Second Regular Session Seventy-fourth General Assembly STATE OF COLORADO INTRODUCED LLS NO. 24-0599.01 Yelana Love x2295 SENATE BILL 24-068 Senate Committees House Committees Health & Human Services A BILL FOR AN ACT C ONCERNING END-OF-LIFE OPTIONS FOR AN INDIVIDUAL WITH A101 TERMINAL ILLNESS.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 .) Current law authorizes an individual with a terminal illness to request, and the individual's attending physician to prescribe to the individual, medication to hasten the individual's death (medical aid-in-dying). The bill modifies the medical aid-in-dying laws by: ! Providing an advanced practice registered nurse with the same authority to evaluate an individual and prescribe SENATE SPONSORSHIP Ginal, HOUSE SPONSORSHIP Brown, 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. medication as a physician; ! Removing the requirement that an individual must be a resident of the state to access end-of-life options; ! Adding language specifying that if any end-of-life options conflict with requirements to receive federal money, the conflicting part is inoperative and the remainder of the law will continue to operate; and ! Reducing the waiting period between oral requests from 15 days to 48 hours, and allowing attending providers to waive the mandatory waiting period if the patient is unlikely to survive more than 48 hours and meets all other qualifications. The bill also prohibits certain insurers from: ! Denying or altering health-care or life insurance benefits otherwise available to a covered individual with a terminal illness based on the availability of medical aid-in-dying; or ! Attempting to coerce an individual with a terminal illness to make a request for medical aid-in-dying medication. Be it enacted by the General Assembly of the State of Colorado:1 SECTION 1. In Colorado Revised Statutes, 25-48-102, amend2 (2), (3), (4), (5), (7), (9), (10), (12), (13), (15), and (16); repeal (8) and3 (14); and add (1.5) as follows:4 25-48-102. Definitions. As used in this article 48, unless the5 context otherwise requires:6 (1.5) "A DVANCED PRACTICE REGISTERED NURSE " HAS THE SAME7 MEANING AS SET FORTH IN SECTION 12-255-104 (1).8 (2) "Attending physician PROVIDER" means a physician OR9 ADVANCED PRACTICE REGISTERED NURSE who has primary responsibility10 for the care of a terminally ill individual and the treatment of the11 individual's terminal illness.12 (3) "Consulting physician PROVIDER" means a physician OR13 ADVANCED PRACTICE REGISTERED NURSE who is qualified by specialty or14 experience to make a professional diagnosis and prognosis regarding a15 SB24-068-2- terminally ill individual's illness.1 (4) "Health-care provider" or "provider" means a person who is2 licensed, certified, registered, or otherwise authorized or permitted by law3 to administer health care or dispense medication in the ordinary course of4 business or practice of a profession. The term includes a health-care5 facility, including a long-term care facility as defined in section6 25-3-103.7 (1)(f.3) and a continuing care retirement community as7 described in section 25.5-6-203 (1)(c)(I)(A).8 (5) "Informed decision" means a decision that is BY A MENTALLY9 CAPABLE INDIVIDUAL TO REQUEST AND OBTAIN A PRESCRIPTION FOR10 MEDICATION PURSUANT TO THIS ARTICLE 48, THAT THE QUALIFIED11 INDIVIDUAL MAY SELF-ADMINISTER TO BRING ABOUT DEATH, AFTER BEING12 FULLY INFORMED BY THE ATTENDING PROVIDER AND THE CONSULTING13 PROVIDER OF:14 (a) Made by an individual to obtain a prescription for medical15 aid-in-dying medication that the qualified individual may decide to16 self-administer to end his or her life in a peaceful manner THE17 INDIVIDUAL'S DIAGNOSIS AND PROGNOSIS;18 (b) Based on an understanding and acknowledgment of the19 relevant facts; and THE POTENTIAL RISKS ASSOCIATED WITH TAKING THE20 MEDICATION TO BE PRESCRIBED;21 (c) Made after the attending