OR CERTIFIED MIDWIFE may establish12
policies, procedures, protocols, or standards of care that limit or prohibit13
delegations by nurses 
OR CERTIFIED MIDWIVES in specified circumstances.14
(6)  The board may promulgate rules pursuant to this section,15
including but not limited to standards on the assessment of the proficiency16
of the delegatee to perform delegated tasks, and standards for17
accountability of any nurse 
OR CERTIFIED MIDWIFE who delegates nursing18
OF CERTIFIED MIDWIFE tasks. The rules shall be consistent with the19
provisions of part 3 of article 1.5 of title 25, section 25.5-10-204 (2)(j),20
and section 27-10.5-103 (2)(i).21
SECTION 21. In Colorado Revised Statutes, 12-255-135, amend22
(2) as follows:23
12-255-135.  Confidential agreement to limit practice. (2)  This24
section and section 12-30-108 do not apply to a nurse 
OR CERTIFIED25
MIDWIFE subject to discipline under section 12-255-120 (1)(i).26
SECTION 22. In Colorado Revised Statutes, 12-20-404, amend27
SB23-167
-39- (1)(d)(II)(J.5) and (3)(a)(II)(J) as follows:1
12-20-404.  Disciplinary actions - regulator powers -2
disposition of fines - mistreatment of at-risk adult. (1)  General3
disciplinary authority. If a regulator determines that an applicant,4
licensee, certificate holder, or registrant has committed an act or engaged5
in conduct that constitutes grounds for discipline or unprofessional6
conduct under a part or article of this title 12 governing the particular7
profession or occupation, the regulator may:8
(d) (II)  A regulator is not authorized under this subsection (1)(d)9
to refuse to renew the license, certification, or registration of a licensee,10
certificate holder, or registrant regulated under the following:11
(J.5)  Article 255 of this title 12 concerning nurses 
AND CERTIFIED12
MIDWIVES;13
(3)  Waiting period after revocation or surrender. (a) (II)  In14
addition, the waiting period specified in subsection (3)(a)(I) of this15
section applies when a person regulated under any of the following16
articles surrenders a license, certification, or registration to avoid17
discipline:18
(J)  Article 255 of this title 12 concerning nurses, 
CERTIFIED19
MIDWIVES, and nurse aides;20
SECTION 23. In Colorado Revised Statutes, 12-20-406, amend21
(2)(b)(IX) as follows:22
12-20-406.  Injunctive relief. (2) (b)  Subsection (2)(a) of this23
section does not apply to the following:24
(IX)  Article 255 of this title 12 concerning nurses, 
CERTIFIED25
MIDWIVES, and nurse aides;26
SECTION 24. In Colorado Revised Statutes, 12-20-407, amend27
SB23-167
-40- (1)(a)(V)(O), (1)(e) introductory portion, and (1)(e)(VII) as follows:1
12-20-407.  Unauthorized practice of profession or occupation2
- penalties - exclusions. (1) (a)  A person commits a class 2 misdemeanor3
and shall be punished as provided in section 18-1.3-501 if the person:4
(V)  Practices or offers or attempts to practice any of the following5
professions or occupations without an active license, certification, or6
registration issued under the part or article of this title 12 governing the7
particular profession or occupation:8
(O)  Practical or professional nursing 
OR PRACTICE AS A CERTIFIED9
MIDWIFE, as regulated under article 255 of this title 12;10
(e)  A person commits a class 6 felony and shall be punished as11
provided in section 18-1.3-401 if the person practices or offers or12
attempts to practice any of the following professions or occupations and13
intentionally and fraudulently represents oneself as a licensed, certified,14
or registered professional or practitioner issued
 pursuant to a part or15
article of this title 12 governing the particular profession or occupation:16
(VII)  Professional nursing 
OR PRACTICE AS A CERTIFIED MIDWIFE,17
as regulated pursuant to article 255 of this title 12;18
SECTION 25. In Colorado Revised Statutes, 12-30-102, amend19
(3)(a)(XI) as follows:20
12-30-102.  Medical transparency act of 2010 - disclosure of21
information about health-care providers - fines - rules - short title -22
legislative declaration - review of functions - repeal. (3) (a)  As used23
in this section, "applicant" means a person applying for a new, active24
license, certification, or registration or to renew, reinstate, or reactivate25
an active license, certification, or registration to practice:26
(XI)  Practical nursing, professional nursing, or
 advanced practice27
SB23-167
-41- registered nursing, OR AS A CERTIFIED MIDWIFE pursuant to article 255 of1
this title 12;2
SECTION 26. In Colorado Revised Statutes, 12-30-105, amend3
(1) introductory portion, (1)(b), (4), (5)(i), and (5)(j) as follows:4
12-30-105.  Nurse-physician advisory task force for Colorado5
health care - creation - duties - definition - repeal. (1)  There is hereby6
created, within the division, the nurse-physician advisory task force for7
Colorado health care, referred to in this section as "NPATCH". The8
purpose of the NPATCH is to promote public safety and improve health9
care in Colorado by supporting collaboration and communication between10
the practices PRACTICE of nursing, THE PRACTICE AS A CERTIFIED11
MIDWIFE, and THE PRACTICE OF medicine. The NPATCH shall:12
(b)  Address issues of mutual concern at the interface of the13
practices PRACTICE of nursing, THE PRACTICE AS A CERTIFIED MIDWIFE,14
and 
THE PRACTICE OF medicine;15
(4)  The division shall staff the NPATCH. The division's costs for16
administering and staffing the NPATCH shall be funded by an increase17
in fees for professional and advanced practice registered nursing,18
CERTIFIED MIDWIFE, and medical license renewal fees, as authorized in19
sections 12-240-130 and 12-255-107 (1)(b)(I), with fifty percent of the20
funding derived from the physician license renewal fees and fifty percent21
derived from the professional and advanced practice registered nursing22
AND CERTIFIED MIDWIFE LICENSE RENEWAL fees.23
(5)  The NPATCH shall prioritize consideration of and make24
recommendations on the following topics:25
(i)  Physician standards, process
 PROCESSES, and metrics to ensure26
appropriate consultation, collaboration, and referral regarding advanced27
SB23-167
-42- practice registered nurse AND CERTIFIED MIDWIFE prescriptive authority;1
(j)  Prescribing issues regarding providers other than physicians,2
and advanced practice registered nurses, AND CERTIFIED MIDWIVES;3
SECTION 27. In Colorado Revised Statutes, 12-30-106, amend4
(1) as follows:5
12-30-106.  Health-care work force data collection. (1)  The6
director of the division shall implement a system to collect health-care7
work force data from health-care professionals who are eligible for the8
Colorado health service corps pursuant to part 5 of article 1.5 of title 25,9
from practical and professional nurses 
AND CERTIFIED MIDWIVES licensed10
pursuant to part 1 of article 255 of this title 12, and from pharmacists11
licensed pursuant to article 280 of this title 12, collectively referred to in12
this section as "health-care professionals". Each health-care professional13
shall submit the data as part of the initial licensure process and upon the14
renewal of the health-care professional's license. Neither an executive15
department nor a board in an executive department is responsible for16
verifying the data or disciplining a health-care professional for17
noncompliance with this section.18
SECTION 28. In Colorado Revised Statutes, 12-30-109, amend19
(4)(c) as follows:20
12-30-109.  Prescriptions - limitations - definition - rules.21
(4)  As used in this section, "prescriber" means:22
(c)  An advanced practice registered nurse 
OR CERTIFIED MIDWIFE23
with prescriptive authority pursuant to section 12-255-112;24
SECTION 29. In Colorado Revised Statutes, 12-30-110, amend25
(7)(h)(II) as follows:26
12-30-110.  Prescribing or dispensing opiate antagonists -27
SB23-167
-43- authorized recipients - definitions. (7)  As used in this section:1
(h)  "Prescriber" means:2
(II)  An advanced practice registered nurse, as defined in section3
12-255-104 (1), 
OR A CERTIFIED MIDWIFE, AS DEFINED IN SECTION4
12-255-104
 (3.2), with prescriptive authority pursuant to section5
12-255-112; or6
SECTION 30. In Colorado Revised Statutes, 12-30-111, amend7
(4)(a)(III) as follows:8
12-30-111.  Electronic prescribing of controlled substances -9
exceptions - rules - definitions. (4)  As used in this section:10
(a)  "Prescriber" means:11
(III)  An advanced practice registered nurse 
OR CERTIFIED MIDWIFE12
with prescriptive authority pursuant to section 12-255-112;13
SECTION 31. In Colorado Revised Statutes, 12-30-114, amend14
(2) as follows:15
12-30-114.  Demonstrated competency - opiate prescribers -16
rules - definition. (2)  For the purposes of this section, "licensed17
health-care provider" includes 
ANY OF THE FOLLOWING PROVIDERS WHO18
ARE LICENSED PURSUANT TO THIS TITLE 12:19
(a)  A physician;20
(b)  A physician assistant;21
(c)  A podiatrist;22
(d)  A dentist;23
(e)  A
N advanced practice registered nurse OR CERTIFIED MIDWIFE24
with prescriptive authority;25
(f)  A
N optometrist; and26
(g)  A veterinarian. licensed pursuant to this title 12.
