PUBLIC HEALTH ORDER 20-38

LIMITED COVID-19 RESTRICTIONS

April 15, 2021

PURPOSE OF THE ORDER

I am issuing this Public Health Order (PHO or Order) in response to the existence of thousands
of confirmed and presumptive cases of Coronavirus disease 2019 (COVID-19) and related deaths
across the State of Colorado. This Order supersedes PHO 20-36 COVID-19 Dial and PHO
20-29 Voluntary and Elective Surgeries and Procedures, and implements reduced restrictions for
individuals, businesses and activities, as well as reporting requirements for hospitals, to prevent
the spread of COVID-19 further in Colorado.

FINDINGS

1. Governor Polis issued Executive Order D 2020 003 on March 11, 2020, declaring a
disaster emergency in Colorado due to the presence of COVID-19. Since that time, the Governor
has taken numerous steps to implement measures to mitigate the spread of disease within
Colorado, and has further required that several public health orders be issued to implement his
orders.

2. I have issued public health orders pertaining to the limitation of visitors and nonessential
individuals in skilled nursing facilities, intermediate care facilities, and assisted living
residences; defining the terms of the Governor’s Stay at Home, Safer at Home, and Protect
our Neighbors requirements as well as Critical Business designations; requiring hospitals to
report information relevant to the COVID-19 response; and requiring the wearing of face
coverings in the workplace and urging their use in public. These measures all act in concert to
reduce the exposure of individuals to disease, and are necessary steps to protect the health and
welfare of the public. Additionally, in reducing the spread of disease, these requirements help to
preserve the medical resources needed for those in our communities who fall ill and require
medical treatment, thus protecting both the ill patients and the healthcare workers who
courageously continue to treat patients.

3. As of April 14, 2021, there have been 485,318 known cases of COVID-19 in Colorado,
26,661 Coloradans have been hospitalized and 6,319 Coloradans have died from COVID-19.
Multiple sources of data show that COVID-19 transmission and the use of the hospital system
due to COVID-19 have leveled off in Colorado.
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4. With the rescission of PHO 20-36 COVID-19 Dial, but the pandemic ongoing, it remains
critical for individuals, communities, businesses, and governments to remain vigilant regarding
the spread of COVID-19. Individuals are encouraged to remain at least 6 feet away from
non-household contacts, wash their hands, and wear a face covering to reduce the likelihood of
disease transmission. As we continue to combat COVID-19 in our communities, continuing
some limited requirements to mitigate disease spread remain appropriate.

5. The following additional public health orders remain in effect:

a. PHO 20-20 Requirements For Colorado Skilled Nursing Facilities, Assisted

Living Residences, Intermediate Care Facilities, And Group Homes For
COVID-19 Prevention And Response;
b. PHO 20-33 Laboratory Data Reporting for COVID-19; and
c. PHO 20-37 Vaccine Access And Data Reporting For COVID-19.

INTENT

This Order includes limited requirements for individuals and businesses to mitigate the spread of
COVID-19 in Colorado. The Order incorporates the requirements of Executive Order D 2020
138, as amended and extended by Executive Order D 2020 164, D 2020 190, D 2020 219, D
2020 237,D 2020 245, D 2020 276, D 2020 281, D 2021 007, D 2021 035, D 2021 056, and D
2021 079 concerning face coverings. Additionally, the Order maintains some restrictions on
certain activities while we continue to take steps to limit the spread of COVID-19 in Colorado,
and includes a provision that authorizes CDPHE to require a county to comply with additional
restrictions should certain metrics be met. The Order also includes hospital reporting
requirements regarding bed capacity to provide the State with critical information to assess the
status of the COVID-19 pandemic relative to the statewide capacity to provide necessary medical
care and services to Coloradans.

ORDER

This Order supersedes and replaces Public Health Orders 20-29 and 20-36, as amended, effective
at 12:01 AM on Friday, April 16, 2021.

