Critical Access Hospital Licensure - SB24-121 - Comment Reminder

 

To: CAHs, hospitals, and all stakeholders interested in SB24-121 From: HFEMSD As required by SB24-121, federally-designated critical access hospitals subject to 42 CFR 485, Subpart F will no longer hold general hospital licenses starting on January 1, 2026. Instead, these hospitals will be required to hold a new critical access hospital license.  Thank you to everyone who participated in stakeholder meetings related to SB24-121. Through meetings held from July 2024 through September 2024, the Department created a draft critical access hospital licensing chapter, 6 CCR 1011-1, Chapter 16, in conjunction with stakeholders. As discussed at the September meeting, this stakeholder process has been altered as a result of stakeholder feedback. The September meeting was our last scheduled meeting to discuss the draft of Chapter 16.  Going forward, the Department will continue to take written comment only. Comments may be submitted via the comment form or send an email to Ash Jackson at ash.jackson@state.co.us. The draft Chapter 16 is available on the Division’s public google folder for this project. All comments and questions regarding the new licensing chapter to implement SB24-121 are welcome. The Department encourages stakeholders to review the draft of Chapter 16 and submit any and all feedback. Feedback from stakeholders is critical to the success of any stakeholder process and we deeply value your input. The written comment form will be available until April 16, 2025, when the Department anticipates that it will request a rulemaking hearing with the Board of Health. If you would like to receive future communication regarding the critical access hospital licensure stakeholder process, please sign-up for the interested parties list to receive email notifications directly to your inbox.  If you have any questions or comments, feel free to contact Ash Jackson at ash.jackson@state.co.us, or Alexandra Haas, at alexandra.haas@state.co.us. .

Critical Access Hospital Licensure - SB24-121

 

To: CAHs and all stakeholders interested in SB24-121 From: HFEMSD You are invited to take part in the stakeholder process to create a new license category for critical access hospitals as required by SB24-121, a law passed by the Colorado Legislature in the 2024 session. Federally-designated critical access hospitals subject to 42 CFR 485, Subpart F, will no longer hold a general hospital license to operate, instead, they will be required to hold a new critical access hospital license type on July 1, 2026. Please note that federal requirements for critical access designation remain the same. As part of this stakeholder process, the Department will be creating a separate licensing chapter for critical access hospitals.  Stakeholder meetings will take place beginning July 24, 2024 and concluding in April 2025. Meetings will be on the fourth Wednesday of the month from 1:00 - 3:00 pm follows: All stakeholder meetings are open to the public and all are welcome to attend and participate. Meetings will be held in hybrid format with an option to attend either in-person, or remotely, via Zoom, to ensure equal access for participation, regardless of geographic location of the attendee.  Details regarding the stakeholder process, including meeting documents, agendas, proposed rule language, presentations, etc., will be available in the public meeting folder. Agendas and proposed rule language will be posted no later than a week in advance of each meeting.  If you would like to receive communication regarding the critical access licensure stakeholder process, please sign-up for the interested parties list to receive email notifications directly to your inbox. Updates and meeting notices will also be sent roughly two weeks in advance of each meeting through the Department’s health facility portal messaging system. If you have any questions or comments prior to the meeting, feel free to contact Ash Jackson at ash.jackson@state.co.us, or Alexandra Haas, at alexandra.haas@state.co.us.  .

9/26 Stakeholder meeting in regards to “Patients’ Right to Know” Act, or HB23-1218

 