27
SB23-167
-44- SECTION 32. In Colorado Revised Statutes, 12-30-201, amend1
(1) introductory portion, (2)(b), and (3) as follows:2
12-30-201.  Legislative declaration. (1)  The general assembly3
hereby finds, determines, and declares that the Colorado medical board4
created in article 240 of this title 12 and the state board of nursing created5
in article 255 of this title 12 act for the state in their sovereign capacity to6
govern licensure, discipline, and professional review of persons licensed7
to practice medicine, persons licensed as physician assistants, and8
advanced practice registered nurses, 
AND CERTIFIED MIDWIVES ,9
respectively, in this state. The general assembly further finds, determines,10
and declares that:11
(2)  The general assembly recognizes that:12
(b)  Many patients lack the knowledge, experience, or education13
to properly evaluate the quality of medical, or
 nursing, OR CERTIFIED14
MIDWIFE practice or the professional conduct of persons licensed to15
practice medicine, persons licensed as physician assistants, and advanced16
practice registered nurses, 
AND CERTIFIED MIDWIVES; and17
(3)  The general assembly recognizes that, in the proper exercise18
of their authority and responsibilities under this part 2, the Colorado19
medical board and the state board of nursing must, to some extent, replace20
competition with regulation, and that the replacement of competition by21
regulation, particularly with regard to persons licensed under article 24022
of this title 12, or
 to advanced practice registered nurses, OR TO CERTIFIED23
MIDWIVES, is related to a legitimate state interest in the protection of the24
health, safety, and welfare of the people of this state.25
SECTION 33. In Colorado Revised Statutes, 12-30-202, amend26
(7); and add (2.5) as follows:27
SB23-167
-45- 12-30-202.  Definitions. As used in this part 2, unless the context1
otherwise requires:2
(2.5)  "C
ERTIFIED MIDWIFE" HAS THE SAME MEANING AS SET FORTH3
IN SECTION 12-255-104 (3.2).4
(7)  "Professional review committee" means any committee5
authorized under this part 2 to review and evaluate the competence of,6
professional conduct of, or the quality and appropriateness of patient care7
provided by any person licensed under article 240 of this title 12, or
 an8
advanced practice registered nurse, 
OR A CERTIFIED MIDWIFE .9
"Professional review committee" includes a governing board, a hearing10
panel appointed by a governing board to conduct a hearing under section11
12-30-204 (8)(a), and an independent third party designated by a12
governing board under section 12-30-204 (9)(b).13
SECTION 34. In Colorado Revised Statutes, 12-30-203, amend14
(1)(a) and (2) as follows:15
12-30-203.  Use of professional review committees. (1) (a)  The16
general assembly recognizes that:17
(I)  The medical board and the nursing board, while assuming and18
retaining ultimate authority for licensure and discipline in accordance19
with article 240 of this title 12 and part 1 of article 255 of this title 12,20
respectively, and in accordance with this part 2, cannot practically and21
economically assume responsibility over every single allegation or22
instance of purported deviation from the standards of quality for the23
practice of medicine, or
 THE PRACTICE OF nursing, OR THE PRACTICE AS24
A CERTIFIED MIDWIFE; from the standards of professional conduct; or from25
the standards of appropriate care; and26
(II)  An attempt to exercise this oversight would result in27
SB23-167
-46- extraordinary delays in the determination of the legitimacy of the1
allegations and would result in the inappropriate and unequal exercise of2
their authority to license and discipline persons licensed under article 2403
of this title 12, or advanced practice registered nurses, OR CERTIFIED4
MIDWIVES.5
(2)  Persons licensed under article 240 of this title 12, and6
advanced practice registered nurses, 
AND CERTIFIED MIDWIVES are7
encouraged to serve upon professional review committees when called to8
do so and to study and review in an objectively reasonable manner the9
professional conduct of persons licensed under article 240 of this title 12,10
or
 advanced practice registered nurses, OR CERTIFIED MIDWIVES, including11
the competence of, professional conduct of, or the quality and12
appropriateness of patient care provided by those persons.13
SECTION 35. In Colorado Revised Statutes, 12-30-204, amend14
(1), (3), (5)(d), (5)(f), (5)(g), (5)(h), (5)(k), (5)(l), (5)(n), (7)(a), (8)15
introductory portion, (8)(a)(I), (9)(a), (11)(b)(II), and (11)(b)(VII); and16
add (5)(d.5) as follows:17
12-30-204.  Establishment of professional review committees18
- function - rules. (1)  A professional review committee may be19
established pursuant to this section to review and evaluate the competence20
of, the quality and appropriateness of patient care provided by, or the21
professional conduct of any person licensed under article 240 of this title22
12, or any advanced practice registered nurse, OR ANY CERTIFIED23
MIDWIFE.24
(3) (a)  A professional review committee that is reviewing the25
competence of, the quality and appropriateness of patient care provided26
by, or the professional conduct of an advanced practice registered nurse27
SB23-167
-47- must either:1
(a) (I)  Have, as a voting member, at least one advanced practice2
registered nurse with a scope of practice similar to that of the person who3
is the subject of the review; or4
(b) (II)  Engage, to perform an independent review as appropriate,5
an independent person who is an advanced practice registered nurse with6
a scope of practice similar to that of the person who is the subject of the7
review. The person conducting the independent review must be a person8
who was not previously involved in the review.9
(b)  A
 PROFESSIONAL REVIEW COMMITTEE THAT IS REVIEWING THE10
COMPETENCE OF, THE QUALITY AND APPROPRIATENESS OF PATIENT CARE11
PROVIDED BY, OR THE PROFESSIONAL CONDUCT OF A CERTIFIED MIDWIFE12
MUST EITHER:13
(I)  H
AVE, AS A VOTING MEMBER , AT LEAST ONE CERTIFIED14
MIDWIFE WITH A SCOPE OF PRACTICE SIMILAR TO THAT OF THE PERSON15
WHO IS THE SUBJECT OF THE REVIEW; OR16
(II)  E
NGAGE, TO PERFORM AN INDEPENDENT REVIEW AS17
APPROPRIATE, AN INDEPENDENT PERSON WHO IS A CERTIFIED MIDWIFE18
WITH A SCOPE OF PRACTICE SIMILAR TO THAT OF THE PERSON WHO IS THE19
SUBJECT OF THE REVIEW. THE PERSON CONDUCTING THE INDEPENDENT20
REVIEW MUST BE A PERSON WHO WAS NOT PREVIOUSLY INVOLVED IN THE21
REVIEW.22
(5)  A professional review committee established by any of the23
following authorized entities is an approved professional review24
committee under this part 2 if it operates in compliance with written25
bylaws, policies, or procedures that are in compliance with this part 2 and26
that have been approved by the authorized entity's governing board and27
SB23-167
-48- if it is registered with the division in accordance with section 12-30-206:1
(d)  A society or association of advanced practice registered nurses2
who WHOSE MEMBERS reside in this state, if the advanced practice3
registered nurse whose services are the subject of the review is a member4
of the society or association;5
(d.5)  A
 SOCIETY OR ASSOCIATION OF CERTIFIED MIDWIVES WHOSE6
MEMBERS RESIDE IN THIS STATE , IF THE CERTIFIED MIDWIFE WHOSE7
SERVICES ARE THE SUBJECT OF THE REVIEW IS A MEMBER OF THE SOCIETY8
OR ASSOCIATION;9
(f)  A society or association of advanced practice registered nurses10
who
 OR CERTIFIED MIDWIVES WHOSE MEMBERS practice in a specified11
nursing 
OR MIDWIFERY role and population focus, as defined by the12
nursing board, which society or association has been designated by the13
nursing board as the specific nursing 