I. COVID-19 RESTRICTIONS

A. FACE COVERINGS
1. Face coverings are required pursuant to Executive Order D 2020 138, as
amended and extended by Executive Order D 2020 164, D 2020 190, D 2020

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219, D 2020 237,D 2020 245, D 2020 276, D 2020 281, D 2021 007, D 2021 035,
D 2021 056, and D 2021 079, for all individuals in the following settings:
a. Preschool through grade 12 schools (including extracurricular activities),
child care centers and services, and indoor children’s camps;
b. Public areas of state government facilities, and areas in state government
facilities where members of the public come into contact with state
government employees;
c. Congregate care facilities, including nursing facilities, assisted living
residences, intermediate care facilities, and group homes;
d. Prisons;
e. Jails;
f. Emergency medical and other healthcare settings (including hospitals,
ambulance service centers, urgent care centers, non-ambulatory surgical
structures, clinics, doctors’ offices, and non-urgent care medical
structures);
g. Personal services; and
h. Limited healthcare settings.
2. For counties with a one week disease incidence rate in excess of 35 per 100,000,
face coverings are also required pursuant to Executive Order D 2020 138, as
amended and extended, in a Public Indoor Space, as defined in Executive Order
D 2020 138, as amended and extended, where 10 or more unvaccinated
individuals or individuals of unknown vaccination status are present.
3. Exceptions to the face covering requirements include
a. individuals 10 years of age or younger,
b. individuals who cannot medically tolerate a face covering, and
c. individuals participating in one of the activities described in Section II.I of
Executive Order D 2020 138, as amended and extended.
4. Face coverings may be removed in a school classroom setting for the limited
purpose of playing an instrument that cannot otherwise be played while wearing a
face covering.
5. Nothing in this Order changes or abrogates the Centers for Disease Control and
Prevention’s (CDC) Order on January 29, 2021, requiring the wearing of masks
by travelers to prevent the spread of COVID-19. All Coloradans must abide by
the CDC’s Order, which can be found at
https://www.cdc.gov/quarantine/masks/mask-travel-guidance.html.

B. ALL BUSINESSES AND GOVERNMENT ENTITIES. All businesses and

government entities shall comply with the requirements in this Section I.B.
1. Work Accommodations. Employers are strongly encouraged to provide
reasonable work accommodations, including accommodations under the

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Americans with Disabilities Act (ADA) for individuals who cannot obtain access
to COVID-19 vaccine or who for medical or other legal reasons cannot take a
COVID-19 vaccine.

2. Face coverings. All employers must implement the face covering requirements in
Executive Order D 2020 138, as amended and extended, as applicable.

3. Disease mitigation practices. Employers and sole proprietors are strongly

encouraged to follow the best practices for disease mitigation found in CDPHE
Guidance.

C. MASS INDOOR GATHERINGS

1. In addition to the requirements in Section I.B of this Order, the requirements in

this Section I.C apply to Mass Indoor Gatherings.

2. When more than 100 people are gathered in a room in a Public Indoor Space, the
setting may operate at 100% capacity not to exceed 500 people, with 6 feet
distancing required between parties of unvaccinated people or when vaccination
status is unknown. Existing approved variances remain in effect, including 5 Star
Program approvals granted by a county. Venues may apply to their local public
health agency for a variance to exceed 500 people, to be finally approved by
CDPHE. These requirements do not apply to the following sectors:
a. Places of worship and associated ceremonies,
b. Retail services,
c. Restaurants that have sit-down dining and do not have unseated areas
where 100 or more people could gather (such as dance floors or common
gathering areas), and
d. School proms and graduations that wish to exceed these thresholds shall
be subject to review and approval by local public health agencies in
accordance with CDPHE prom and graduation guidance.

3. Face coverings are required for all individuals in a Mass Indoor Gathering,
except in the following circumstances:
a. individuals 10 years of age or younger,
b. individuals who cannot medically tolerate a face covering, and
c. individuals participating in one of the activities described in Section II.I of
Executive Order D 2020 138, as amended and extended.

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D. OUTDOOR EVENTS

1. Outdoor ticketed, seated event venues in excess of 30,000 square feet

require CDPHE approval, in consultation with the local public health
agency. Existing approved variances, including 5 Star Program approvals
granted by a county, remain in effect.