physician fully informs the individual22 of: THE PROBABLE RESULT OF TAKING THE MEDICATION TO BE23 PRESCRIBED;24 (I) His or her medical diagnosis and prognosis of six months or25 less;26 (II) The potential risks associated with taking the medical aid-in27 SB24-068 -3- dying medication to be prescribed;1 (III) The probable result of taking the medical aid-in-dying2 medication to be prescribed;3 (IV) The choices available to an individual that demonstrate his4 or her self-determination and intent to end his or her life in a peaceful5 manner, including the ability to choose whether to:6 (A) Request medical aid in dying;7 (B) Obtain a prescription for medical aid-in-dying medication to8 end his or her life;9 (C) Fill the prescription and possess medical aid-in-dying10 medication to end his or her life; and11 (D) Ultimately self-administer the medical aid-in-dying12 medication to bring about a peaceful death; and13 (V) All feasible alternatives or additional treatment opportunities,14 including comfort care, palliative care, hospice care, and pain control.15 (d) T HE FEASIBLE END-OF-LIFE CARE AND TREATMENT OPTIONS16 FOR THE INDIVIDUAL'S TERMINAL DISEASE, INCLUDING COMFORT CARE ,17 PALLIATIVE CARE, HOSPICE CARE, AND PAIN CONTROL, AND THE RISKS AND18 BENEFITS OF EACH OF THESE OPTIONS; AND19 (e) T HE INDIVIDUAL'S RIGHT TO WITHDRAW A REQUEST PURSUANT20 TO THIS ARTICLE 48 OR WITHDRAW CONSENT FOR ANY OTHER TREATMENT21 AT ANY TIME.22 (7) "Medical aid-in-dying" means the medical practice of a 23 physician prescribing medical aid-in-dying medication to a qualified24 individual that the individual may choose to self-administer to bring about25 a peaceful death PRACTICE OF EVALUATING A REQUEST, THE DETERMINING26 OF QUALIFICATION, THE PERFORMING OF THE DUTIES IN SECTIONS27 SB24-068 -4- 25-48-106 AND 25-48-107, AND THE PROVIDING OF A PRESCRIPTION TO A1 QUALIFIED INDIVIDUAL PURSUANT TO THIS ARTICLE 48.2 (8) "Medical aid-in-dying medication" means medication3 prescribed by a physician pursuant to this article to provide medical aid4 in dying to a qualified individual.5 (9) "Medically confirmed" means that a consulting physician who6 PROVIDER has examined the terminally ill individual and the individual's7 relevant medical records AND has confirmed the medical opinion of the8 attending physician PROVIDER.9 (10) "Mental capacity" or "mentally capable" means that in the10 opinion of an individual's attending physician PROVIDER, consulting11 physician, psychiatrist or psychologist PROVIDER, OR LICENSED MENTAL12 HEALTH PROVIDER, the individual has the ability to make and13 communicate an informed decision to health-care providers.14 (12) "Prognosis of six months or less" means a prognosis resulting15 from a terminal illness that the illness will, within reasonable medical16 judgment, result in death within six months. and which has been17 medically confirmed.18 (13) (a) "Qualified individual" means a terminally ill adult with19 a prognosis of six months or less, who has mental capacity, has made an20 informed decision, is a resident of the state, and has satisfied the21 requirements of this article in order to obtain a prescription for medical22 aid-in-dying medication to end his or her life in a peaceful manner23 CAPABLE ADULT WHO HAS SATISFIED THE REQUIREMENTS OF THIS ARTICLE24 48 IN ORDER TO OBTAIN A PRESCRIPTION FOR MEDICATION TO BRING25 ABOUT A DEATH.26 (b) A N INDIVIDUAL IS NOT A "QUALIFIED INDIVIDUAL" BASED27 SB24-068 -5- SOLELY ON THE INDIVIDUAL'S AGE OR DISABILITY.1 (14) "Resident" means an individual who is able to demonstrate2 residency in Colorado by providing any of the following documentation3 to his or her attending physician:4 (a) A Colorado driver's license or identification card issued5 pursuant to article 2 of title 42, C.R.S.;6 (b) A Colorado voter registration card or other documentation7 showing the individual is registered to vote in Colorado;8 (c) Evidence that the individual owns or leases property in9 Colorado; or10 (d) A Colorado income tax return for the most recent tax year.11 (15) (a) "Self-administer" means WHEN a qualified individual's 12 affirmative, conscious, and physical act of administering the medical13 aid-in-dying medication to himself or herself to bring about his or her14 own death INDIVIDUAL PERFORMS AN AFFIRMATIVE , CONSCIOUS,15 VOLUNTARY ACT TO INGEST MEDICATION PRESCRIBED PURSUANT TO THIS16 ARTICLE 48 TO BRING ABOUT THE INDIVIDUAL'S DEATH.17 (b) "S ELF-ADMINISTER" DOES NOT INCLUDE ADMINISTRATION BY18 PARENTERAL INJECTION OR INFUSION.19 (16) "Terminal illness" means an incurable and irreversible illness 20 DISEASE that HAS BEEN MEDICALLY CONFIRMED AND will, within21 reasonable medical judgment, result in death WITHIN SIX MONTHS.22 SECTION 2. In Colorado Revised Statutes, 25-48-103, amend23 (1) introductory portion, (1)(a), and (1)(b) as follows:24 25-48-103. Right to request medical aid-in-dying medication.25 (1) An adult resident of Colorado may make a request, in accordance26 with sections 25-48-104 and 25-48-112, to receive a prescription for27 SB24-068 -6- medical aid-in-dying medication if:1 (a) The individual's attending physician PROVIDER has diagnosed2 the individual with a terminal illness with a prognosis of six months or3 less;4 (b) The individual's attending physician PROVIDER has determined5 the individual has mental capacity; and6 SECTION 3. In Colorado Revised Statutes, 25-48-104, amend7 (1) and (2)(c) as follows:8 25-48-104. Request process - witness requirements.9 (1) (a) E XCEPT AS PROVIDED IN SUBSECTION (1)(b) OF THIS SECTION, in10 order to receive a prescription for medical aid-in-dying medication11 pursuant to this article ARTICLE 48, an individual who satisfies the12 requirements in section 25-48-103 must make two oral requests, separated13 by at least fifteen days FORTY-EIGHT HOURS, and a valid written request14 to his or her THE INDIVIDUAL'S attending physician PROVIDER.15 (b) I F AN INDIVIDUAL'S ATTENDING PROVIDER HAS DETERMINED16 THAT THE INDIVIDUAL WILL, WITHIN REASONABLE MEDICAL JUDGMENT ,17 DIE WITHIN FORTY-EIGHT HOURS AFTER MAKING THE INITIAL ORAL18 REQUEST UNDER THIS SECTION , THE INDIVIDUAL MAY SATISFY THE19 REQUIREMENTS OF THIS SECTION BY REITERATING THE ORAL REQUEST TO20 THE ATTENDING PROVIDER AT ANY TIME AFTER MAKING THE INITIAL ORAL21 REQUEST.22 (2) (c) Neither The individual's attending physician nor OR23 CONSULTING PROVIDER OR a person authorized as the individual's24 qualified power of attorney or durable medical power of attorney shall25 NOT serve as a witness to the written request.26 SECTION 4. In Colorado Revised Statutes, 25-48-105, amend27 SB24-068 -7- (2) as follows:1 25-48-105. Right to rescind request - requirement to offer2 opportunity to rescind. (2) An attending physician PROVIDER shall not3 write a prescription for medical aid-in-dying medication under this article4 ARTICLE 48 unless the attending physician PROVIDER offers the qualified5 individual an opportunity to rescind the request for the medical6 aid-in-dying medication.7 SECTION 5. In Colorado Revised Statutes, 25-48-106, amend8 (1) introductory portion, (1)(d), (1)(f), (1)(h) introductory portion,9 (1)(h)(IV), (1)(i), and (1)(l); and repeal (1)(b) as follows:10 25-48-106. Attending provider responsibilities. (1) The11 attending physician PROVIDER shall:12 (b) Request that the individual demonstrate Colorado residency by13 providing documentation as described in section 25-48-102 (14);14 (d) Refer the individual to a consulting physician PROVIDER for15 medical confirmation of the diagnosis and prognosis and for a16 determination of whether the individual is mentally capable, is making an17 informed decision, and acting voluntarily;18 (f) Refer the individual to a licensed mental health professional19 pursuant to section 25-48-108 if the attending physician