To: All Stakeholders interested in regulations related to “Patients’ Right to Know” Act, or HB23-1218 From: HFEMSD You are invited to participate in the stakeholder process regarding The “Patients’ Right to Know” Act, or HB23-1218 is a law passed by the Colorado Legislature in the 2023 session. This new law requires hospitals, rehabilitation hospitals, freestanding emergency departments, and licensed community clinics to make publicly available a list of the health care services which are generally available or subject to significant restriction specifically relating to health care in three areas: Reproductive health-care services; LGBTQ health-care services; and End-of-life health-care services. In response to the new law the Division will develop, in collaboration with stakeholders, a “Service Availability Form.” Once the form itself is developed, the Division will work to establish rules which bring the law into the pertinent health facility licensing chapters. Once the form is finalized and published, the affected health facilities will be required to provide this form to patients, members of the public, and the Department for public display. For more information, please see the whitepaper here.  Our first monthly meeting will be Tuesday, September 26th, 2023, from 12:30 pm to 3:30 pm, and on the fourth Tuesday of the month thereafter until the process concludes in spring 2024. Zoom Meeting Information  https://us02web.zoom.us/j/84947474990?pwd=ZHJzdm05ZjZPZTBKb2laUjJiSWowUT09 Meeting ID: 849 4747 4990 Passcode: 002226 Notice of each meeting will be provided to facilities through the Division’s portal messaging system roughly two weeks in advance of each meeting. Notice will also be emailed directly to all individuals who sign up to receive such messages. Please sign up here. Please feel free to share this link with other interested parties. All who are interested are welcome to attend and participate. Meeting documents, including agendas, proposed rule language, presentations, etc., will be posted to the public meeting drive no later than a week before each meeting.  If you have any questions or comments prior to the meeting, feel free to contact Ash Jackson at ash.jackson@state.co.us, or Alexandra Haas, at alexandra.haas@state.co.us. 

Infection Control in Critical Access Hospitals

 

To: Critical Access Hospitals From: Pamela Fricke  CDPHE HAI/AR Program My name is Pamela Fricke, and I am the Field Infection Preventionist (IP) in the Healthcare Associated Infection and Antimicrobial Resistance (HAI/AR) Program at Colorado Department of Public Health and Environment (CDPHE). I am writing to you to let you know about a new infection prevention initiative we are launching for critical access hospitals.  I am reaching out today to introduce myself and the HAI/AR Program. The HAI/AR Program exists to prevent healthcare-associated infections and control the spread of emerging antimicrobial-resistant threats in all healthcare settings in Colorado through surveillance, containment and response, infection prevention, and antimicrobial stewardship. We serve as subject matter experts (SMEs), using best practices and evidence-based recommendations to guide mitigation and prevention efforts, provide education, and respond to current HAI/AR events. Our work often includes consultation and on-site infection control assessments in order to better understand facility processes, transmission threats, and guide mitigation.  Starting September 1st, 2023, we will conduct proactive infection prevention assessments in critical access hospitals. The purpose of the assessments will be to support best practices for infection prevention as part of a statewide quality improvement initiative. Proactive infection control assessments are distinct from response-driven assessments. Prevention-based infection control assessments are intended to provide feedback on infection control policies and practices before a problem is identified to help improve healthcare programs. These assessments are known as ICARs (Infection Control Assessment and Response surveys) and will require direct in-person observation and the use of a structured form for data collection Infection Control Assessment Tools | HAI | CDC.  The infection prevention assessments will focus on core infection prevention practices. Depending on the setting, we will assess practices for sterile instrument reprocessing, injection safety, and prevention of catheter-associated urinary tract infections (CAUTI), central line-associated bloodstream infections (CLABSI), and ventilator-associated events (VAE). We will prioritize assistance to facilities that offer on-site hemodialysis. Assessments will generally consist of a six-hour visit (at minimum) that will be scheduled ahead of time at the convenience of the facility. An infection preventionist from the HAI/AR Program will accompany facility staff to conduct an in-depth review that will include direct observation of infection prevention practices related to patient care. At the end of the assessment, we will discuss our immediate findings with facility staff. Following the visit, we will provide a written summary of findings with recommendations for improvement and additional resources to guide quality improvement and priorities for mitigation. Participation is voluntary and highly encouraged. The site visit is not a regulatory visit and the purpose is not punitive. Rather, the purpose is to support and improve infection control practices and to guide education and training. The HAI/AR Program supports efforts aimed at improving healthcare practices in Colorado. Either myself or a team member will be reaching out to facilities individually for participation. When contacted, we encourage facilities to take advantage of this opportunity. In the meantime, I’d like to share some great resources specific to infection prevention and control (IPC): CDC/STRIVE Infection Control Training: Provides training courses, including those specific to core IPC practices (hand hygiene, PPE, environmental cleaning, etc.) and high-risk care activities (e.g., CAUTI, CLABSI, etc.). Additional IPC Training for Healthcare Professionals can be found here. CDCs Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings: Guidance that is similarly separated by topic/care activity, providing healthcare facilities with current evidence-based recommendations.  Continuing education and IPC training specific to setting types can be found here. Project First Line: CDC’s National Training Collaborative for Healthcare Infection Control. More information on Infection Control can be found here. Should you have any questions, want to schedule your assessment in advance, or need other HAI/AR support, please email me directly at pamela.fricke@state.co.us. We look forward to collaborating with you and your facility. You can view the full letter here.

