First Regular Session
Sixty-second General Assembly
LLS NO. 99-0589.01 Beth Braby SENATE BILL 99-146
STATE OF COLORADO
BY SENATOR Dennis
HEALTH, ENVIRONMENT, WELFARE & INSTITUTIONS
APPROPRIATIONS
A BILL FOR AN ACT
101 CONCERNING IMPLEMENTATION OF A PUBLIC HEALTH PROGRAM TO
102 ADDRESS OSTEOPOROSIS.
Bill Summary
(Note: This summary applies to this bill as introduced and does
not necessarily reflect any amendments that may be subsequently
adopted.)
Authorizes and instructs the executive director of the department
of public health and environment to create an osteoporosis prevention and
treatment education program. Directs that the program shall:
Implement a public education program to raise public
awareness about the causes and nature of osteoporosis, the
value of prevention and early detection, personal risk
factors, and options for diagnosing and treating the disease.
Educate consumers about risk factors, appropriate diet and
exercise, diagnostic procedures and indications for use,
risks and benefits of drug therapies currently approved by
the United States food and drug administration,
environmental safety and injury prevention, and the
availability of diagnostic, treatment, and rehabilitation
services.
Educate health care professionals and service providers on
the most recent, accurate, scientific information and
findings available on osteoporosis prevention, diagnosis,
treatment, therapeutic decision-making, guidelines for
detection and treatment in special populations, risks and
benefits of medications, and research advances.
States that if resources allow after implementation of the
educational parts of the program, the executive director of the department
of public health and environment shall have the authority to conduct a
[ ] denotes HOUSE amendment. { } denotes SENATE amendment.
Capital letters indicate new material to be added to existing statute.
Dashes through the words indicate material to be deleted from existing statute.
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needs assessment to investigate and identify specific needs with respect
to osteoporosis prevention and treatment. Requires the department to use
the findings of the needs assessment to develop, disseminate, and
maintain a list of osteoporosis-related services and osteoporosis health
care providers that specialize in the prevention, diagnoses, and treatment
of osteoporosis.
Creates the osteoporosis prevention and treatment education fund
and allows for credits to this fund.
1 Be it enacted by the General Assembly of the State of Colorado:
2 SECTION 1. Article 4 of title 25, Colorado Revised Statutes, is
3 amended BY THE ADDITION OF A NEW PART to read:
4 PART 20
5 OSTEOPOROSIS PREVENTION
6 AND TREATMENT EDUCATION PROGRAM ACT
7 25-4-2001. Short title. THIS PART 20 SHALL BE KNOWN AND MAY
8 BE CITED AS THE "OSTEOPOROSIS PREVENTION AND TREATMENT
9 EDUCATION PROGRAM ACT".
10 25-4-2002. Legislative declaration. (1) THE GENERAL
11 ASSEMBLY HEREBY FINDS, DETERMINES, AND DECLARES THAT:
12 (a) OSTEOPOROSIS, A BONE-THINNING DISEASE, IS A MAJOR PUBLIC
13 HEALTH PROBLEM THAT POSES A THREAT TO THE HEALTH AND QUALITY OF
14 LIFE OF AS MANY AS TWENTY-FIVE MILLION AMERICANS;
15 (b) BECAUSE OSTEOPOROSIS PROGRESSES SILENTLY AND WITHOUT
16 SENSATION OVER MANY YEARS, MANY CASES OF OSTEOPOROSIS REMAIN
17 UNDIAGNOSED UNTIL A FRACTURE OF THE HIP, SPINE, OR WRIST;
18 (c) CURRENTLY, APPROXIMATELY ONE MILLION FIVE HUNDRED
19 THOUSAND FRACTURES EACH YEAR ARE ATTRIBUTABLE TO OSTEOPOROSIS.
20 THESE FRACTURES CAUSE PAIN, DISABILITY, IMMOBILITY, SOCIAL
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1 ISOLATION, POOR QUALITY OF LIFE, AND AN INABILITY TO LIVE
2 INDEPENDENTLY.
3 (d) STATISTICS INDICATE THAT ONE OUT OF TWO WOMEN AND ONE
4 OUT OF FIVE MEN WILL SUFFER FROM AN OSTEOPOROTIC FRACTURE IN
5 THEIR LIFETIME;
6 (e) STATISTICS FURTHER INDICATE THAT A WOMAN'S RISK OF HIP
7 FRACTURE IS EQUAL TO HER COMBINED RISK OF BREAST, UTERINE, AND
8 OVARIAN CANCER;
9 (f) THE ANNUAL DIRECT AND INDIRECT COSTS OF OSTEOPOROSIS TO
10 THE HEALTH CARE SYSTEM WERE ESTIMATED TO BE AS HIGH AS EIGHTEEN
11 BILLION DOLLARS IN 1993 AND ARE EXPECTED TO RISE TO SIXTY TO EIGHTY
12 BILLION DOLLARS BY 2020;
13 (g) BECAUSE OSTEOPOROSIS PROGRESSES SILENTLY AND
14 CURRENTLY HAS NO CURE, THE KEYS TO REDUCTION OF THE PREVALENCE
15 AND DEVASTATION OF THIS DISEASE ARE PREVENTION, EARLY DIAGNOSIS,
16 AND TREATMENT;
17 (h) WHILE THERE IS A LARGE QUANTITY OF PUBLIC INFORMATION
18 ABOUT OSTEOPOROSIS, IT REMAINS INADEQUATELY DISSEMINATED AND
19 NOT TAILORED TO MEET THE NEEDS OF SPECIFIC POPULATION GROUPS;
20 (i) MOST CITIZENS, INCLUDING PHYSICIANS AND HEALTH CARE
21 PROVIDERS, CONTINUE TO LACK KNOWLEDGE ABOUT THE PREVENTION,
22 DETECTION, AND TREATMENT OF THIS DISEASE;
23 (j) IN THE ABSENCE OF A CURE FOR OSTEOPOROSIS, EMPHASIS MUST
24 BE PLACED ON OTHER MEANS OF DISEASE AWARENESS AND PREVENTION,
25 INCLUDING, BUT NOT LIMITED TO, EDUCATION OF MEDICAL EXPERTS,
26 SERVICE PROVIDERS, AND THE GENERAL PUBLIC REGARDING PREVENTION.
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1 THIS APPROACH MAY BE THE ONLY MEANS OF ASSURING THAT
2 OSTEOPOROSIS WILL BE PREVENTABLE AND TREATABLE IN THE FUTURE,
3 THEREBY REDUCING THE COSTS OF LONG-TERM CARE.
4 (k) OSTEOPOROSIS IS A MULTI-GENERATIONAL ISSUE BECAUSE
5 BUILDING STRONG BONES DURING YOUTH AND PRESERVING THEM DURING