OR MIDWIFERY society or association14
representative of those advanced practice registered nurses 
OR CERTIFIED15
MIDWIVES practicing in that nursing OR MIDWIFERY role and population16
focus, if the advanced practice registered nurse 
OR CERTIFIED MIDWIFE17
whose services are the subject of the review is a member of the18
designated nursing 
OR MIDWIFERY society or association;19
(g)  An individual practice association or a preferred provider20
organization consisting of persons licensed under article 240 of this title21
12, or
 of advanced practice registered nurses, OR OF CERTIFIED MIDWIVES22
or a medical group that predominantly serves members of a health23
maintenance organization licensed pursuant to parts 1 and 4 of article 1624
of title 10. A professional review committee established pursuant to this25
subsection (5)(g) has jurisdiction to review persons licensed under article26
240 of this title 12, or advanced practice registered nurses, OR CERTIFIED27
SB23-167
-49- MIDWIVES only if the persons licensed under said article, or the advanced1
practice registered nurses, 
OR THE CERTIFIED MIDWIVES are members of2
the association or organization creating and authorizing that committee;3
except that the professional review committee may review the care4
provided to a particular patient referred by a member of the association5
or organization to another person who is not a member of the association6
or organization and is licensed under article 240 of this title 12, or
 is an7
advanced practice registered nurse, 
OR IS A CERTIFIED MIDWIFE.8
(h)  A corporation authorized pursuant to article 3 of title 10 to9
insure persons licensed under article 240 of this title 12, or
 advanced10
practice registered nurses, 
OR CERTIFIED MIDWIVES or any other11
organization authorized to insure such persons in this state when12
designated by the medical board or nursing board under subsection (6) of13
this section;14
(k) (I)  A nonprofit corporation or association consisting of15
representatives from a statewide professional society and a statewide16
hospital association. The association must consist of persons licensed17
under article 240 of this title 12, or
 advanced practice registered nurses,18
OR CERTIFIED MIDWIVES, AS APPLICABLE, AND hospital administrators and19
hospital trustees, with a majority of the representatives being persons20
licensed under article 240 of this title 12 SUBJECT TO THE FOLLOWING21
REQUIREMENTS:22
(A)  When the subject of the investigation is a person licensed23
under article 240 of this title 12, and A MAJORITY OF THE24
REPRESENTATIVES MUST BE PERSONS LICENSED UNDER ARTICLE 240 OF25
THIS TITLE 12;26
(B)  W
HEN THE SUBJECT OF THE INVESTIGATION IS AN ADVANCED27
SB23-167
-50- PRACTICE REGISTERED NURSE, at least one of the representatives being1
MUST BE an advanced practice registered nurse; when the subject of the2
investigation is an advanced practice registered nurse. AND3
(C)  W
HEN THE SUBJECT OF THE INVESTIGATION IS A CERTIFIED4
MIDWIFE, AT LEAST ONE OF THE REPRESENTATIVES MUST BE A CERTIFIED5
MIDWIFE.6
(II)  The association may establish, or contract for, one or more7
professional review committees to review the care by hospital staff8
personnel who are licensed under article 240 of this title 12, or
 are9
advanced practice registered nurses, 
OR ARE CERTIFIED MIDWIVES, with10
priority given to small rural hospital staffs. These professional review11
services must be available statewide on a fee-for-service basis to licensed12
or certified hospitals at the joint request of the governing board and the13
medical, or
 nursing, OR CERTIFIED MIDWIFE staff of the hospital or at the14
sole request of the governing board of the hospital. If a member being15
reviewed specializes in a generally recognized specialty of medicine, or16
nursing, 
OR MIDWIFERY, at least one of the health-care providers on the17
professional review committee must be a person who is licensed under18
article 240 of this title 12, or
 is an advanced practice registered nurse, OR19
IS A CERTIFIED MIDWIFE and who practices such specialty. 20
(II) (III)  For purposes of the introductory portion to this21
subsection (5) and this subsection (5)(k), the bylaws, policies, or22
procedures must be in compliance with this part 2 and approved by the23
nonprofit corporation or association.24
(l)  The medical, or nursing, OR CERTIFIED MIDWIFE staff of an25
ambulatory surgical center licensed pursuant to part 1 of article 3 of title26
25;27
SB23-167
-51- (n)  A provider network that is organized pursuant to part 3 of1
article 18 of title 6 and includes persons licensed under article 240 of this2
title 12, or advanced practice registered nurses, OR CERTIFIED MIDWIVES;3
(7) (a)  A professional review committee acting pursuant to this4
part 2 may investigate or cause to be investigated:5
(I)  The qualifications and competence of any person licensed6
under article 240 of this title 12, or any advanced practice registered7
nurse, 
OR ANY CERTIFIED MIDWIFE who seeks to subject himself or herself
8
THEMSELVES to the authority of any authorized entity; or9
(II)  The quality or appropriateness of patient care rendered by, or10
the professional conduct of, any person licensed under article 240 of this11
title 12, or any advanced practice registered nurse, OR ANY CERTIFIED12
MIDWIFE who is subject to the authority of the authorized entity.13
(8)  The written bylaws, policies, or procedures of any professional14
review committee for persons licensed under article 240 of this title 12,15
or advanced practice registered nurses, OR CERTIFIED MIDWIVES must16
provide for at least the following:17
(a) (I)  Except as provided in subsection (8)(a)(II) of this section,18
if the findings of any investigation indicate that a person licensed under19
article 240 of this title 12, or an advanced practice registered nurse, OR A20
CERTIFIED MIDWIFE who is the subject of the investigation is lacking in21
qualifications or competency, has provided substandard or inappropriate22
patient care, or has exhibited inappropriate professional conduct and the23
professional review committee takes or recommends an action to24
adversely affect the person's membership, affiliation, or privileges with25
the authorized entity, the professional review committee shall hold a26
hearing to consider the findings and recommendations unless the person27
SB23-167
-52- waives, in writing, the right to a hearing or is given notice of a hearing1
and fails to appear.2
(9) (a)  All governing boards shall adopt written bylaws, policies,3
or procedures under which a person who is licensed under article 240 of4
this title 12, or is an advanced practice registered nurse, OR IS A CERTIFIED5
MIDWIFE and who is the subject of an adverse recommendation by a6
professional review committee may appeal to the governing board7
following a hearing in accordance with subsection (8) of this section. The8
bylaws, policies, or procedures must provide that the person be given9
reasonable notice of his or her THE PERSON'S right to appeal and, unless10
waived by the person, has the right to appear before the governing board,11
to be represented by legal counsel, and to offer the argument on the12
record that the person deems appropriate.13
(11) (b)  Subject to subsection (14) of this section, the records are14
subject to subpoena and available for use:15
(II)  By a person licensed under article 240 of this title 12, or an16
advanced practice registered nurse, 
OR A CERTIFIED MIDWIFE in a suit17
seeking judicial review of an action by the governing board;18
(VII)  By the nursing board within the scope of its authority over19
advanced practice registered nurses 