believes that the20 individual may not be mentally capable of making an informed decision21 PROVIDER OBSERVES SIGNS THAT THE INDIVIDUAL MAY NOT BE CAPABLE22 OF MAKING AN INFORMED DECISION ;23 (h) Counsel EDUCATE the individual about the importance of:24 (IV) Notifying his or her THE INDIVIDUAL'S next of kin OR ANY25 PERSON WHO PLAYS A SIGNIFICANT ROLE IN THE INDIVIDUAL 'S LIFE, WHICH26 MAY INCLUDE A PERSON NOT LEGALLY RELATED TO THE INDIVIDUAL , of27 SB24-068 -8- the request for medical aid-in-dying medication;1 (i) Inform the individual that he or she THE INDIVIDUAL may2 rescind the request for medical aid-in-dying medication at any time and3 in any manner PURSUANT TO THIS ARTICLE 48;4 (l) Either:5 (I) Dispense medical aid-in-dying medications directly to the6 qualified individual, including ancillary medications intended to minimize7 the individual's discomfort, if the attending physician PROVIDER has a8 current drug enforcement administration certificate and complies with any9 applicable administrative rule; or10 (II) Deliver the written prescription personally, by mail, or11 through authorized electronic transmission in the manner permitted under12 article 280 of title 12, to a licensed pharmacist, who shall dispense the13 medical aid-in-dying medication to the qualified individual, the attending14 physician PROVIDER, or an individual expressly designated by the15 qualified individual.16 SECTION 6. In Colorado Revised Statutes, amend 25-48-107 as17 follows:18 25-48-107. Consulting provider responsibilities. (1) Before an19 individual who is requesting medical aid-in-dying medication may receive20 a prescription for the medical aid-in-dying medication, a consulting21 physician PROVIDER must:22 (1) (a) Examine the individual and his or her THE INDIVIDUAL'S23 relevant medical records; AND24 (2) (b) Confirm, in writing, to the attending physician PROVIDER25 THAT THE INDIVIDUAL:26 (a) (I) That the individual Has a terminal illness;27 SB24-068 -9- (b) (II) The individual Has a prognosis of six months or less;1 (c) (III) That the individual Is making an informed decision; and2 (d) (IV) That the individual Is mentally capable, or provide3 documentation that the consulting physician PROVIDER has referred the4 individual for further evaluation in accordance with section 25-48-108;5 AND6 (V) H AS REQUESTED A PRESCRIPTION FOR MEDICAL AID -IN-DYING7 MEDICATION.8 SECTION 7. In Colorado Revised Statutes, repeal and reenact,9 with amendments, 25-48-108 as follows:10 25-48-108. Confirmation that individual is mentally capable11 - referral to mental health professional. (1) I F EITHER THE ATTENDING12 PROVIDER OR THE CONSULTING PROVIDER HAS DOUBTS AS TO WHETHER AN13 INDIVIDUAL IS MENTALLY CAPABLE , THE PROVIDER SHALL REFER THE14 INDIVIDUAL TO A LICENSED MENTAL HEALTH PROVIDER FOR15 DETERMINATION REGARDING MENTAL CAPABILITY .16 (2) T HE LICENSED MENTAL HEALTH PROVIDER TO WHOM THE17 INDIVIDUAL IS REFERRED PURSUANT TO SUBSECTION (1) OF THIS SECTION18 SHALL SUBMIT TO THE REQUESTING ATTENDING PROVIDER OR THE19 CONSULTING PROVIDER WHO REFERRED THE INDIVIDUAL A WRI TTEN20 DETERMINATION OF WHETHER THE INDIVIDUAL IS MENTALLY CAPABLE .21 (3) I F THE LICENSED MENTAL HEALTH PROVIDER DETERMINES THAT22 THE INDIVIDUAL IS NOT MENTALLY CAPABLE , THE INDIVIDUAL IS NOT A23 QUALIFIED INDIVIDUAL AND THE ATTENDING PROVIDER SHALL NOT24 PRESCRIBE MEDICATION TO THE INDIVIDUAL UNDER THIS ARTICLE 48.25 SECTION 8. In Colorado Revised Statutes, 25-48-109, amend26 (1) as follows:27 SB24-068 -10- 25-48-109. Death certificate. (1) Unless otherwise prohibited by1 law, the attending physician PROVIDER or the hospice medical director2 shall sign the death certificate of a qualified individual who obtained and3 self-administered MEDICAL aid-in-dying medication.4 SECTION 9. In Colorado Revised Statutes, 25-48-110, amend5 (2) as follows:6 25-48-110. Informed decision required. (2) Immediately before7 