E. SCHOOLS AND CHILD CARE

1. Schools and child care shall work with their local public health agencies as
COVID-19 cases occur, and shall follow the CDPHE guidance for Cases
and Outbreaks in Schools and Child Care.
2. Schools that are entirely remote learning due to ongoing COVID-19 cases
and outbreaks shall not have in-person extracurricular activities.

E. ADDITIONAL COUNTY RESTRICTIONS

1. CDPHE may require counties whose resident hospitalizations threaten to exceed
85% of hospital or hospital system capacity to implement additional restrictions to
mitigate disease transmission.

II. HOSPITAL FACILITY REPORTING

A. COVID-19 Case Reporting. All Colorado hospitals shall report to CDPHE in a form and
format determined by CDPHE, certain information for all suspected (pending laboratory
test) and confirmed (positive laboratory test) cases of COVID-19, including but not
limited to:
1. race and ethnicity;
2. numbers of suspected and confirmed cases who are hospitalized, who are
hospitalized and using a ventilator, or who are in the emergency department
waiting for an inpatient bed;
3. numbers of suspected and confirmed cases who are discharged and in recovery;
4. deaths due to COVID-19; and
5. medical equipment and supply information, including but not limited to total bed
and intensive care unit (ICU) bed capacity and occupancy, ventilator availability
and utilization, and availability of N95 masks.
Reporting by hospitals shall be done in CDPHE’s EMResource reporting system on a
daily basis or as otherwise required by this Order.

B. Hospital Bed Capacity Reporting. All Colorado hospitals shall report to CDPHE the
following in EMResource daily at 10:00 a.m.:

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1. The daily maximum number of beds that are currently or can be made
available within 24 hours for patients in need of ICU level care; and
2. The daily maximum number of all staffed acute care beds, including ICU
beds, available for patients in need of non-ICU hospitalization.

III. DEFINITIONS

A. Limited Healthcare Settings means those locations where certain healthcare services are
provided, including acupuncture (not related to personal services), athletic training (not
related to personal services), audiology services, services by hearing aid providers,
chiropractic care, massage therapy (not related to personal services), naturopathic care,
occupational therapy services, physical therapy, and speech language pathology services.

B. Mass Indoor Gathering is any indoor space where more than 100 unvaccinated
individuals or individuals with unknown vaccination status are gathered in a room.

C. Personal Services means services and products that are not necessary to maintain an
individual’s health or safety, or the sanitation or essential operation of a business or
residence. Personal Services include, but are not limited to, personal training, dog
grooming, or body art and also applies to noncritical professionals regulated by the
Division of Professions and Occupations, within the Department of Regulatory Agencies
(DORA) including but not limited to services provided by personal beauty professionals
such as hairstylists, barbers, cosmetologists, estheticians, nail technicians, as well as
massage therapists, whose work requires these professionals to be less than six feet from
the person for whom the services are being provided.

D. Public Indoor Space means any enclosed indoor area that is publicly or privately owned,
managed, or operated to which individuals have access by right or by invitation,
expressed or implied, and that is accessible to the public, serves as a place of
employment, or is an entity providing services. Public Indoor Space does not mean a
person’s residence, including a room in a motel or hotel or a residential room for students
at an educational facility.

E. School means pre-kindergarten through 12th grade. A school includes all grade levels
contained in a building or multiple buildings on a campus.

IV. ENFORCEMENT

This Order will be enforced by all appropriate legal means. Local authorities are encouraged to
determine the best course of action to encourage maximum compliance. Failure to comply with

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this order could result in penalties, including jail time, and fines, and may also be subject to
discipline on a professional license based upon the applicable practice act.

V. SEVERABILITY

If any provision of this Order or the application thereof to any person or circumstance is held to
be invalid, the remainder of the Order, including the application of such part or provision to other
persons or circumstances, shall not be affected and shall continue in full force and effect. To this
end, the provisions of this Order are severable.

VI. DURATION

This Order shall become effective at 12:01 AM on Friday, April 16, 2021 and will expire in 30
days unless extended, rescinded, superseded, or amended in writing.

_________________________________ April 15, 2021

____________________________
Jill Hunsaker Ryan, MPH Date
Executive Director