AND CERTIFIED MIDWIVES.20
SECTION 36. In Colorado Revised Statutes, 12-30-205, amend21
(1) as follows:22
12-30-205.  Hospital professional review committees. (1)  The23
quality and appropriateness of patient care rendered by persons licensed24
under article 240 of this title 12, advanced practice registered nurses,25
CERTIFIED MIDWIVES, and other licensed health-care professionals so26
influence the total quality of patient care that a review of care provided27
SB23-167
-53- in a hospital is ineffective without concomitantly reviewing the overall1
competence of, professional conduct of, or the quality and2
appropriateness of care rendered by these persons.3
SECTION 37. In Colorado Revised Statutes, 12-30-206, amend4
(1), (2) introductory portion, (2)(b)(II) introductory portion, and (3)(a) as5
follows:6
12-30-206.  Governing boards to register with division - annual7
reports - aggregation and publication of data - definition - rules.8
(1)  As used in this section, "adversely affecting" has the same meaning9
as set forth in 45 CFR 60.3; except that it does not include a10
precautionary suspension or any professional review action affecting, for11
a period of thirty or fewer days, a person licensed under article 240 of this12
title 12, or an advanced practice registered nurse, OR A CERTIFIED13
MIDWIFE.14
(2)  Each governing board that establishes or uses one or more15
professional review committees to review the practice of persons licensed16
under article 240 of this title 12, or of advanced practice registered17
nurses, 
OR OF CERTIFIED MIDWIVES shall:18
(b)  In addition to any other state or federal reporting requirements:19
(II)  Report annually to the nursing board, in a form satisfactory to20
the nursing board, the number of final professional review actions in each21
of the following categories relating to advanced practice registered nurses22
AND CERTIFIED MIDWIVES:23
(3) (a)  The division shall publish the data provided pursuant to24
subsections (2)(b) and (2)(c) of this section in aggregate form and without25
individually identifiable information concerning the governing board, the26
authorized entity, or any person who was subject to review and is licensed27
SB23-167
-54- under article 240 of this title 12, or is an advanced practice registered1
nurse, 
OR IS A CERTIFIED MIDWIFE.2
SECTION 38. In Colorado Revised Statutes, 12-30-207, amend3
(1), (2) introductory portion, and (2)(d) as follows:4
12-30-207.  Immunity from liability. (1)  A member of a5
professional review committee, a governing board, or any committee or6
third party designated by the governing board under section 12-30-2047
(9)(b); and
 any person serving on the staff of that committee, board,8
panel, or third party; a witness or consultant before a professional review9
committee; and any person who files a complaint or otherwise10
participates in the professional review process is immune from suit and11
liability for damages in any civil or criminal action, including antitrust12
actions, brought by a person licensed under article 240 of this title 12, or13
an advanced practice registered nurse, 
OR A CERTIFIED MIDWIFE who is the14
subject of the review by the professional review committee unless, in15
connection with the professional review process, the person provided16
false information and knew that the information was false.17
(2)  The governing board and the authorized entity that has18
established a professional review committee pursuant to section19
12-30-204 is immune from suit and liability for damages in any civil or20
criminal action, including antitrust actions, brought by a person licensed21
under article 240 of this title 12, or
 an advanced practice registered nurse,22
OR A CERTIFIED MIDWIFE who is the subject of the review by such23
professional review committee if the professional review action was taken24
within the scope of the professional review process and was taken:25
(d)  In accordance with procedures that, under the circumstances,26
were fair to the person licensed under article 240 of this title 12, or the27
SB23-167
-55- advanced practice registered nurse, OR THE CERTIFIED MIDWIFE.1
SECTION 39. In Colorado Revised Statutes, 12-30-208, amend2
(3)(b)(I), (3)(c) introductory portion, and (3)(c)(V) as follows:3
12-30-208.  Conformance with federal law and regulation -4
legislative declaration - rules - limitations on liability - definition.5
(3) (b) (I)  Notwithstanding subsection (3)(a) of this section, nothing in6
this section relieves an authorized entity that is a health-care facility7
licensed or certified pursuant to part 1 of article 3 of title 25 or certified8
pursuant to section 25-1.5-103 (1)(a)(II) of liability to an injured person9
or wrongful death claimant for the facility's independent negligence in the10
credentialing or privileging process for a person licensed under article11
240 of this title 12, or an advanced practice registered nurse, OR A12
CERTIFIED MIDWIFE who provided health-care services for the injured or13
deceased person at the facility. For purposes of this subsection (3), the14
facility's participation in the credentialing process or the privileging15
process does not constitute the corporate practice of medicine.16
(c)  For the purposes of AS USED IN this subsection (3), unless the17
context otherwise requires, "professional review action" means an action18
or recommendation of a professional review committee that is taken or19
made in the conduct of professional review activity and that is based on20
the quality and appropriateness of patient care provided by, or the21
competence or professional conduct of, an individual person licensed22
under article 240 of this title 12, or an advanced practice registered nurse,23
OR A CERTIFIED MIDWIFE, which action affects or may affect adversely the24
person's clinical privileges of or membership in an authorized entity.25
"Professional review action" includes a formal decision by the26
professional review committee not to take an action or make a27
SB23-167
-56- recommendation as provided in this subsection (3)(c) and also includes1
professional review activities relating to a professional review action. An2
action is not based upon the competence or professional conduct of a3
person if the action is primarily based on:4
(V)  Any other matter that does not relate to the quality and5
appropriateness of patient care provided by, or the competence or6
professional conduct of, a person licensed under article 240 of this title7
12, or an advanced practice registered nurse, OR A CERTIFIED MIDWIFE.8
SECTION 40. In Colorado Revised Statutes, 12-225-101, amend9
(1)(b) and (2)(c) as follows:10
12-225-101.  Scope of article - exemptions - legislative11
declaration. (1) (b) (I)  A person who is a certified nurse-midwife12
authorized pursuant to section 12-255-111, 
A CERTIFIED MIDWIFE13
AUTHORIZED PURSUANT TO SECTION 12-255-111.5, or a physician as14
provided in article 240 of this title 12 shall not simultaneously be so15
licensed and also be registered under this article 225. A physician, or
16
certified nurse-midwife, 
OR CERTIFIED MIDWIFE who holds a license in17
good standing may relinquish the license and subsequently be registered18
under this article 225.19
(II)  A direct-entry midwife shall not represent himself or herself
20
ONESELF as a nurse-midwife, or certified nurse-midwife, OR CERTIFIED21
MIDWIFE.22
(III)  The fact that a direct-entry midwife may hold a practical or23
professional nursing 
OR CERTIFIED MIDWIFE license does not expand the24
scope of practice of the direct-entry midwife.25
(IV)  The fact that a practical or professional nurse 
OR CERTIFIED26