6 ADULTHOOD MAY PREVENT FRACTURES LATER IN LIFE;
7 (l) EDUCATING THE GENERAL PUBLIC AND HEALTH CARE
8 COMMUNITY THROUGHOUT THE STATE ABOUT THIS POTENTIALLY
9 DEVASTATING DISEASE IS OF PARAMOUNT IMPORTANCE AND IS IN EVERY
10 RESPECT IN THE PUBLIC INTEREST AND TO THE BENEFIT OF ALL RESIDENTS
11 OF THE STATE OF COLORADO.
12 (2) THE GENERAL ASSEMBLY FURTHER DECLARES THAT THE
13 PURPOSE OF THIS PART 20 IS TO CREATE AND DEVELOP A PROGRAM THAT
14 WILL:
15 (a) FOSTER A MULTI-GENERATIONAL, STATEWIDE PROGRAM TO
16 PROMOTE PUBLIC AWARENESS AND KNOWLEDGE ABOUT THE CAUSES OF
17 OSTEOPOROSIS, PERSONAL RISK FACTORS, THE VALUE OF PREVENTION AND
18 EARLY DETECTION, AND THE OPTIONS AVAILABLE FOR TREATMENT;
19 (b) FACILITATE AND ENHANCE KNOWLEDGE AND AWARENESS OF
20 OSTEOPOROSIS BY DISSEMINATING EDUCATIONAL MATERIALS TO HEALTH
21 CARE PROFESSIONALS, PATIENTS, POLICY MAKERS, STATE AND LOCAL
22 PUBLIC OFFICIALS, AND THE GENERAL PUBLIC, SUCH AS INFORMATION
23 RELATED TO RESEARCH RESULTS, OTHER SERVICE PROVIDERS, AND
24 STRATEGIES FOR PREVENTION AND TREATMENT;
25 (c) UTILIZE EDUCATIONAL AND TRAINING RESOURCES AND
26 SERVICES THAT HAVE BEEN DEVELOPED BY ORGANIZATIONS WITH
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1 APPROPRIATE EXPERTISE AND KNOWLEDGE OF OSTEOPOROSIS;
2 (d) EVALUATE EXISTING OSTEOPOROSIS SERVICES IN THE
3 COMMUNITY AND ASSESS THE NEED FOR IMPROVING THE QUALITY AND
4 ACCESSIBILITY OF THESE SERVICES;
5 (e) PROVIDE EASY ACCESS TO CLEAR, COMPLETE, AND ACCURATE
6 OSTEOPOROSIS AND PATIENT REFERRAL SERVICES INFORMATION;
7 (f) COORDINATE COMMUNITY-BASED AND LOCAL ORGANIZATIONS
8 TO ADDRESS THE ISSUE OF OSTEOPOROSIS;
9 (g) PROMOTE THE DEVELOPMENT OF SUPPORT GROUPS FOR
10 OSTEOPOROSIS PATIENTS, THEIR FAMILIES, AND THEIR CAREGIVERS; AND
11 (h) PROVIDE LASTING IMPROVEMENTS IN THE DELIVERY OF
12 OSTEOPOROSIS HEALTH CARE, THUS PROVIDING PATIENTS WITH AN
13 IMPROVED QUALITY OF LIFE AND PROVIDING SOCIETY WITH THE
14 CONTAINMENT OF HEALTH CARE COSTS.
15 25-4-2003. Definitions. AS USED IN THIS PART 20, UNLESS THE
16 CONTEXT OTHERWISE REQUIRES:
17 (1) "CDC" MEANS THE FEDERAL CENTERS FOR DISEASE CONTROL
18 AND PREVENTION.
19 (2) "DEPARTMENT" MEANS THE DEPARTMENT OF PUBLIC HEALTH
20 AND ENVIRONMENT.
21 (3) "HEALTH CARE PROFESSIONAL" MEANS ANY PERSON LICENSED
22 IN THIS STATE OR ANY OTHER STATE TO PRACTICE MEDICINE,
23 CHIROPRACTIC, NURSING, PHYSICAL THERAPY, PODIATRY, DENTISTRY,
24 PHARMACY, OPTOMETRY, OR OTHER HEALING ARTS. THE TERM INCLUDES
25 ANY PROFESSIONAL CORPORATION OR OTHER PROFESSIONAL ENTITY
26 COMPRISED OF SUCH HEALTH CARE PROVIDERS AS PERMITTED BY THE LAWS
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1 OF THIS STATE.
