Second Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
REREVISED
This Version Includes All Amendments
Adopted in the Second House
LLS NO. 24-1158.02 Brita Darling x2241
HOUSE BILL 24-1456
House Committees Senate Committees
Health & Human Services Health & Human Services
A BILL FOR AN ACT
C
ONCERNING TESTING FOR SYPHILIS DURING THE PERINATAL PERIOD .101
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
.)
The bill expands the existing requirement to test a person who is
pregnant for syphilis at the person's first professional visit with a
health-care provider or during the first trimester of pregnancy to also
require testing for syphilis early in the third trimester of pregnancy and at
delivery. The person who is pregnant may decline any testing.
SENATE
3rd Reading Unamended
May 7, 2024
SENATE
2nd Reading Unamended
May 6, 2024
HOUSE
3rd Reading Unamended
April 30, 2024
HOUSE
Amended 2nd Reading
April 29, 2024
HOUSE SPONSORSHIP
Marvin and Daugherty, Amabile, Bacon, Bird, Boesenecker, Brown, Duran, Froelich,
Garcia, Hamrick, Hernandez, Herod, Jodeh, Joseph, Kipp, Lieder, Lindsay, Lindstedt,
Mabrey, Marshall, Mauro, McCluskie, McCormick, McLachlan, Rutinel, Sirota, Snyder,
Vigil, Woodrow, Young
SENATE SPONSORSHIP
Michaelson Jenet, Bridges, Buckner, Cutter, Exum, Fields, Ginal, Hinrichsen, Jaquez
Lewis, Marchman, Mullica, Priola
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. Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. Legislative declaration. (1) The general assembly2
finds and declares that:3
(a) Syphilis is a bacterial infection that, if untreated, can progress4
to severe infection of the brain, eyes, and other body organs;5
(b) Congenital syphilis occurs when the infection is passed to a6
fetus during pregnancy and can cause miscarriage, stillbirth, severe7
congenital abnormalities, or death. The department of health care policy8
and financing estimates that the cost of care for a baby born with syphilis9
is approximately $30,000 in the baby's first year of life.10
(c) According to the federal centers for disease control and11
prevention, over ten times as many babies were born with syphilis in 202212
than in 2012, the highest number of infected babies reported in a single13
year since 1992;14
(d) Colorado has experienced a 900 percent increase in congenital15
syphilis cases since 2017, based on 2023 provisional data;16
(e) During the first quarter of 2024, there have already been 2217
reported congenital syphilis cases, including five stillbirths and two fetal18
deaths;19
(f) Congenital syphilis disproportionately impacts Hispanic and20
Black communities;21
(g) The spread of syphilis and congenital syphilis is preventable22
when caught early and treated in a timely manner with routine and23
inexpensive antibiotics like penicillin;24
(h) Currently, Colorado requires only one syphilis test during the25
prenatal period: In the first trimester or when initiating prenatal care;26
(i) Reinfection or inadequate treatment can result in a syphilis27
1456
-2- infection being present after the first trimester, putting the baby at risk of1
congenital syphilis;2
(j) Additional syphilis testing in the third trimester and at delivery3
provides additional opportunities to identify and treat an infection;4
(k) At least 17 other states require testing later in pregnancy in5
addition to testing during the first trimester, including North Carolina,6
Texas, Georgia, and Arizona, which have laws that require testing during7
the first trimester, during the third trimester, and at delivery of the baby;8
and9
(l) Therefore, to reduce the rapidly increasing rates of syphilis and10
congenital syphilis infection in Colorado, it is necessary and appropriate11
to require additional testing throughout the prenatal period, including12
during the third trimester and at delivery of the baby.13
SECTION 2. In Colorado Revised Statutes, amend 25-4-201 as14
follows:15
25-4-201. Blood testing during pregnancy - HIV - syphilis -16
rules - repeal. (1) (a) Every EACH licensed health-care provider17
authorized to provide care to a pregnant woman PERSON WHO IS18
PREGNANT in this state for conditions relating to her THE pregnancy19