writing a prescription for medical aid-in-dying medication under this8 article ARTICLE 48, the attending physician PROVIDER shall verify that the9 individual with a terminal illness is making an informed decision.10 SECTION 10. In Colorado Revised Statutes, 25-48-111, amend11 (1) introductory portion, (1)(c), (1)(d), and (1)(g) as follows:12 25-48-111. Medical record documentation requirements -13 reporting requirements - department compliance reviews - rules.14 (1) The attending physician PROVIDER shall document in the individual's15 medical record, the following information:16 (c) The attending physician's PROVIDER'S diagnosis and prognosis,17 determination of mental capacity, and that the individual is making a18 voluntary request and an informed decision;19 (d) The consulting physician's PROVIDER'S confirmation of20 diagnosis and prognosis, mental capacity, and that the individual is21 making an informed decision;22 (g) A notation by the attending physician PROVIDER that all23 requirements under this article ARTICLE 48 have been satisfied AND24 indicating steps taken to carry out the request, including a notation of the25 medical aid-in-dying medications prescribed and when.26 SECTION 11. In Colorado Revised Statutes, amend 25-48-11227 SB24-068 -11- as follows:1 25-48-112. Form of written request. (1) A request for medical2 aid-in-dying medication authorized by this article ARTICLE 48 must be in3 substantially the following form:4 Request for medication to end my life5 in a peaceful manner6 I, am an adult of sound mind. I am suffering from ,7 which my attending physician PROVIDER has determined is a terminal8 illness and which has been medically confirmed. I have been fully9 informed of my diagnosis and prognosis of six months or less, the nature10 of the medical aid-in-dying medication to be prescribed and potential11 associated risks, the expected result, and the feasible alternatives or12 additional treatment opportunities, including comfort care, palliative care,13 hospice care, and pain control.14 I request that my attending physician PROVIDER prescribe medical15 aid-in-dying medication that will end my life in a peaceful manner if I16 choose to take it, and I authorize my attending physician PROVIDER to17 contact any pharmacist about my request.18 I understand that I have the right to rescind this request at any time.19 I understand the seriousness of this request, and I expect to die if I take20 the aid-in-dying medication prescribed.21 I further understand that although most deaths occur within three hours,22 my death may take longer, and my attending physician PROVIDER has23 counseled me about this possibility. I make this request voluntarily,24 without reservation, and without being coerced, and I accept full25 responsibility for my actions.26 Signed: 27 SB24-068 -12- Dated: 1 Declaration of witnesses2 We declare that the individual signing this request:3 Is personally known to us or has provided proof of identity;4 Signed this request in our presence;5 Appears to be of sound mind and not under duress, coercion, or undue6 influence; and7 I am not the attending physician PROVIDER for the individual.8 witness 1/date9 witness 2/date10 Note: Of the two witnesses to the written request, at least one must not:11 Be a relative (by blood, marriage, civil union, or adoption) of the12 individual signing this request; be entitled to any portion of the13 individual's estate upon death; or own, operate, or be employed at a14 health-care facility where the individual is a patient or resident.15 And neither the individual's attending physician OR CONSULTING16 PROVIDER nor a person authorized as the individual's qualified power of17 attorney or durable medical power of attorney shall serve as a witness to18 the written request.19 SECTION 12. In Colorado Revised Statutes, 25-48-116, amend20 (3) introductory portion as follows:21 25-48-116. Immunity