2 (4) "OSTEOPOROSIS" MEANS A BONE DISEASE CHARACTERIZED BY
3 LOW BONE MASS AND DETERIORATION OF BONE TISSUE THAT LEAVES
4 BONES FRAGILE AND SUSCEPTIBLE TO FRACTURE.
5 (5) "PROGRAM" MEANS THE OSTEOPOROSIS PREVENTION AND
6 TREATMENT EDUCATION PROGRAM CREATED IN THIS PART 20.
7 (6) "SCREENING" MEANS ADMINISTRATION OF AN EXAMINATION OR
8 TEST EXCLUSIVELY FOR THE PURPOSE OF ASCERTAINING THE EXISTENCE OF
9 ANY PHYSIOLOGICAL ABNORMALITY THAT MIGHT BE INDICATIVE OF THE
10 PRESENCE OF OSTEOPOROSIS.
11 25-4-2004. Powers and duties of the executive director -
12 osteoporosis prevention and treatment education program. (1) THE
13 EXECUTIVE DIRECTOR OF THE DEPARTMENT SHALL DESIGN AND IMPLEMENT
14 AN OSTEOPOROSIS PREVENTION AND TREATMENT EDUCATION PROGRAM TO:
15 (a) RAISE PUBLIC AWARENESS OF THE CAUSES AND NATURE OF
16 OSTEOPOROSIS, THE VALUE OF PREVENTION AND EARLY DETECTION,
17 PERSONAL RISK FACTORS, AND OPTIONS FOR DIAGNOSING AND TREATING
18 THE DISEASE. AT A MINIMUM, PUBLIC EDUCATION DESIGNED TO RAISE
19 AWARENESS OF THESE ISSUES SHALL INCLUDE:
20 (I) EMPLOYMENT OF PUBLIC COMMUNICATION STRATEGIES,
21 INCLUDING THE PRINT MEDIA, RADIO, TELEVISION, VIDEO, INTERNET, AND
22 ANY OTHER APPROPRIATE FORM OF COMMUNICATION IN ORDER TO PROVIDE
23 BASIC INFORMATION ABOUT OSTEOPOROSIS TO THE GENERAL PUBLIC AND
24 TO TARGETED AT-RISK POPULATIONS;
25 (II) COORDINATION WITH COMMUNITY-BASED ORGANIZATIONS TO
26 SPONSOR COMMUNITY FORUMS AND TO UNDERTAKE OTHER APPROPRIATE
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1 COMMUNITY OUTREACH ACTIVITIES;
2 (III) DISSEMINATION OF WRITTEN INFORMATION ABOUT
3 OSTEOPOROSIS AND PATIENT REFERRAL SERVICES AT PUBLIC EVENTS;
4 (IV) DISTRIBUTION OF INFORMATION TO THE GENERAL PUBLIC
5 THROUGH COUNTY HEALTH DEPARTMENTS, SCHOOLS, AREA AGENCIES ON
6 AGING, EMPLOYER WELLNESS PROGRAMS, PHYSICIANS, HOSPITALS AND
7 HEALTH MAINTENANCE ORGANIZATIONS, WOMEN'S GROUPS, NONPROFIT
8 ORGANIZATIONS, COMMUNITY-BASED ORGANIZATIONS, AND
9 DEPARTMENTAL REGIONAL OFFICES; AND
10 (V) PROVISION OF RELIABLE INFORMATION TO POLICYMAKERS.