Switchback Team Resilience, Recovery and Development Training Program

 

To: Local Public Health Agencies or Medical Organizations (e.g. critical access hospitals, clinical practices, FQHC) without financial resources necessary to pay for similar experiences. From: CO-CARES Team (Colorado Alliance for Resilient & Equitable Systems) & Switchback Institute Switchback Institute serves those who serve others. It is dedicated to individuals, teams, and organizations doing high-impact, high-stakes work. Switchback champions individuals, teams, and organizational leadership in engineering environments that promote individual and team resilience, connectedness, and effectiveness. Workshops are designed to be interactive, and participant-centered. They are customized to meet the needs of individuals and achieve agency-identified outcomes. Group sessions are no-fault, strengths-based, collaborative, and fun! The Team Resilience, Recovery, and Development Training Program includes participation in a recovery retreat, an assessment of team intelligence leading to a team development plan, and team coaching to achieve self-identified goals. By the end of our time together you will have the tools needed to sustain consistent professional growth and resilience both individually and collectively. Most importantly, we want your teams to be reunited with the passion that took them into the healthcare field. The Team Resilience, Recovery, and Development Training Program aims to provide resources, training, and coaching to individuals/teams from the public health and medical care workforce to respond to and grow from the challenges faced currently and over the last 3 years. We will accomplish this in partnership with selected teams through the following activities: Retreat 1: A day-long Resilience and Recovery retreat focused on understanding challenges, and providing support as well as tools to process and grow as individuals and as a team. Inter-stage period: 2-3 virtual team coaching sessions to support ongoing agendas set by team. Completing Team Emotional and Social Intelligence (TESI) assessment that describes a team’s current effectiveness in 7 domains: team identity, motivation, communication, positive mood, stress tolerance, social awareness, and conflict management. Retreat 2: A half-day retreat to debrief TESI assessment, prioritize areas for development, and identify ongoing activities to meet development goals. Inter-stage period: 2-3 virtual team coaching sessions to support ongoing development agendas.  Closing Retreat 3: To celebrate accomplishments and commit to the ongoing development. Visit the CO-CARES page at Switchback Institute to learn more and submit your letter of interest for the program.

Join NHSN AUR Module Colorado Group Office Hour on 8/02/2023

 

Please join us for our National Healthcare Safety Network (NHSN) AUR Module Colorado Group Office Hour webinar on Wednesday, August 2, 2023 from 1:00 – 1:45 MST. The Colorado Department of Public Health and Environment (CDPHE), Healthcare-Associated Infections and Antimicrobial Resistance Program, offers NHSN Colorado user group office hours quarterly via webinar to provide updates and training related to the NHSN Antimicrobial Use and Resistance Module (AUR). Currently, general NHSN office hours are paused and this session will only discuss the AUR module. Staff will provide a brief presentation followed by a question and answer session. The office hours are not required but are an opportunity for your facility to ask questions about the NHSN AUR Module. If you need assistance, please help us maximize the NHSN office hours, and feel free to stop by for any amount of time you like. Intended audience: Acute Care Hospitals, Critical Access Hospitals, and Long-Term Acute Care Hospitals reporting to NHSN AUR Module. Agenda for August 2nd office hour: Antimicrobial Stewardship and the NHSN Antimicrobial Use and Resistance (AUR) Module. Antibiotic Use Feedback Reports. Discussion. Please register in advance for this webinar: https://zoom.us/meeting/register/tJwufumprjwuE9FiInm0rrDbYveTEw9Not95 After registering, you will receive a confirmation email containing information about joining the webinar. Please let us know if there are any specific topics or content you would like to see in our next office hour webinar in Fall 2023. For comments or questions, please contact Lauren Biehle at lauren.biehle@state.co.us.