for actions in good faith - prohibition22 against reprisals. (3) A request by an individual for, or the provision by23 an attending physician PROVIDER of, medical aid-in-dying medication in24 good faith compliance with this article ARTICLE 48 does not:25 SECTION 13. In Colorado Revised Statutes, 25-48-117, amend26 (2); and add (3) as follows:27 SB24-068 -13- 25-48-117. No duty to prescribe or dispense. (2) If a1 health-care provider is unable or unwilling to carry out an individual's2 request for medical aid-in-dying medication made in accordance with this3 article, and the individual transfers his or her care to a new health-care4 provider, the prior health-care provider shall transfer, upon request, a5 copy of the individual's relevant medical records to the new health-care6 provider. ARTICLE 48, THE PROVIDER SHALL:7 (a) I NFORM THE INDIVIDUAL OF THE PROVIDER 'S INABILITY OR8 UNWILLINGNESS; AND9 (b) N OTE THE INDIVIDUAL'S DATE OF REQUEST AND PROVIDER 'S10 NOTICE TO THE INDIVIDUAL OF THE PROVIDER 'S INABILITY OR11 UNWILLINGNESS TO CARRY OUT THE INDIVIDUAL 'S REQUEST IN THE12 MEDICAL RECORD.13 (3) I F THE INDIVIDUAL TRANSFERS THE INDIVIDUAL 'S CARE TO A14 NEW HEALTH-CARE PROVIDER, THE PRIOR HEALTH-CARE PROVIDER SHALL15 TRANSFER, UPON REQUEST, A COPY OF THE INDIVIDUAL 'S RELEVANT16 MEDICAL RECORDS TO THE NEW HEALTH -CARE PROVIDER.17 SECTION 14. In Colorado Revised Statutes, 25-48-118, amend18 (1); and add (2.5) and (2.7) as follows:19 25-48-118. Health-care facility permissible prohibitions -20 sanctions if provider violates policy. (1) A health-care facility may21 prohibit a physician PROVIDER employed or under contract from writing22 a prescription for medical aid-in-dying medication for a qualified23 individual who intends to use the medical aid-in-dying medication on the24 facility's premises. The health-care facility must notify the physician25 PROVIDERS AND STAFF AT THE TIME OF HIRING , CONTRACTING WITH, OR26 PRIVILEGING AND ON A YEARLY BASIS THEREAFTER in writing of its policy27 SB24-068 -14- with regard to prescriptions for medical aid-in-dying medication. A1 health-care facility that fails to provide EXPLICIT advance notice to the2 physician PROVIDERS AND STAFF shall not be entitled to enforce such a3 policy. against the physician.4 (2.5) A HEALTH-CARE FACILITY SHALL NOT PROHIBIT A PROVIDER5 FROM FULFILLING THE FOLLOWING REQUIREMENTS OF INFORMED CONSENT6 AND MEETING THE STANDARD OF MEDICAL CARE BY :7 (a) P ROVIDING INFORMATION TO AN INDIVIDUAL REGARDING THE8 INDIVIDUAL'S HEALTH STATUS, INCLUDING DIAGNOSIS, PROGNOSIS,9 RECOMMENDED TREATMENT , AND TREATMENT ALTERNATIVES, INCLUDING10 THE RISKS AND BENEFITS OF THE RECOMMENDED TREATMENT AND EACH11 TREATMENT ALTERNATIVE ;12 (b) P ROVIDING INFORMATION REGARDING HEALTH -CARE SERVICES13 AVAILABLE PURSUANT TO THIS ARTICLE 48, INFORMATION ABOUT14 RELEVANT COMMUNITY RESOURCES , AND INFORMATION ABOUT HOW THE15 INDIVIDUAL CAN ACCESS THOSE SERVICES AND RESOURCES TO RECEIVE16 CARE;17 (c) P RACTICING MEDICAL AID-IN-DYING OUTSIDE THE SCOPE OF18 THE PROVIDER'S EMPLOYMENT OR CONTRACT WITH THE FACILITY AND OFF19 THE PREMISES OF THE FACILITY; OR20 (d) B EING PRESENT WHEN A QUALIFIED INDIVIDUAL21 SELF-ADMINISTERS MEDICATION PRESCRIBED PURSUANT TO THIS ARTICLE22 48 OR AT THE TIME OF THE INDIVIDUAL'S DEATH, IF REQUESTED BY THE23 QUALIFIED INDIVIDUAL OR THE INDIVIDUAL 'S REPRESENTATIVE, AND IF24 ACTING OUTSIDE THE SCOPE OF THE PROVIDER 'S EMPLOYMENT OR25 CONTRACTUAL DUTIES.26 (2.7) A HEALTH-CARE FACILITY THAT PROHIBITS A PROVIDER ,27 SB24-068 -15- WHILE PERFORMING DUTIES FOR THE FACILITY , FROM DETERMINING1 WHETHER AN INDIVIDUAL IS A QUALIFIED INDIVIDUAL OR FROM2 PRESCRIBING OR DISPENSING MEDICATION PURSUANT TO THIS ARTICLE 483 SHALL PROVIDE NOTICE OF THIS PROHIBITION TO THE PUBLIC BY POSTING4 THE NOTICE ON THE HEALTH-CARE FACILITY'S PUBLIC-FACING WEBSITE.5 SECTION 15. In Colorado Revised Statutes, amend 25-48-1206 