MIDWIFE may be registered as a direct-entry midwife does not expand the27
SB23-167
-57- scope of practice of the nurse OR CERTIFIED MIDWIFE.1
(2)  Nothing in this article 225 shall be construed to prohibit, or to2
require registration under this article 225, with regard to:3
(c)  The rendering of services by certified nurse-midwives 
OR4
CERTIFIED MIDWIVES properly licensed and practicing in accordance with5
the provisions of
 part 1 of article 255 of this title 12; or6
SECTION 41. In Colorado Revised Statutes, 12-225-106, amend7
(5)(a)(III)(C) and (5)(a)(III)(F) as follows:8
12-225-106.  Prohibited acts - practice standards - informed9
consent - emergency plan - risk assessment - referral - rules. (5) (a)  A10
direct-entry midwife shall keep appropriate records of midwifery-related11
activity, including but not limited to the following:12
(III)  Before accepting a client for care, the direct-entry midwife13
shall obtain the client's informed consent, which shall be evidenced by a14
written statement in a form prescribed by the director and signed by both15
the direct-entry midwife and the client. The form shall certify that full16
disclosure has been made and acknowledged by the client as to each of17
the following items, with the client's acknowledgment evidenced by a18
separate signature or initials adjacent to each item in addition to the19
client's signature at the end of the form:20
(C)  A description of the available alternatives to direct-entry21
midwifery care, including a statement that the client understands she THE22
CLIENT is not retaining a certified nurse midwife, or a nurse midwife, OR23
A CERTIFIED MIDWIFE;24
(F)  A statement informing the client that, if subsequent care is25
required resulting from the acts or omissions of the direct-entry midwife,26
any physician, nurse, 
CERTIFIED MIDWIFE, prehospital emergency27
SB23-167
-58- personnel, and health-care institution rendering subsequent care shall1
WILL be held only to a standard of gross negligence or willful and wanton2
conduct;3
SECTION 42. In Colorado Revised Statutes, 12-225-112, amend4
(1) as follows:5
12-225-112.  Assumption of risk - no vicarious liability -6
professional liability insurance required. (1)  It is the policy of this7
state that registrants shall be ARE liable for their acts or omissions in the8
performance of the services that they provide, and that no licensed9
physician, nurse, 
CERTIFIED MIDWIFE, prehospital emergency medical10
personnel, or health-care institution shall be
 IS liable for any act or11
omission resulting from the administration of services by any registrant.12
This subsection (1) does not relieve any physician, nurse, 
CERTIFIED13
MIDWIFE, prehospital emergency personnel, or health-care institution from14
liability for any willful and wanton act or omission or any act or omission15
constituting gross negligence, or under circumstances where a registrant16
has a business or supervised relationship with the physician, nurse,17
CERTIFIED MIDWIFE, prehospital emergency personnel, or health-care18
institution. A physician, nurse, 
CERTIFIED MIDWIFE, prehospital19
emergency personnel, or health-care institution may provide consultation20
or education to the registrant without establishing a business or21
supervisory relationship, and is encouraged to accept referrals from22
registrants pursuant to this article 225.23
SECTION 43. In Colorado Revised Statutes, 12-240-107, amend24
(1) introductory portion, (1)(f)(I), (3)(j), and (3)(s) as follows:25
12-240-107.  Practice of medicine defined - exemptions from26
licensing requirements - unauthorized practice by physician27
SB23-167
-59- assistants and anesthesiologist assistants - penalties - definitions -1
rules - repeal. (1)  For the purpose of AS USED IN this article 240,2
"practice of medicine" means:3
(f)  The practice of midwifery, except:4
(I)  Services rendered by certified nurse-midwives 
OR CERTIFIED5
MIDWIVES properly licensed and practicing in accordance with the
6
provisions of part 1 of article 255 of this title 12; or7
(3)  A person may engage in, and shall not be required to obtain a8
license or a physician training license under this article 240 with respect9
to, any of the following acts:10
(j)  The rendering of nursing 
OR MIDWIFERY services and delegated11
medical functions by registered or other nurses 
OR CERTIFIED MIDWIVES12
in the lawful discharge of their duties;13
(s) (I)  The rendering of prescriptions by an advanced practice14
registered nurse 
OR CERTIFIED MIDWIFE pursuant to section 12-255-112.15
(II)  On or after July 1, 2010, a physician who serves as a preceptor16
or mentor to an advanced practice registered nurse 
OR CERTIFIED MIDWIFE17
pursuant to sections 12-240-108 and 12-255-112 (4) shall have a license18
in good standing without disciplinary sanctions to practice medicine in19
Colorado and an unrestricted registration by the federal drug enforcement20
administration for the same schedules as the collaborating advanced21
practice registered nurse 
OR CERTIFIED MIDWIFE.22
(III)  It is unlawful and a violation of this article 240 for any23
person, corporation, or other entity to require payment or employment as24
a condition of entering into a mentorship relationship with the
 AN25
advanced practice registered nurse 
OR A CERTIFIED MIDWIFE pursuant to26
sections 12-240-108 and 12-255-112 (4), but the mentor may request27
SB23-167
-60- reimbursement of reasonable expenses and time spent as a result of the1
mentorship relationship.2
SECTION 44. In Colorado Revised Statutes, 12-240-108, amend3
(1) as follows:4
12-240-108.  Collaboration with advanced practice registered5
nurses and certified midwives with prescriptive authority -6
mentorships. (1) (a)  A physician licensed pursuant to this article 2407
may, and is encouraged to, serve as a mentor to an advanced practice8
registered nurse 
OR A CERTIFIED MIDWIFE who is applying for prescriptive9
authority pursuant to section 12-255-112 (4). A physician who serves as10
a mentor to an advanced practice registered nurse 
OR A CERTIFIED11
MIDWIFE seeking prescriptive authority shall:12
(I)  Be practicing in Colorado and shall have education, training,13
experience, and active practice that corresponds with the role and14
population focus of the advanced practice registered nurse 
OR CERTIFIED15
MIDWIFE; and16
(II)  Have a license in good standing without disciplinary sanctions17
to practice medicine in Colorado and an unrestricted registration by the18
federal drug enforcement administration for the same schedules as the19
advanced practice registered nurse 
OR CERTIFIED MIDWIFE.20
(b)  A physician serving as a mentor to an advanced practice21
registered nurse 
OR A CERTIFIED MIDWIFE pursuant to section 12-255-11222
(4) shall not require payment or employment as a condition of entering23
into the mentorship relationship, but the physician may request24
reimbursement of reasonable expenses and time spent as a result of the25
mentorship relationship.26
(c)  Upon successful completion of a mentorship as described in27
SB23-167
-61- section 12-255-112 (4)(b)(I), the physician shall verify by his or her THE1
PHYSICIAN'S signature that the advanced practice registered nurse OR2
CERTIFIED MIDWIFE has successfully completed the mentorship within the3
required period.4
SECTION 45. In Colorado Revised Statutes, 12-240-121, amend5
(1)(bb) as follows:6
12-240-121.  Unprofessional conduct - definitions.7
(1)  "Unprofessional conduct" as used in this article 240 means:8
(bb)  Entering into or continuing in a mentorship relationship with9
an advanced practice registered nurse 
OR A CERTIFIED MIDWIFE pursuant10
to sections 12-240-108 and 12-255-112 (4) that fails to meet generally11