Switchback Team Resilience, Recovery and Development Training Program

 

To: Local Public Health Agencies or Medical Organizations (e.g. critical access hospitals, clinical practices, FQHC) without financial resources necessary to pay for similar experiences. From: CO-CARES Team (Colorado Alliance for Resilient & Equitable Systems) & Switchback Institute Switchback Institute serves those who serve others. It is dedicated to individuals, teams, and organizations doing high impact, high stakes work. Switchback champions individuals, teams, and organizational leadership in engineering environments that promote individual and team resilience, connectedness, and effectiveness. Workshops are designed to be interactive, and participant centered. They are customized to meet the needs of individuals and achieve agency-identified outcomes. Group sessions are no-fault, strengths-based, collaborative, and fun! The Team Resilience, Recovery and Development Training Program includes participation in a recovery retreat, an assessment of team intelligence leading to a team development plan, and team coaching to achieve self-identified goals. By the end of our time together you will have tools needed to sustain consistent professional growth and resilience both individually and collectively. Most importantly, we want your teams to be reunited with the passion that took them into the healthcare field. The Team Resilience, Recovery and Development Training Program aims to provide resources, training, and coaching to individuals/teams from the public health and medical care workforce to respond to and grow from the challenges faced currently and over the last 3 years. We will accomplish this in partnership with selected teams through the following activities: Retreat 1: A day-long Resilience and Recovery retreat focused on understanding challenges, providing support as well as tool to process and grow as individuals and as a team. Inter-stage period: 2-3 virtual team coaching sessions to support ongoing agendas set by the team. Completing Team Emotional and Social Intelligence (TESI) assessment that describes a team’s current effectiveness in 7 domains: team identity, motivation, communication, positive mood, stress tolerance, social awareness, and conflict management. Retreat 2: A half-day retreat to debrief the TESI assessment, prioritize areas for development, and identify ongoing activities to meet development goals. Inter-stage period: 2-3 virtual team coaching sessions to support ongoing development agendas. Closing Retreat 3: To celebrate accomplishments and commit to the ongoing development. Visit the CO-CARES page at Switchback Institute to learn more and submit your letter of interest for the program.

Proposed Changes to 6 CCR 1009-1

 

To: Healthcare Stakeholders    From: Chris Czaja, Medical Epidemiologist, Program Manager    Please see the attached information. Announcing another opportunity to review and provide feedback to the proposed Board of Health rules for communicable disease control.  Memo 6 CCR1009-1 Draft rule text only 6 CCR 1009-1

Chapter 4, Hospitals Rule Revision Stakeholder Meeting Information – March 21, 2023 – First Notice

 

To: All Stakeholders From: HFEMSD The Department is continuing its stakeholder process for the 6 CCR 1011-1 Chapter 4, Hospitals rule revision pertaining to House Bill 22-1401. This new law seeks to ensure hospitals are prepared for a public health emergency or staffing shortage through the implementation of a robust nurse staffing committee and plan, comprehensive emergency management, and reporting on staffed-bed capacity to the Department. This month’s meeting topics include a review of changes made since last meeting as well as a final review of all parts of Chapter 4 being impacted by House Bill 22-1401. Meetings are open to the public. This meeting will be held remotely via Zoom only. When: Tuesday, March 21, 2023 from 12:30 – 3:30 p.m. Remote access through Zoom: https://us05web.zoom.us/j/81827983761?pwd=eTVuVWRVVWZSaVVwMlpEN0ZSRVRKQT09 Audio line: 1-719-359-4580 Meeting ID: 818 2798 3761 The stakeholder meeting schedule and detailed information regarding the rule revision process can be accessed at this link. We recommend that you return to this site on the day of the meeting to check for additional or revised meeting materials. To sign up to receive email communications regarding this rule revision, please add your contact information to the interested stakeholder list. Please submit any questions related to House Bill 22-1401 and subsequent rulemaking(s) here. 