as follows:7 25-48-120. Safe disposal of unused medical aid-in-dying8 medications. (1) A person who has custody or control of medical9 aid-in-dying medication dispensed under this article that the terminally ill10 individual decides not to use or that remains unused ARTICLE 48 after the11 A terminally ill individual's death shall dispose of the unused medical12 aid-in-dying medication either by:13 (1) (a) Returning the unused medical aid-in-dying medication to14 the attending physician PROVIDER who prescribed the medical15 aid-in-dying medication, who shall dispose of the unused medical16 aid-in-dying medication in the manner required by law; or17 (2) (b) Lawful means in accordance with section 25-15-328,18 C.R.S. or any other state or federally approved medication take-back19 program authorized under the federal "Secure and Responsible Drug20 Disposal Act of 2010", Pub.L. 111-273, and regulations adopted pursuant21 to the federal act.22 SECTION 16. In Colorado Revised Statutes, amend 25-48-12123 as follows:24 25-48-121. Actions complying with article not a crime. Nothing25 in this article ARTICLE 48 authorizes a physician PROVIDER or any other26 person to end an individual's life by lethal injection, mercy killing, or27 SB24-068 -16- euthanasia. Actions taken in accordance with this article ARTICLE 48 do1 not, for any purpose, constitute suicide, assisted suicide, mercy killing,2 homicide, or elder abuse under the "Colorado Criminal Code", as set forth3 in title 18. C.R.S.4 SECTION 17. In Colorado Revised Statutes, amend 25-48-1225 as follows:6 25-48-122. Claims by government entity for costs. A7 government entity that incurs costs resulting from an individual8 terminating his or her life pursuant to this article SELF-ADMINISTRATION9 OF MEDICATION PRESCRIBED UNDER THIS ARTICLE 48 in a public place has10 a claim against the estate of the individual to recover the costs and11 reasonable attorney fees related to enforcing the claim.12 SECTION 18. In Colorado Revised Statutes, add 25-48-124 as13 follows:14 25-48-124. Severability. I F ANY PART OF THIS ARTICLE 48 IS15 FOUND TO BE IN CONFLICT WITH FEDERAL REQUIREMENTS THAT ARE A16 PRESCRIBED CONDITION FOR RECEIPT OF FEDERAL FUNDS , THE17 CONFLICTING PART OF THIS SECTION IS INOPERATIVE SOLELY TO THE18 EXTENT OF THE CONFLICT, AND THE CONFLICT DOES NOT AFFECT THE19 OPERATION OF THE REMAINDER OF THIS ARTICLE 48.20 SECTION 19. In Colorado Revised Statutes, 10-7-103, add (3)21 as follows:22 10-7-103. Life insurance policies - prohibition. (3) A LIFE23 INSURANCE COMPANY DOING BUSINESS IN COLORADO SHALL NOT DENY OR24 ALTER BENEFITS OTHERWISE AVAILABLE TO AN INDIVIDUAL WITH A25 TERMINAL DISEASE BASED ON THE AVAILABILITY OF MEDICAL26 AID-IN-DYING PURSUANT TO ARTICLE 48 OF TITLE 25.27 SB24-068 -17- SECTION 20. In Colorado Revised Statutes, add 10-16-167 as1 follows:2 10-16-167. Medical aid-in-dying - carrier prohibitions. (1) A3 CARRIER SHALL NOT:4 (a) D ENY OR ALTER BENEFITS OTHERWISE AVAILABLE TO A5 COVERED INDIVIDUAL WITH A TERMINAL DISEASE BASED ON THE6 AVAILABILITY OF MEDICAL AID-IN-DYING PURSUANT TO ARTICLE 48 OF7 TITLE 25.8 (b) A TTEMPT TO COERCE AN INDIVIDUAL WITH A TERMINAL9 DISEASE TO MAKE A REQUEST FOR MEDICAL AID -IN-DYING MEDICATION.10 SECTION 21. Act subject to petition - effective date. This act11 takes effect at 12:01 a.m. on the day following the expiration of the12 ninety-day period after final adjournment of the general assembly; except13 that, if a referendum petition is filed pursuant to section 1 (3) of article V14 of the state constitution against this act or an item, section, or part of this15 act within such period, then the act, item, section, or part will not take16 effect unless approved by the people at the general election to be held in17 November 2024 and, in such case, will take effect on the date of the18 official declaration of the vote thereon by the governor.19 SB24-068 -18-