HOUSE BILL 24-1456
BY REPRESENTATIVE(S) Marvin and Daugherty, Amabile, Bacon, Bird,
Boesenecker, Brown, Duran, Froelich, Garcia, Hamrick, Hernandez, Herod,
Jodeh, Joseph, Kipp, Lieder, Lindsay, Lindstedt, Mabrey, Marshall, Mauro,
McCormick, McLachlan, Rutinel, Sirota, Snyder, Vigil, Woodrow, Young,
McCluskie;
also SENATOR(S) Michaelson Jenet, Bridges, Buckner, Cutter, Exum,
Fields, Ginal, Hinrichsen, Jaquez Lewis, Marchman, Mullica, Priola.
C
ONCERNING TESTING FOR SYPHILIS DURING THE PERINATAL PERIOD .
Be it enacted by the General Assembly of the State of Colorado:
SECTION 1. Legislative declaration. (1) The general assembly
finds and declares that:
(a) Syphilis is a bacterial infection that, if untreated, can progress to
severe infection of the brain, eyes, and other body organs;
(b) Congenital syphilis occurs when the infection is passed to a fetus
during pregnancy and can cause miscarriage, stillbirth, severe congenital
abnormalities, or death. The department of health care policy and financing
estimates that the cost of care for a baby born with syphilis is approximately
NOTE: This bill has been prepared for the signatures of the appropriate legislative
officers and the Governor. To determine whether the Governor has signed the bill
or taken other action on it, please consult the legislative status sheet, the legislative
history, or the Session Laws.
________
Capital letters or bold & italic numbers indicate new material added to existing law; dashes
through words or numbers indicate deletions from existing law and such material is not part of
the act. $30,000 in the baby's first year of life.
(c) According to the federal centers for disease control and
prevention, over ten times as many babies were born with syphilis in 2022
than in 2012, the highest number of infected babies reported in a single year
since 1992;
(d) Colorado has experienced a 900 percent increase in congenital
syphilis cases since 2017, based on 2023 provisional data;
(e) During the first quarter of 2024, there have already been 22
reported congenital syphilis cases, including five stillbirths and two fetal
deaths;
(f) Congenital syphilis disproportionately impacts Hispanic and
Black communities;
(g) The spread of syphilis and congenital syphilis is preventable
when caught early and treated in a timely manner with routine and
inexpensive antibiotics like penicillin;
(h) Currently, Colorado requires only one syphilis test during the
prenatal period: In the first trimester or when initiating prenatal care;
(i) Reinfection or inadequate treatment can result in a syphilis
infection being present after the first trimester, putting the baby at risk of
congenital syphilis;
(j) Additional syphilis testing in the third trimester and at delivery
provides additional opportunities to identify and treat an infection;
(k) At least 17 other states require testing later in pregnancy in
addition to testing during the first trimester, including North Carolina,
Texas, Georgia, and Arizona, which have laws that require testing during
the first trimester, during the third trimester, and at delivery of the baby; and
(l) Therefore, to reduce the rapidly increasing rates of syphilis and
congenital syphilis infection in Colorado, it is necessary and appropriate to
require additional testing throughout the prenatal period, including during
the third trimester and at delivery of the baby.
PAGE 2-HOUSE BILL 24-1456 SECTION 2. In Colorado Revised Statutes, amend 25-4-201 as
follows:
25-4-201. Blood testing during pregnancy - HIV - syphilis - rules
- repeal. (1) (a) Every EACH licensed health-care provider authorized to
provide care to a pregnant woman PERSON WHO IS PREGNANT in this state
for conditions relating to her THE pregnancy during the period of gestation
or at delivery shall take or cause to be taken a sample of blood of the
woman
PERSON at the time of the first professional visit or during the first
trimester for testing pursuant to this section. The blood specimen obtained
shall be submitted to an approved laboratory for a standard serological test
for syphilis and HIV. Every other person permitted by law to attend
TO A
PERSON WHO IS
pregnant women in this state but not permitted by law to
take blood samples shall cause a sample of blood of each
PERSON UNDER
THE ATTENDANT
'S CARE WHO IS pregnant woman
to be taken by a licensed
health-care provider authorized to take blood samples and shall have the
sample submitted to an approved laboratory for a standard serological test
for syphilis and HIV. A
PERSON WHO IS pregnant woman
may decline to be
tested as specified in this subsection (1) (1)(a), in which case the licensed
health-care provider shall document that fact in her THE PERSON'S medical
record.
(b) T
HIS SUBSECTION (1) IS REPEALED, EFFECTIVE JANUARY 1, 2025.