acceptable standards of medical practice;12
SECTION 46. In Colorado Revised Statutes, 12-240-139, amend13
(1)(b)(I) introductory portion, (1)(b)(I)(B), (1)(b)(I)(C), (1)(b)(II)(B),14
(1)(b)(III), and (1)(b)(V) introductory portion as follows:15
12-240-139.  Injuries to be reported - penalty for failure to16
report - immunity from liability - definitions. (1) (b) (I)  When a17
licensee, or
 nurse, OR CERTIFIED MIDWIFE performs a medical forensic18
examination that includes the collection of evidence at the request of a19
victim of sexual assault, the licensee's, or nurse's, OR CERTIFIED MIDWIFE'S20
employing medical facility shall, with the consent of the victim of the21
sexual assault, make one of the following reports to law enforcement:22
(B)  A medical report if a victim wishes to obtain a medical23
forensic examination with evidence collection but at the time of the24
medical forensic examination chooses not to participate in the criminal25
justice system. The licensee, or nurse, OR CERTIFIED MIDWIFE shall collect26
the evidence and victim-identifying information, and the employing27
SB23-167
-62- medical facility shall release the evidence and information to law1
enforcement for testing in accordance with section 24-33.5-113 (1)(b)(III)2
and storage in accordance with section 18-3-407.5 (3)(c).3
(C)  An anonymous report if a victim wishes to obtain a medical4
forensic examination with evidence collection but at the time of the5
medical forensic examination chooses not to have personal identifying6
information provided to law enforcement or to participate in the criminal7
justice system. The licensee, or nurse, OR CERTIFIED MIDWIFE shall collect8
the evidence, and the employing medical facility shall release it to law9
enforcement for storage in accordance with section 18-3-407.5 (3)(c).10
Law enforcement shall receive no identifying information for the victim.11
Law enforcement shall assign a unique identifying number to the12
evidence, and the licensee, or nurse, OR CERTIFIED MIDWIFE shall record13
the identifying number in the medical record and notify the victim that the14
identifying number is recorded. Additionally, the licensee, or nurse, OR15
CERTIFIED MIDWIFE shall provide the identifying number to the victim.16
(II)  Nothing in this section:17
(B)  Requires a licensee, nurse, 
CERTIFIED MIDWIFE, or medical18
facility to make a report to law enforcement concerning an alleged sexual19
assault if medical forensic evidence is not collected.20
(III)  If the licensee's, 
NURSE'S, OR CERTIFIED MIDWIFE'S employing21
medical facility knows where the alleged sexual assault occurred, the22
facility shall make the report with the law enforcement agency in whose23
jurisdiction the crime occurred regarding preservation of the evidence. If24
the medical facility does not know where the alleged sexual assault25
occurred, the facility shall make the report with its local law enforcement26
agency regarding preservation of the evidence.27
SB23-167
-63- (V)  A licensee, or nurse, OR CERTIFIED MIDWIFE who performs a1
medical forensic examination as described in subsection (1)(b)(I) of this2
section shall inform the victim:3
SECTION 47. In Colorado Revised Statutes, 12-245-220, amend4
(2)(b) as follows:5
12-245-220.  Disclosure of confidential communications -6
definitions. (2)  Subsection (1) of this section does not apply and a person7
may disclose confidential information when:8
(b)  A licensee, registrant, or certificate holder was in consultation9
with a physician, registered professional nurse, 
CERTIFIED MIDWIFE,10
licensee, registrant, or certificate holder against whom a suit or complaint11
was filed based on the case out of which the suit or complaint arises;12
SECTION 48. In Colorado Revised Statutes, 12-250-106, amend13
(7) as follows:14
12-250-106.  Practice of naturopathic medicine by15
naturopathic doctors - exclusions - protected activities - definition -16
rules. (7)  As used in this section, "licensed pediatric health-care17
provider" means a licensed physician, or
 AN advanced practice registered18
nurse, 
OR A CERTIFIED MIDWIFE who treats children.19
SECTION 49. In Colorado Revised Statutes, 12-280-123, amend20
(1)(b) as follows:21
12-280-123.  Prescription required - exception - dispensing22
opiate antagonists - selling nonprescription syringes and needles.23
(1) (b)  A pharmacist who receives an order for a controlled substance24
that is included in schedule II, III, or IV from a podiatrist, dentist,25
physician, physician assistant, advanced practice registered nurse,26
CERTIFIED MIDWIFE, or optometrist, which order is not transmitted27
SB23-167
-64- electronically to the pharmacist, is not required to verify the applicability1
of an exception to electronic prescribing of controlled substances under2
section 12-30-111 and may dispense the controlled substance pursuant to3
a written, oral, or facsimile-transmitted order that is otherwise valid and4
consistent with the requirements of current law.5
SECTION 50. In Colorado Revised Statutes, 12-280-125.7,6
amend (1)(f)(II) as follows:7
12-280-125.7.  Pharmacists' authority to prescribe and8
dispense HIV infection prevention drugs - definitions - rules. (1)  As9
used in this section:10
(f)  "Prescriber" means:11
(II)  An advanced practice registered nurse, as defined in section12
12-255-104 (1), 
OR A CERTIFIED MIDWIFE, AS DEFINED IN SECTION13
12-255-104
 (3.2), with prescriptive authority pursuant to section14
12-255-112.15
SECTION 51. In Colorado Revised Statutes, 12-300-104, amend16
(3)(c), (3)(d)(II), and (3)(e) as follows:17
12-300-104.  Definitions. As used in this article 300, unless the18
context otherwise requires:19
(3)  "Respiratory therapy" means providing therapy, management,20
rehabilitation, support services for diagnostic evaluation, and care of21
patients with deficiencies and abnormalities that affect the pulmonary22
system under the overall direction of a medical director. Respiratory23
therapy includes the following:24
(c)  Direct and indirect respiratory care services, including but not
25
limited to the administration of pharmacological, diagnostic, and26
therapeutic agents related to respiratory care procedures necessary to27
SB23-167
-65- implement a treatment, disease prevention, and pulmonary rehabilitative1
or diagnostic regimen prescribed by a physician, or AN advanced practice2
registered nurse, 
OR A CERTIFIED MIDWIFE;3
(d)  Observation and monitoring of signs, symptoms, reactions,4
general behavior, and general physical response to respiratory care5
treatment and diagnostic testing for:6
(II)  The implementation based on observed abnormalities of7
appropriate reporting, referral, or respiratory care protocols or changes in8
treatment regimen pursuant to a prescription by a physician, or
 AN9
advanced practice registered nurse, 
OR A CERTIFIED MIDWIFE or the10
initiation of emergency procedures;11
(e)  The diagnostic and therapeutic use of the following in12
accordance with the prescription of a physician, or
 AN advanced practice13
registered nurse, 
OR A CERTIFIED MIDWIFE: Administration of medical14
gases, exclusive of general anesthesia; aerosols; humidification;15
environmental control systems and biomedical therapy; pharmacologic16
agents related to respiratory care procedures; mechanical or physiological17
ventilatory support; bronchopulmonary hygiene; respiratory protocol and18
evaluation; cardiopulmonary resuscitation; maintenance of the natural19
airways; insertion and maintenance of artificial airways; diagnostic and20
testing techniques required for implementation of respiratory care21
protocols; collection of specimens from the respiratory tract; or analysis22