HFEMSD Survey of Colorado Rural & Critical Access Hospitals re: CMS Rural Emergency Hospital (REH) Program – Second Request

 

To: Facility Administrators – Colorado Rural & Critical Access Hospitals From: HFEMSD Greetings Rural & Critical Access Hospital Provider Facilities; Second request for Survey Response. If your facility has already responded, thank you, and please disregard this request. The Department is aware of recent CMS rulemaking regarding the Rural Emergency Hospitals (REH) program. This program will allow Critical Access Hospitals and specifically defined Rural Hospitals the option to convert to a Rural Emergency Hospital (REH), and be subject to those new Conditions of Participation through CMS. Our understanding is this option will become available to applicant facilities in 2023. More information about this CMS program can be found on the CMS website news release. The Division is looking to better understand the intentions of eligible Colorado hospitals in response to this new program. To accomplish this, we have created a very short survey, which should take less than 5 minutes to complete: Survey Link. A response to this survey is only requested of those eligible facilities: Critical Access Hospitals and specifically defined Rural Hospitals. Thank you in advance for your time in providing feedback on this survey.

HEALTH ALERT NETWORK BROADCAST

To: All Providers

From: Colorado Department of Public Health and Environment

HEALTH ALERT NETWORK (HAN) BROADCAST
Vaping cartridges potentially related to the severe acute pulmonary disease outbreak

- As of August 19th, more than 120 cases of severe acute pulmonary disease hospitalizations and respiratory support among previously healthy adults have been reported in at least 15 states. To date, one suspect case has been reported in Colorado.
- A reported common exposure among these patients is that they have been vaporizing or dabbing with cartridges or products, some containing cannabis (THC) or cannabindiol (CBD) oils, nicotine, synthetic cannabinoids, or a combination of these. At this time, no infectious cause has been identified.
Detailed background information, case definition and recommendations for providers is included on the HAN notice which accompanies this message.
- Clinicians and local health departments who become aware of cases similar to those described in the HAN notice are asked to report them to the Colorado Department of Public Health and Environment's (CDPHE) Disease Reporting Line: 303-692-2700 or 303-370-9395 (after hours). 

HAN Advisory - Vaping cartridges potentially related to the severe acute pulmonary disease outbreak

Emergency Preparedness- Updates to Appendix Z of the State Operations Manual (SOM)

To: Administrators and Directors,

The Centers for Medicare and Medicaid Services (CMS)) has made revisions, effective immediately, to Appendix Z of the State Operations Manual (SOM), which is the Interpretive Guidance for Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers. These are not changing any requirements, but just adding some clarifications. You can view or download the revised Appendix Z at: https://drive.google.com/file/d/1yEoPpmWUOGHXAoeE3lgKnCEON_RN_W9I/view?usp=sharing 

Changes are highlighted in red italics.

The main revisions include: 

- (Definitions) CMS is adding "emerging infectious diseases" or "EIDs" to the current definition of all-hazards approach, after determining that is critical for facilities to include planning for infectious diseases within their emergency preparedness programs. Examples of EIDs include Influenza, Ebola Virus, Zika and others.

- (Tag E-0004)It added EIDs to the list of hazards that facilities should include as their conduct their risk assessments. 

- (Tags E-0015 and E-0042) Alternate Source Power and Emergency Power Standby Systems, clarifies that facilities should use the most appropriate energy source or electrical system based on their facility's risk assessment and as required by existing regulations or state requirements. Whatever alternate source is selected must meet local and state laws, manufacturer requirements and Life Safety Code requirements. If a facility chooses a portable and mobile generator (rather than permanent generator), then the LSC provisions, e.g. generator testing/maintenance/etc under NFPA guidelines would not apply, except for NFPA 70-National Electrical Code. 

These updates are NOT related to the proposed rule changes published in the Federal Register September 20, 2018, related to reducing the regulatory burden on facilities in meeting the emergency preparedness requirements. We still await guidance on the outcome of that proposed rule. 

If you have questions regarding the emergency preparedness rule, please contact SCGEmergencyPrep@cms.hhs.gov or Melanie Roth at CDPHE, Melanie.Roth-Lawson@state.co.us. 

Join NHSN Colorado Group Monthly Webinar on 12/5/2018

The Colorado Department of Public Health and Environment is hosting a monthly NHSN Colorado user group webinar to provide updates and training related to NSHN. The purpose of the monthly webinar is to provide updates and training on various topics to the licensed facilities in Colorado who report in NHSN. Immediately following the webinar, CDPHE staff will be available to assist new users in NHSN set-up, enrollment and other facility specific questions. 