(2) (a) If a
PERSON WHO IS pregnant woman entering
ENTERS a
hospital for delivery
AND has not been tested for HIV during her
THE
pregnancy OR THERE IS NO AVAILABLE RECORD OF TESTING , the hospital
shall notify the woman PERSON WHO IS PREGNANT that she THE PERSON will
be tested for HIV unless she THE PERSON objects and declines the test. If the
woman PERSON declines to be tested, the hospital shall document that fact
in the pregnant woman's PERSON'S medical record.
(b) E
ACH LICENSED HEALTH -CARE PROVIDER AUTHORIZED TO
PROVIDE CARE TO A PERSON WHO IS PREGNANT IN THIS STATE SHALL
, FOR
ALL PERSONS WHO ARE PREGNANT UNDER THE CARE OF THE LICENSED
HEALTH
-CARE PROVIDER, TAKE, OR CAUSE TO BE TAKEN, A BLOOD SAMPLE
AND SUBMIT THE BLOOD SAMPLE TO AN APPROVED LABORATORY FOR A
STANDARD SEROLOGICAL TEST FOR
HIV. IF THE PERSON DECLINES TO BE
TESTED
, THE LICENSED HEALTH-CARE PROVIDER SHALL DOCUMENT THAT
FACT IN THE PERSON
'S MEDICAL RECORD.
PAGE 3-HOUSE BILL 24-1456 (3) (a) ON OR BEFORE JANUARY 1, 2025, THE STATE BOARD OF
HEALTH CREATED IN SECTION
25-1-103 SHALL PROMULGATE RULES
CONCERNING PRENATAL TESTING STANDARDS FOR SYPHILIS
, INCLUDING
FREQUENCY OF TESTING
.
(b) A
T LEAST ONCE EVERY THREE YEARS , THE DEPARTMENT OF
PUBLIC HEALTH AND ENVIRONMENT SHALL REVIEW THE RULES
PROMULGATED PURSUANT TO THIS SECTION FOR ALIGNMENT WITH NATIONAL
PRENATAL TESTING RECOMMENDATIONS FOR SEXUALLY TRANSMITTED
INFECTIONS AS WELL AS THE DEPARTMENT OF PUBLIC HEALTH AND
ENVIRONMENT
'S INFECTION CONTROL DUTIES ESTABLISHED IN SECTION
25-4-408. BEFORE EACH REVIEW OF THE RULES, THE DEPARTMENT OF PUBLIC
HEALTH AND ENVIRONMENT SHALL MAKE RELEVANT STAKEHOLDERS AWARE
OF THE REVIEW
, INCLUDING HEALTH-CARE PROVIDERS AND LOCAL PUBLIC
HEALTH AGENCIES
.
SECTION 3. In Colorado Revised Statutes, 25-4-406, amend (1)
introductory portion; and add (1.5) as follows:
25-4-406. Reports - confidentiality. (1) The public health reports
required pursuant to section 25-4-405 and any records resulting from
compliance with that section held by the state department and local
COUNTY
AND DISTRICT
public health agencies, or any health-care provider, facility,
third-party payer, physician, clinic, laboratory, blood bank, health records
database, or other agency, are confidential information. The information
may
SHALL only be released, shared with any agency or institution, or made
public, upon subpoena, search warrant, discovery proceedings, or otherwise,
under the following circumstances:
(1.5) I
N ACCORDANCE WITH SUBSECTION (1)(a) OF THIS SECTION, FOR
STATISTICAL PURPOSES
, THE STATE DEPARTMENT SHALL MAKE AVAILABLE
TO COUNTY AND DISTRICT PUBLIC HEALTH AGENCIES DE
-IDENTIFIED CASE
RATE DATA FOR SYPHILIS THAT IS SPECIFIC TO THE COUNTY OR DISTRICT
,
WHICH DATA MUST REMAIN CONFIDENTIAL PURSUANT TO THIS SECTION .
SECTION 4. Safety clause. The general assembly finds,
determines, and declares that this act is necessary for the immediate
preservation of the public peace, health, or safety or for appropriations for
PAGE 4-HOUSE BILL 24-1456 the support and maintenance of the departments of the state and state
institutions.
____________________________ ____________________________
Julie McCluskie Steve Fenberg
SPEAKER OF THE HOUSE PRESIDENT OF
OF REPRESENTATIVES THE SENATE
____________________________ ____________________________
Robin Jones Cindi L. Markwell
CHIEF CLERK OF THE HOUSE SECRETARY OF
OF REPRESENTATIVES THE SENATE
APPROVED________________________________________
(Date and Time)
_________________________________________
Jared S. Polis
GOVERNOR OF THE STATE OF COLORADO
PAGE 5-HOUSE BILL 24-1456