11 (b) EDUCATE CONSUMERS ABOUT RISK FACTORS, APPROPRIATE
12 DIET AND EXERCISE, DIAGNOSTIC PROCEDURES AND INDICATIONS FOR USE,
13 RISKS AND BENEFITS OF DRUG THERAPIES CURRENTLY APPROVED BY THE
14 UNITED STATES FOOD AND DRUG ADMINISTRATION, ENVIRONMENTAL
15 SAFETY AND INJURY PREVENTION, AND THE AVAILABILITY OF DIAGNOSTIC,
16 TREATMENT, AND REHABILITATION SERVICES. AT A MINIMUM, CONSUMER
17 EDUCATION ON THESE ISSUES SHALL INCLUDE:
18 (I) IDENTIFICATION AND PROCUREMENT OF EDUCATIONAL
19 MATERIALS INCLUDING BROCHURES AND VIDEOTAPES PREPARED BY THE
20 CDC AND OTHER NATIONAL AND LOCAL HEALTH ASSOCIATIONS THAT
21 TRANSLATE ACCURATELY THE LATEST SCIENTIFIC INFORMATION ON
22 OSTEOPOROSIS IN EASY-TO-UNDERSTAND TERMS;
23 (II) PROVISION OF STATEWIDE INFORMATION ABOUT OSTEOPOROSIS
24 AND PATIENT REFERRAL SERVICES;
25 (III) ESTABLISHMENT OF A STATE LINK TO AN EXISTING TOLL-FREE
26 HOTLINE FOR CONSUMERS;
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1 (IV) FACILITATION OF THE DEVELOPMENT AND MAINTENANCE OF
2 OSTEOPOROSIS SUPPORT GROUPS; AND
3 (V) PRESENTATION OF WORKSHOPS AND SEMINARS FOR THE
4 GENERAL CONSUMER.
5 (c) EDUCATE HEALTH CARE PROFESSIONALS AND SERVICE
6 PROVIDERS ON THE MOST RECENT AND ACCURATE SCIENTIFIC INFORMATION
7 AND FINDINGS AVAILABLE ON OSTEOPOROSIS PREVENTION, DIAGNOSIS,
8 TREATMENT, THERAPEUTIC DECISION-MAKING, GUIDELINES FOR DETECTION
9 AND TREATMENT IN SPECIAL POPULATIONS, RISKS AND BENEFITS OF
10 MEDICATIONS, AND RESEARCH ADVANCES. AT A MINIMUM, HEALTH
11 PROFESSIONAL EDUCATION ON THESE ISSUES SHALL INCLUDE:
12 (I) IDENTIFICATION AND PROCUREMENT OF RECENT EDUCATIONAL
13 MATERIALS PREPARED BY THE CDC AND OTHER NATIONAL AND LOCAL
14 HEALTH ASSOCIATIONS FOR THE PURPOSE OF EDUCATING AND PROVIDING
15 CLINICAL APPLICATION TO HEALTH CARE PROFESSIONALS;
16 (II) BASIC INFORMATION ABOUT THE IMPORTANCE OF
17 OSTEOPOROSIS PREVENTION, EARLY DETECTION, TREATMENT, AND
18 REHABILITATION;
19 (III) PROVISION OF WORKSHOPS AND SEMINARS FOR IN-DEPTH
20 PROFESSIONAL DEVELOPMENT IN THE CARE AND MANAGEMENT OF THE
21 PATIENT WITH OSTEOPOROSIS; AND
22 (IV) PRESENTATION OF A STATEWIDE CONFERENCE ON
23 OSTEOPOROSIS AT APPROPRIATE INTERVALS.
24 (2) AFTER IMPLEMENTATION OF SUBSECTION (1) OF THIS SECTION,
25 IF FUNDING IS AVAILABLE, THE EXECUTIVE DIRECTOR OF THE DEPARTMENT
26 SHALL HAVE THE AUTHORITY TO CONDUCT A NEEDS ASSESSMENT TO
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1 IDENTIFY:
2 (a) RESEARCH BEING CONDUCTED WITHIN COLORADO;
3 (b) AVAILABLE TECHNICAL ASSISTANCE AND EDUCATIONAL
4 MATERIALS AND PROGRAMS NATIONWIDE;
5 (c) THE LEVEL OF PUBLIC AND PROFESSIONAL AWARENESS ABOUT
6 OSTEOPOROSIS;
7 (d) NEEDS OF OSTEOPOROSIS PATIENTS, THEIR FAMILIES, AND THEIR
8 CAREGIVERS;
9 (e) NEEDS OF HEALTH CARE PROFESSIONALS;
10 (f) SERVICES AVAILABLE TO THE OSTEOPOROSIS PATIENT;
11 (g) OSTEOPOROSIS TREATMENT PROGRAMS;
12 (h) OSTEOPOROSIS SUPPORT GROUPS;