The monthly webinar will be held on the first Wednesday of every month from 1p.m. - 1:30 p.m. (MST). 

Please join us at our next monthly webinar on December 5, 2018. Go tohttps://stateofcolorado.centurylinkccc.com/CenturylinkWeb/LyndaSaignaphone to join the webinar.

Agenda:
- Updates and announcements
- Changes to Reporting Healthcare Personnel Influenza Vaccination Data
- Dialysis Validation Findings and ESRD Reports 
- Q&A

Go to https://www.colorado.gov/pacific/cdphe/hai-professionals to view additional training opportunities provided by the Healthcare Associated Infection program. 

For questions, please contact Lynda Saignaphone at 303-692-2923, lynda.saignaphone@state.co.us.

Proposed Rule to Revise Emergency Preparedness Requirements

To: Administrators

From: Greg Schlosser, Branch Chief, Education & Technical Assistance Branch

On September 20, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule in the Federal Register to change the emergency preparedness requirements to reduce regulations that are burdensome, and to increase provider flexibility to focus on delivering high-quality healthcare. View the proposed rule here 

CMS proposes to:
- Change the review of the emergency program to every TWO years, instead of the current requirement of every year. 
- Require that facilities provide training biennially (every two years), after facilities conduct initial training for their emergency program. CMS will require additional training when the emergency plan is significantly outdated. 
- Change testing requirements. For inpatient providers, CMS will expand the types of acceptable testing exercises that may be conducted, and for outpatient providers, CMS proposes only one testing exercise required annually. 
- Eliminate the requirement that facilities document efforts to contact local, tribal, regional, State, and Federal emergency preparedness officials, and that facilities document their participation in collaborative and cooperative planning efforts. Only the documentation requirements would be eliminated. Facilities would still be required to include a process for cooperation and collaboration with these entities to maintain an integrated response during a disaster or emergency situation

Comments to CMS on the proposed rule, Medicare and Medicaid Programs, Regulatory Provisions to Promote Program Efficiency, Transparency and Burden Reduction must be received no later than 5 p.m. on November 19, 2018. When commenting, refer to file code CMS-3346-P. Comments can be submitted in one of the following ways: 
- Electronically to http://www.regulations.gov. Follow the "Submit a comment" instructions.
- By regular mail to CMS, Department of Health and Human Services, Attention: CMS-3346-P, P.O. Box 8010, Baltimore, MD 21244-1810.
- By express or overnight mail to CMS, Department of Health and Human Services, Attention: CMS-3346-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.

For further information, contact Alpha-Banu Wilson, (410) 786-8687. CMS has also included a subject matter expert under the "Provisions of the Proposed Rule" section for each provision set out in the proposed rule.

Tuberculosis for Health Care Workers – Glenwood, Colorado

To: Medical Directors, Directors of Nursing, Health Care Workers and Local Public Health Agencies

From: Colorado Department of Public Health and Environment

SPACE STILL AVAILABLE!!!

The Colorado Department of Public Health and Environment is partnering with Mesa and Garfield County to host a full day training on Tuberculosis (TB). This free training will increase your understanding of and comfort with managing TB by providing information and skill building activities on the following topics:

- Introduction to TB 
- Diagnosis and Treatment for TB infection and disease
- TB case management 
- TB contact investigation

We invite nurses and other interested personnel who provide health services to patients with or at risk for tuberculosis in Colorado to attend the two day training, TB for Health Care Workers on September 24th from 8:30 am - 4:30 pm and 25th from 8:30-12:30. The first day will be held at the Glenwood Springs Library and the second day will be held at Colorado Mountain College, Glenwood Springs.

The last day to register is September 16th, 2018.

For more details and to register go to: http://www.train.org/colorado/home and search for course #1080090 under the course catalog tab.

Registration cost is FREE
Space is very limited so please register early. 

For more information please contact Tavia Mirassou-Wolf at 303-692-2638 or Tavia.mirassou-wolf@state.co.us with any questions. 

Tuberculosis for Health Care Workers – Montrose, Colorado

To: Medical Directors, Directors of Nursing, Health Care Workers and Local Public Health Agencies

From: Colorado Department of Public Health and Environment

SPACE STILL AVAILABLE!!!