of blood gases and respiratory secretions and participation in23
cardiopulmonary research; and24
SECTION 52. In Colorado Revised Statutes, 10-16-139, amend25
(1) as follows:26
10-16-139.  Access to care - rules - definitions. (1)  Access to27
SB23-167
-66- obstetricians and gynecologists. A health benefit plan that is delivered,1
issued, renewed, or reinstated in this state on or after January 1, 2014, that2
provides coverage for reproductive health or gynecological care shall not3
be delivered, issued, renewed, or reinstated unless the plan provides a4
woman covered by the plan direct access to an obstetrician, a5
gynecologist, a physician assistant authorized under section 12-240-1076
(6), or an advanced practice registered nurse who is a certified nurse7
midwife pursuant to section 12-255-111, 
OR A CERTIFIED MIDWIFE8
LICENSED PURSUANT TO SECTION 12-255-111.5, participating and9
available under the plan for her reproductive health care or gynecological10
care.11
SECTION 53. In Colorado Revised Statutes, 13-21-108.7,12
amend (2)(b)(I)(A) as follows:13
13-21-108.7.  Persons rendering emergency assistance through14
the administration of an opiate antagonist - limited immunity -15
legislative declaration - definitions. (2)  Definitions. As used in this16
section, unless the context otherwise requires:17
(b) (I)  "Health-care provider" means:18
(A)  A licensed physician, 
AN advanced practice registered nurse,19
OR A CERTIFIED MIDWIFE who has prescriptive authority pursuant to20
section 12-255-112; 
A physician assistant; or A pharmacist; or21
SECTION 54. In Colorado Revised Statutes, 13-21-115.5, add22
(3)(c)(II)(E.5) as follows:23
13-21-115.5.  Volunteer service act - immunity - exception for24
operation of motor vehicles - short title - legislative declaration -25
definitions. (3)  As used in this section, unless the context otherwise26
requires:27
SB23-167
-67- (c) (II)  "Volunteer" includes:1
(E.5)  A
 CERTIFIED MIDWIFE GOVERNED BY THE "NURSE AND2
N
URSE AIDE PRACTICE ACT", ARTICLE 255 OF TITLE 12, PERFORMING3
CERTIFIED MIDWIFE TASKS WITHIN THE SCOPE OF THE PERSON 'S CERTIFIED4
MIDWIFE LICENSE AND PERFORMING PRACTICE AS A CERTIFIED MIDWIFE5
UNDER AUTHORITY GRANTED BY THE STATE BOARD OF NURSING PURSUANT6
TO SECTIONS 12-255-111.5 AND 12-255-112 AS A VOLUNTEER FOR A7
NONPROFIT ORGANIZATION , A NONPROFIT CORPORATION , A8
GOVERNMENTAL ENTITY , OR A HOSPITAL;9
SECTION 55. In Colorado Revised Statutes, 25-1-802, amend10
(1)(a) and (1)(b)(II) as follows:11
25-1-802.  Patient records in custody of individual health-care12
providers. (1) (a)  Every patient record in the custody of a podiatrist,13
chiropractor, dentist, doctor of medicine, doctor of osteopathy, nurse,14
CERTIFIED MIDWIFE, optometrist, occupational therapist, audiologist,15
acupuncturist, direct-entry midwife, or physical therapist required to be16
licensed under title 12; a naturopathic doctor required to be registered17
pursuant to article 250 of title 12; or a person practicing psychotherapy18
under article 245 of title 12, except records withheld in accordance with19
45 CFR 164.524 (a), must be available to the patient or the patient's20
personal representative upon submission of a valid authorization for21
inspection of records, dated and signed by the patient, at reasonable times22
and upon reasonable notice. A summary of records pertaining to a23
patient's mental health problems may, upon written request accompanied24
by a signed and dated authorization, be made available to the patient or25
the patient's personal representative following termination of the26
treatment program.27
SB23-167
-68- (b) (II)  If a licensed health-care professional determines that a1
copy of a radiographic study, including an X ray, mammogram, CT scan,2
MRI, or other film, is not sufficient for diagnostic or other treatment3
purposes, the podiatrist, chiropractor, dentist, doctor of medicine, doctor4
of osteopathy, nurse, 
CERTIFIED MIDWIFE, optometrist, audiologist,5
acupuncturist, direct-entry midwife, or physical therapist required to be6
licensed under title 12, or, subject to the provisions of section 25-1-8017
(1)(a) and subsection (1)(a) of this section, the person practicing8
psychotherapy under article 245 of title 12, shall make the original of any9
radiographic study available to the patient, the patient's personal10
representative, a person authorized by the patient, or another health-care11
professional or facility as specifically directed by the patient, personal12
representative, authorized person, or health-care professional or facility13
pursuant to a HIPAA-compliant authorization and upon the payment of14
the reasonable fees for the radiographic study. If a practitioner releases an15
original radiographic study pursuant to this subsection (1)(b)(II), the16
practitioner is not responsible for any loss, damage, or other17
consequences as a result of the release. Any original radiographic study18
made available pursuant to this subsection (1)(b)(II) must be returned19
upon request to the lending practitioner within thirty days.20
SECTION 56. In Colorado Revised Statutes, 25-1-1202, amend21
(1)(n) and (1)(q) as follows:22
25-1-1202.  Index of statutory sections regarding medical23
record confidentiality and health information. (1)  Statutory provisions24
concerning policies, procedures, and references to the release, sharing,25
and use of medical records and health information include the following:26
(n)  Section 12-30-204, concerning professional review27
SB23-167
-69- committees for physicians HEALTH-CARE PROVIDERS SPECIFIED IN PART 21
OF ARTICLE 30 OF TITLE 12;2
(q)  Section 12-255-119, concerning disciplinary proceedings3
against a practical nurse, a professional nurse, 
A CERTIFIED MIDWIFE, or4
a psychiatric technician;5
SECTION 57. In Colorado Revised Statutes, 25-3.5-207, amend6
(1)(e) as follows:7
25-3.5-207.  Ability of certified or licensed emergency medical8
service providers to work in clinical settings - restrictions -9
definitions - rules. (1)  As used in this section, unless the context10
otherwise requires:11
(e)  "Medical supervisor" means a Colorado-licensed physician,12
physician assistant, advanced practice registered nurse, or
 registered13
nurse, 
OR CERTIFIED MIDWIFE.14
SECTION 58. In Colorado Revised Statutes, 25-4-1709, amend15
(5) as follows:16
25-4-1709.  Limitations on liability. (5)  A practitioner licensed17
to practice medicine pursuant to article 240 of title 12 or 
LICENSED TO18
PRACTICE nursing OR AS A CERTIFIED MIDWIFE pursuant to part 1 of article19
255 of title 12 or the health-care clinic, hospital, office of a private20
practitioner, or county public health clinic at which the immunization was21
administered that relies on the health history and other information given22
by a person who has been delegated the authority to consent to the23
immunization of a minor pursuant to section 25-4-1704 (2.5) is not liable24
for damages related to an immunization resulting from factual errors in25
the health history or information given to the practitioner or the26
health-care clinic, hospital, office of a private practitioner, or county27
SB23-167
-70- public health clinic at which the immunization was administered by the1
person when such practitioner or health-care clinic, hospital, office of a2
private practitioner, or county public health clinic reasonably relies upon3
the health history information given and exercises reasonable and prudent4
care in administering the immunization.5
SECTION 59. In Colorado Revised Statutes, 25-4-2403, amend6
(8) as follows:7
25-4-2403.  Department of public health and environment -8
powers and duties - immunization tracking system - rules -9
