Board of Nursing: Legislative Updates

New Legislation 2019

On May 29, 2019, Governor Jared Polis signed HB19-1203 School Nurse Grant Program. The bill creates the School Nurse Grant Program in the Primary Care Office of the Colorado Department of Public Health and Environment (CDPHE) to award grants on a five-year cycle to local education providers (LEPs) to increase the number of school nurses. LEPs may use grant awards to hire school nurses, however, the grant may not supplant existing expenditures on school nurse positions or other student health care services

On May 29, 2019, Governor Jared Polis signed SB19-218 Sunset Medical Marijuana Program. This bill extends the Medical Marijuana Program in the Department of Public Health and Environment (CDPHE) until September 1, 2028, implements recommendations from the Department of Regulatory Agencies sunset review and makes a number of other changes. Specifically, the bill clarifies that:

  • Clarifies that if the patient is a minor, the physician must consult with the patient and the patient's parents and clarifies that a parent can serve as a primary caregiver for a child with a disabling medical condition.
  • Specifies that doctor-patient consultations include explaining the possible risks and benefits of the use of medical marijuana
  • Clarifies that caregivers for patients with debilitating medical conditions are extended the same confidentiality protections as caregivers for patients with disabling medical conditions.
  • Clarifies that medical marijuana registry cards are subject to revocation if a patient is convicted of a drug crime.
  • Specifies that only a physician can make a medical marijuana recommendation, except for recommendations for patients with disabling medical conditions, which may be made by a physician, dentist, or advanced practice practitioner with prescriptive authority who holds a license in good standing and who is acting within his or her scope of practice.
  • Directs CDPHE to promulgate rules related to the length of time that a medical marijuana registry card is valid.
  • Requires financial disclosures from members of the Retail Marijuana Public Health Advisory Committee and expands the expertise that must be represented on the committee.
  • Allows CDPHE to inquire about collecting Colorado-specific data from the All-Payer Claims Database, hospital discharge data, and available peer-reviewed research studies.

On May 23, 2019, Governor Jared Polis signed SB19-228 Substance Use Disorders Prevention. The law went into effect immediately upon the Governor's signature. The law requires the Colorado Medical Board, State Board of Nursing, Colorado Dental Board, State Board of Optometry, Colorado Podiatry Board, and the State Board of Veterinary Medicine to adopt rules on substance use disorder training for prescribers. The rules must require certain health care providers, as a condition of license renewal, reactivation or reinstatement on or after October 1, 2019, to complete up to four credit hours of training per licensing cycle related to:

  • Best practices for opioid prescribing, according to the most recent version of the Division‚Äôs Guidelines for Prescribing and Dispensing Opioids,
  • Recognition of substance use disorders,
  • Referral of patients with substance use disorders for treatment, and,
  • Use of the Electronic Prescription Drug Monitoring Program.

The new requirements apply to podiatrists, physicians, physician assistants, dentists, advanced practice nurses with prescriptive authority, optometrists, and veterinarians, except that each Board's rules must exempt from the training requirements any health care provider who:

  • Maintains a national board certification that requires equivalent substance use prevention training, or
  • Attests to the appropriate board that the health care provider does not prescribe opioids.

In addition to the substance abuse prevention training requirements, the new law includes the following provisions:

  • Restricts a physician, physician assistant, or advanced practice nurse from accepting any direct or indirect benefits for prescribing a specific medication,
  • Allows pharmacies to charge enhanced dispensing fees if they provide counseling concerning the risks of opioids to patients who have not previously received opioid prescriptions,
  • Allows medical examiners and coroners to access the Prescription Drug Monitoring Program (PDMP) under specified circumstances,
  • Requires opioid prescriptions for outpatient use to bear a warning label, and,
  • Provides funding for the implementation of several programs for the prevention of opioid and other substance use disorders in the Department of Human Services (DHS), the Department of Public Health and Environment (CDPHE) and local public health agencies (LPHAs), and the University of Colorado.

On May 23, 2019, Governor Jared Polis signed SB19-227 Harm Reduction Substance Use Disorders. The new law creates and expands certain substance use disorder treatment programs. Among other provisions, the new law:

  • creates an opiate antagonist bulk purchase program,
  • expands the list of individuals and organizations to whom a physician and advanced practice nurse may prescribe or dispense an opiate antagonist,
  • requires opioid antagonists to be made available alongside publicly funded defibrillators,
  • allows opiate antagonists to be administered by school staff, and,
  • expands the medication take-back program to include syringes.

On May 16, 2019, Governor Jared Polis signed SB19-052 Emergency Medical Service Provider Scope of Practice. The new law is effective August 2, 2019, and expands an emergency medical service (EMS) provider's scope of practice to practice in a clinical setting under the medical supervision of a physician, physician assistant, advanced practice nurse, or registered nurse. The State Board of Health in the Department of Public Health and Environment must promulgate conforming rules. Each clinical setting at which EMS provider practices must establish operating policies and procedures to ensure that EMS providers perform tasks and procedures within their scope of practice.

On May 13, 2019, Governor Jared Polis signed SB19-154 Sunset Regulation of Psychiatric Technicians. The new law goes into effect on July 1, 2019, and continues the regulation of psychiatric technicians by the State Board of Nursing (Board) in the Department of Regulatory Agencies to September 1, 2034. The new law also:

  • Changes references from "accredited" psychiatric technician education programs to "approved" programs.
  • Removes a requirement that applicants submit a statement of whether he or she has been convicted of a felony or misdemeanor involving moral turpitude.
  • Modifies the grounds for discipline for alcohol or substance abuse and remove the terms "willfully" and "negligently" as conditions for various grounds for discipline.
  • Allows the board to enter into a confidential agreement with a psychiatric technician to limit their scope of practice if the psychiatric technician suffers from physical or mental illness and subjects a psychiatric technician to discipline if he or she does not limit their practice as agreed to in the confidential agreement.
  • Eliminates a requirement that the Board sends letters of admonition by certified mail.

On May 6, 2019, Governor Jared Polis signed SB 19-201 Open Discussions About Adverse Health Care Incidents. This new law creates the "Colorado Candor Act" and establishes a process for the communication between a patient and a healthcare provider or health facility after an adverse health care incident. Under the new law, if an adverse health care incident occurs, a health care provider involved with the incident, either individually or jointly with the facility involved, may request that the patient enters into an open discussion concerning the incident. The request must include certain components listed in the law.

If an offer of compensation is made, the new law requires certain processes for payment and financial resolution to be followed. If a health care provider or health facility determines that no offer of compensation is warranted, the health care provider or health facility shall orally communicate that decision with the patient.

A health care provider or facility may provide de-identified information about an adverse health care incident to any patient safety centered nonprofit organization.