The Colorado Department of Public Health and Environment is partnering with the Montrose County Health and Human Services to host a full day training on Tuberculosis (TB). This free training will increase your understanding of and comfort with managing TB by providing information and skill building activities on the following topics:

- Introduction to TB 
- Diagnosis and Treatment for TB infection and disease
- TB case management 
- TB contact investigation

We invite nurses and other interested personnel who provide health services to patients with or at risk for tuberculosis in Colorado to attend the TB for Health Care Workers training on September 27th from 8:30 am - 4:30 pm in the Board Room at the Montrose County Health and Human Services (1845 S Townsend Avenue, Montrose, Colorado 81401). 

The last day to register is September 16th, 2018!

For more details and to register go to: http://www.train.org/colorado/home and search for course #1071602 under the course catalog tab.

Registration cost is FREE
Space is very limited so please register early. 

For more information please contact Tavia Mirassou-Wolf at 303-692-2638 or Tavia.mirassou-wolf@state.co.us with any questions. 

TB Update and Skin Testing Practicum for Health Care Providers

SPACE STILL AVAILABLE!!!

The Denver Metro TB Clinic invite nurses and other health care providers from home health agencies, clinics, and long-term care facilities to attend a tuberculosis update and skin testing practicum on Thursday, October 4th, 2018 from 12:30pm - 5:00pm in the Public Health Auditorium, 2nd floor at Denver Public Health (605 Bannock Street, Denver). 

Course Objectives are: 
- Express an increased and updated knowledge of TB infection and TB disease
- Demonstrate their skill in placing and reading the TST

For more details and a link to register go to: http://denverpublichealth.org/home/clinics-and-services/tuberculosis-clinic/for-providers/tb-education 

Registration cost is $60 
Space is very limited so please register early. 

For more information please contact Carolyn Bargman at 303-602-7243 cbargman@dhha.org with any questions. 

HFEMSD Chapter 2 rule revision

Dear Stakeholder:

In keeping with the statutory requirement to routinely review and update our regulations, the department is beginning the stakeholder process this August for the regulatory review of 6 CCR 1011-1, Chapter 2 - General Licensure Standards. This chapter, which can be accessed at http://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=6751, covers a wide range of topics, from licensure renewal to occurrence reporting to flu immunizations of health care workers.

HFEMSD Chapter 2 Rule Revision group

Meeting agendas, handouts, and resources can be found at https://www.colorado.gov/pacific/cdphe/hb-1294-stakeholder-forum

If you have questions, please contact Alexandra Haas at Alexandra.haas@state.co.us or Thom Miller at thomasl.miller@state.co.us

Updated Communicable Disease Reportable Conditions List – Effective July 15, 2018

The Colorado Board of Health updates the Communicable Disease regulations (6 CCR 1009-1) and Environmental Health regulations (6 CCR 1009-1) periodically to reflect changes in public health priorities for disease surveillance. Reportable conditions may be added, removed or modified. The communicable disease regulations have been revised this year and additions and modifications became effective on July 15, 2018. 

Major changes include:
- Addition of all suspect Candida auris statewide
- Addition Extended-Spectrum Beta-Lactamase (ESBL)-producing Enterobacteriaceae (E.coli and Klebsiella 
  species) for Boulder County only. 
- Reporting of carbapenem-resistant Enterobacteriaceae has been modified to include six additional genera.
- Suspect outbreaks are now reportable by laboratories as well as healthcare providers.
- Catheter-associated urinary tract infections (CAUTIs) and methicillin-resistant Staphylococcus aureus 
  (MRSA) bacteremia by certain healthcare facilities has also been added. 

This change requires facilities that are already reporting these data to the National Healthcare Safety Network (NHSN) to confer rights to CDPHE to allow the Department to have access to these data. 

A complete and updated list of reportable conditions with information on how to report and a list of conditions to be reported through the National Healthcare Safety Network (NSHN) are attached to this message and can be accessed here: https://www.colorado.gov/pacific/cdphe/report-a-disease 

For further information:

For concerns or questions about disease reporting, please contact the CDPHE Integrated Disease Reporting Program (IDRP) staff at 303-692-2700 or email cdphe_idrp@state.co.us. 

Colorado Reportable Conditions effective July 15, 2018

Reportable Conditions Posters