definitions. (8)  A person licensed to practice medicine pursuant to article10
240 of title 12; a person licensed to practice nursing 
OR AS A CERTIFIED11
MIDWIFE pursuant to part 1 of article 255 of title 12; any other licensed12
health-care practitioner as defined in section 25-4-1703; providers of13
county nursing services; staff members of health-care clinics, hospitals,14
and offices of private practitioners; county, district, and municipal public15
health agencies; and all persons and entities listed in subsection (2) of this16
section are authorized to report to the immunization tracking system and17
to use the reminder and recall process established by the immunization18
tracking system.19
SECTION 60. In Colorado Revised Statutes, amend 25-6-203 as20
follows:21
25-6-203.  Extent of services. Family planning and birth control22
services shall include: Interview with trained personnel; distribution of23
literature; referral to a licensed physician, or
 AN advanced practice24
registered nurse, 
OR A CERTIFIED MIDWIFE for consultation, examination,25
tests, medical treatment, and prescription; and, to the extent so prescribed,26
the distribution of rhythm charts, drugs, medical preparations,27
SB23-167
-71- contraceptive devices, and similar products.1
SECTION 61. In Colorado Revised Statutes, 25-37-102, amend2
the introductory portion and (7) as follows:3
25-37-102.  Definitions. As used in this article ARTICLE 37, unless4
the context otherwise requires:5
(7)  "Health-care provider" means a person licensed or certified in6
this state to practice medicine, pharmacy, chiropractic, nursing, physical7
therapy, podiatry, dentistry, optometry, occupational therapy; 
TO8
PRACTICE AS A CERTIFIED MIDWIFE; or TO PRACTICE other healing arts.9
"Health-care provider" also means an ambulatory surgical center, a10
licensed pharmacy or provider of pharmacy services, and a professional11
corporation or other corporate entity consisting of licensed health-care12
providers as permitted by the laws of this state.13
SECTION 62. In Colorado Revised Statutes, 25.5-4-412, amend14
(5) as follows:15
25.5-4-412.  Family planning services - family-planning-related16
services - rules - definitions. (5)  Any recipient may obtain family17
planning services or family-planning-related services from any licensed18
health-care provider, including but not limited to
 a doctor of medicine,19
doctor of osteopathy, physician assistant, or advanced practice registered20
nurse, 
OR CERTIFIED MIDWIFE who provides such services. The enrollment21
of a recipient in a managed care organization, or a similar entity, does not22
restrict a recipient's choice of the licensed provider from whom the23
recipient may receive those services.24
SECTION 63. In Colorado Revised Statutes, 25.5-10-204,25
amend (2)(j)(III) and (2)(j)(IV) as follows:26
25.5-10-204.  Duties of the executive director - state board27
SB23-167
-72- rules - definitions - repeal. (2)  The state board shall adopt such rules,1
in accordance with section 24-4-103, as are necessary to carry out the2
provisions and purposes of this article 10, including but not limited to the3
following subjects:4
(j) (III)  A person who is not otherwise authorized by law to5
administer nutrition and fluids through gastrostomy tubes is allowed to6
perform the duties only under the supervision of a licensed nurse, 
A7
LICENSED CERTIFIED MIDWIFE, or A LICENSED physician. A person who8
administers nutrition and fluids in compliance with the provisions of
 this9
subsection (2)(j) is exempt from the licensing requirements of the10
"Colorado Medical Practice Act", article 240 of title 12, and the "Nurse11
and Nurse Aide Practice Act", article 255 of title 12. Nothing in this12
subsection (2)(j) shall be deemed to authorize the administration of13
medications through gastrostomy tubes. A person administering14
medications through gastrostomy tubes is subject to the requirements of15
part 3 of article 1.5 of title 25.16
(IV)  For purposes of this paragraph (j), AS USED IN THIS17
SUBSECTION (2)(j):18
(A)  "Administration" means assisting a person in the ingestion of19
nutrition or fluids according to the direction and supervision of a licensed20
nurse, 
A LICENSED CERTIFIED MIDWIFE, or A LICENSED physician.21
(B)  "C
ERTIFIED MIDWIFE" HAS THE SAME MEANING AS SET FORTH22
IN SECTION 12-255-104 (3.2).23
SECTION 64. In Colorado Revised Statutes, 27-10.5-103,24
amend (2)(i)(III) and (2)(i)(IV) as follows:25
27-10.5-103.  Duties of the executive director - rules -26
definitions. (2)  In accordance with section 24-4-103, and in coordination27
SB23-167
-73- with the requirements of article 10 of title 25.5, the department shall1
adopt such rules as are necessary to carry out the provisions and purposes2
of this article 10.5, including but not limited to the following:3
(i) (III)  A person who is not otherwise authorized by law to4
administer nutrition and fluids through gastrostomy tubes is allowed to5
perform the duties only under the supervision of a licensed nurse, 
A6
LICENSED CERTIFIED MIDWIFE, or A LICENSED physician. A person who7
administers nutrition and fluids in compliance with the provisions of
 this8
subsection (2)(i) is exempt from the licensing requirements of the9
"Colorado Medical Practice Act", article 240 of title 12, and the "Nurse10
and Nurse Aide Practice Act", article 255 of title 12. Nothing in this11
subsection (2)(i) shall be deemed to authorize the administration of12
medications through gastrostomy tubes. A person administering13
medications through gastrostomy tubes is subject to the requirements of14
part 3 of article 1.5 of title 25.15
(IV)  For purposes of this paragraph (i), AS USED IN THIS16
SUBSECTION (2)(i):17
(A)  "Administration" means assisting a person in the ingestion of18
nutrition or fluids according to the direction and supervision of a licensed19
nurse, 
A LICENSED CERTIFIED MIDWIFE, or A LICENSED physician.20
(B)  "C
ERTIFIED MIDWIFE" HAS THE SAME MEANING AS SET FORTH21
IN SECTION 12-255-104 (3.2).22
SECTION 65. In Colorado Revised Statutes, 27-81-118, amend23
(2)(a)(I)(C) as follows:24
27-81-118.  Opioid crisis recovery funds advisory committee -25
creation - membership - purpose. (2) (a)  The committee consists of26
members appointed as follows:27
SB23-167
-74- (I)  Thirteen members appointed by the governor, including:1
(C)  One member licensed to practice as a nurse 
OR AS A CERTIFIED2
MIDWIFE pursuant to part 1 of article 255 of title 12;3
SECTION 66. In Colorado Revised Statutes, 27-82-202, amend4
(2) as follows:5
27-82-202.  Definitions. As used in this part 2, unless the context6
otherwise requires:7
(2)  "Licensed health-care provider" means a physician or8
physician assistant licensed pursuant to article 240 of title 12 or a nurse9
OR CERTIFIED MIDWIFE licensed pursuant to part 1 of article 255 of title10
12.11
SECTION 67. In Colorado Revised Statutes, 38-12-401, amend12
(4) as follows:13
38-12-401.  Definitions. As used in this part 4, unless the context14
otherwise requires:15
(4)  "Medical professional" means a person licensed to practice16
medicine pursuant to article 240 of title 12 or 
TO PRACTICE NURSING OR17
AS A CERTIFIED MIDWIFE PURSUANT TO part 1 of article 255 of title 12.18
SECTION 68.  Effective date. This act takes effect upon passage;19
except that section 12-255-105, Colorado Revised Statues, as amended20
in section 3 of this act, takes effect July 1, 2024.21
SECTION 69. Safety clause. The general assembly hereby finds,22
determines, and declares that this act is necessary for the immediate23
preservation of the public peace, health, or safety.24
SB23-167
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