during the period of gestation or at delivery shall take or cause to be taken20
a sample of blood of the woman PERSON at the time of the first21
professional visit or during the first trimester for testing pursuant to this22
section. The blood specimen obtained shall be submitted to an approved23
laboratory for a standard serological test for syphilis and HIV. Every24
other person permitted by law to attend
TO A PERSON WHO IS pregnant25
women
in this state but not permitted by law to take blood samples shall26
cause a sample of blood of each
PERSON UNDER THE ATTENDANT 'S CARE27
1456
-3- WHO IS pregnant woman to be taken by a licensed health-care provider1
authorized to take blood samples and shall have the sample submitted to2
an approved laboratory for a standard serological test for syphilis and3
HIV. A
PERSON WHO IS pregnant woman
may decline to be tested as4
specified in this subsection (1) (1)(a), in which case the licensed5
health-care provider shall document that fact in her THE PERSON'S medical6
record.7
(b) THIS SUBSECTION (1) IS REPEALED, EFFECTIVE JANUARY 1,8
2025.9
(2) (a) If a PERSON WHO IS pregnant woman entering ENTERS a10
hospital for delivery
AND has not been tested for HIV
during her THE11
pregnancy
OR THERE IS NO AVAILABLE RECORD OF TESTING , the hospital12
shall notify the woman
PERSON WHO IS PREGNANT that she THE PERSON13
will be tested for HIV
unless she THE PERSON objects and declines the14
test. If the woman PERSON declines to be tested, the hospital shall15
document that fact in the pregnant woman's PERSON'S medical record. 16
(b) EACH LICENSED HEALTH-CARE PROVIDER AUTHORIZED TO17
PROVIDE CARE TO A PERSON WHO IS PREGNANT IN THIS STATE SHALL, FOR18
ALL PERSONS WHO ARE PREGNANT UNDER THE CARE OF THE LICENSED19
HEALTH-CARE PROVIDER, TAKE, OR CAUSE TO BE TAKEN, A BLOOD SAMPLE20
AND SUBMIT THE BLOOD SAMPLE TO AN APPROVED LABORATORY FOR A21
STANDARD SEROLOGICAL TEST FOR HIV. IF THE PERSON DECLINES TO BE22
TESTED, THE LICENSED HEALTH-CARE PROVIDER SHALL DOCUMENT THAT23
FACT IN THE PERSON'S MEDICAL RECORD.24
(3) (a) ON OR BEFORE JANUARY 1, 2025, THE STATE BOARD OF25
HEALTH CREATED IN SECTION 25-1-103 SHALL PROMULGATE RULES26
CONCERNING PRENATAL TESTING STANDARDS FOR SYPHILIS, INCLUDING27
1456
-4- FREQUENCY OF TESTING.1
(b) AT LEAST ONCE EVERY THREE YEARS , THE DEPARTMENT OF2
PUBLIC HEALTH AND ENVIRONMENT SHALL REVIEW THE RULES3
PROMULGATED PURSUANT TO THIS SECTION FOR ALIGNMENT WITH4
NATIONAL PRENATAL TESTING RECOMMENDATIONS FOR SEXUALLY5
TRANSMITTED INFECTIONS AS WELL AS THE DEPARTMENT OF PUBLIC6
HEALTH AND ENVIRONMENT'S INFECTION CONTROL DUTIES ESTABLISHED7
IN SECTION 25-4-408. BEFORE EACH REVIEW OF THE RULES, THE8
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT SHALL MAKE9
RELEVANT STAKEHOLDERS AWARE OF THE REVIEW, INCLUDING10
HEALTH-CARE PROVIDERS AND LOCAL PUBLIC HEALTH AGENCIES .11
SECTION 3. In Colorado Revised Statutes, 25-4-406, amend (1)12
introductory portion; and add (1.5) as follows:13
25-4-406. Reports - confidentiality. (1) The public health14
reports required pursuant to section 25-4-405 and any records resulting15
from compliance with that section held by the state department and local16
COUNTY AND DISTRICT public health agencies, or any health-care17
provider, facility, third-party payer, physician, clinic, laboratory, blood18
bank, health records database, or other agency, are confidential19
information. The information may SHALL only be released, shared with20
any agency or institution, or made public, upon subpoena, search warrant,21
discovery proceedings, or otherwise, under the following circumstances:22
(1.5) IN ACCORDANCE WITH SUBSECTION (1)(a) OF THIS SECTION,23
FOR STATISTICAL PURPOSES, THE STATE DEPARTMENT SHALL MAKE24
AVAILABLE TO COUNTY AND DISTRICT PUBLIC HEALTH AGENCIES25
DE-IDENTIFIED CASE RATE DATA FOR SYPHILIS THAT IS SPECIFIC TO THE26
COUNTY OR DISTRICT , WHICH DATA MUST REMAIN CONFIDENTIAL27
1456
-5- PURSUANT TO THIS SECTION.1
SECTION 4. Safety clause. The general assembly finds,2
determines, and declares that this act is necessary for the immediate3
preservation of the public peace, health, or safety or for appropriations for4
the support and maintenance of the departments of the state and state5
institutions.6
1456
-6-