13 (i) REHABILITATION SERVICES; AND
14 (j) THE AMOUNT AND LOCATION OF BONE DENSITY TESTING
15 EQUIPMENT AVAILABLE FOR USE IN THE STATE.
16 (3) BASED ON THE NEEDS ASSESSMENT FINDINGS PURSUANT TO
17 SUBSECTION (2) OF THIS SECTION, THE DEPARTMENT SHALL DEVELOP AND
18 MAINTAIN A LIST OF OSTEOPOROSIS-RELATED SERVICES AND OSTEOPOROSIS
19 HEALTH CARE PROVIDERS THAT SPECIALIZE IN THE PREVENTION,
20 DIAGNOSIS, AND TREATMENT OF OSTEOPOROSIS. THIS LIST SHALL BE
21 DISSEMINATED WITH A DESCRIPTION OF DIAGNOSTIC TESTING PROCEDURES,
22 APPROPRIATE INDICATIONS FOR THEIR USE, DRUG THERAPIES CURRENTLY
23 APPROVED BY THE UNITED STATES FOOD AND DRUG ADMINISTRATION, AND
24 A CAUTIONARY STATEMENT ABOUT THE CURRENT STATUS OF
25 OSTEOPOROSIS RESEARCH, PREVENTION, AND TREATMENT. SUCH A
26 STATEMENT SHALL ALSO INDICATE THAT THE DEPARTMENT DOES NOT
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1 LICENSE, CERTIFY, OR IN ANY WAY APPROVE OSTEOPOROSIS PROGRAMS OR
2 CENTERS IN THE STATE.
3 (4) THE DEPARTMENT IS AUTHORIZED TO ACCEPT ANY GRANT OR
4 AWARD OF FUNDS FROM THE FEDERAL GOVERNMENT OR PRIVATE SOURCES
5 FOR THE FURTHERANCE OF THE PURPOSES OF THIS PART 20.
6 25-4-2005. Osteoporosis prevention and treatment education
7 fund - creation. (1) THERE IS HEREBY ESTABLISHED IN THE STATE
8 TREASURY A FUND TO BE KNOWN AS THE OSTEOPOROSIS PREVENTION AND
9 TREATMENT EDUCATION FUND, REFERRED TO IN THIS SECTION AS THE
10 "FUND", WHICH FUND SHALL BE SUBJECT TO ANNUAL APPROPRIATION TO
11 THE DEPARTMENT BY THE GENERAL ASSEMBLY FOR THE PURPOSES OF THIS
12 PART 20. THE FUND SHALL BE CREDITED WITH SUCH APPROPRIATIONS AS
13 THE GENERAL ASSEMBLY MAY MAKE FROM THE GENERAL FUND FOR THIS
14 PROGRAM, AS WELL AS ANY GIFTS, GRANTS, OR AWARDS RECEIVED
15 PURSUANT TO SECTION 25-4-2004 (4). IN ACCORDANCE WITH SECTION
16 24-36-114, C.R.S., ALL INTEREST DERIVED FROM THE DEPOSIT AND
17 INVESTMENT OF THIS FUND SHALL BE CREDITED TO THE GENERAL FUND.
18 (2) ALL MONEYS CREDITED TO THE OSTEOPOROSIS PREVENTION
19 AND TREATMENT EDUCATION FUND WHICH ARE NOT EXPENDED DURING
20 THE FISCAL YEAR SHALL BE RETAINED IN THE FUND FOR PURPOSES OF THIS
21 PART 20 AND SHALL NOT BE CREDITED OR TRANSFERRED TO THE GENERAL
22 FUND OR ANY OTHER FUND.
23 SECTION 2. Effective date. This act shall take effect at 12:01
24 a.m. on the day following the expiration of the ninety-day period after
25 final adjournment of the general assembly that is allowed for submitting
26 a referendum petition pursuant to article V, section 1 (3) of the state
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1 constitution; except that, if a referendum petition is filed against this act
2 or an item, section, or part of this act within such period, then the act,
3 item, section, or part, if approved by the people, shall take effect on the
4 date of the official declaration of the vote thereon by proclamation of the
5 governor.