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Tri-County Health Department's Simplified Dial Order - Spanish

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1. ¿Existe una orden de salud pública en todo el estado y un orden local de salud pública TCHD, ¿qué reglas debo seguir?

• Los condados bajo órdenes locales y órdenes estatales deben cumplir con los requisitos más estrictos de ambas. Todas las personas, empleadores y empleados están obligados a cumplir con los requisitos de la orden estatal de salud pública 20-38. La orden de TCHD permitió a los condados excluirse de sus requisitos. 

• El condado Douglas ha optado por no cumplir con la orden local de Salud Pública de TCHD y ya no está sujeto a sus requisitos. Los individuos, empleadores y empleados del condado Douglas deben seguir cumpliendo con todos los requisitos bajo las órdenes de salud pública en todo el estado.

• El condado Adams y el condado Arapahoe permanecerán bajo la orden local de Salud Pública de TCHD y la orden de Salud Pública en todo el estado y deben cumplir con los requisitos más estrictos de ambas.

2. ¿Por qué se está adoptando un dial modificado?

Si bien las tasas de casos y las hospitalizaciones en la región metropolitana de Denver han bajado de los picos de noviembre y diciembre de 2020, han aumentado en las últimas semanas a medida que Colorado está en su 4ª ola y otro factor que complica es la propagación de cepas variantes más transmisibles del virus en todo el estado. Los datos de modelado de la Escuela de Salud Pública de Colorado sugieren que retrasar los cambios en las políticas que flexibilizan las restricciones hasta mediados de mayo evitará un número sustancial de hospitalizaciones y muertes adicionales.  

Este enfoque gradual también permitirá a los condados y a la región más tiempo para aumentar los niveles de vacunación y trabajar hacia la inmunidad de rebaño. Al 7 de abril de 2021, se estima que alrededor del 30% de los habitantes de Colorado son inmunes al COVID-19. Los expertos en salud pública estiman que entre el 70 y el 85% de la población necesita ser vacunada para detener la propagación comunitaria continua del COVID-19.

3. .¿Es más protectora la Orden Estatal o la de TCHD?

La Orden de TCHD es más protectora en el sentido de que restringe todas las actividades a los límites de capacidad de nivel azul entre el 16 de abril de 2021 y el 15 de mayo de 2021 y requiere el cumplimiento de un conjunto limitado de requisitos de mitigación para todos los sectores, incluido el distanciamiento de 6 pies en niveles azul a púrpura.

La Orden Estatal es más protectora en el caso de que:

• Requiere que los eventos en interiores en todos los niveles cumplan con el distanciamiento de 6 pies entre las partes si planean albergar a 100 personas o más.
• Limita la capacidad de eventos en interiores a 500 personas. Los lugares pueden solicitar una variación a través de TCHD para superar las 500 personas.
• Requiere que lugares con eventos al aire libre, con boletos y sentados de más de 30,000 pies cuadrados obtengan la aprobación de CDPHE antes de operar.
• Requiere que las escuelas P-12 cumplan con la orientación de casos y brotes y suspendan las actividades extracurriculares si la escuela está en aprendizaje remoto debido a casos y brotes en la escuela.

4. ¿Qué requisitos se mantienen en este nuevo dial simplificado?

Se requieren restricciones de capacidad y requisitos de mitigación para todos los sectores en niveles azul, amarillo, naranja, rojo y púrpura. Los requisitos de mitigación se han simplificado para garantizar la coherencia en todos los sectores y limitar los requisitos solo aquellos que son más críticos para reducir la propagación del COVID-19.

Los requisitos incluyen:

• Cumplir con los límites de capacidad basados en la designación de nivel y la actividad/industria
• Observar el distanciamiento de 6 pies entre los miembros no domésticos, con excepciones limitadas
• Siguiendo la guía de limpieza y desinfección de sus instalaciones por parte de los CDC
• Maximizar la ventilación siempre que sea posible
• Señalización colgante
• Las máscaras se requieren que sean usadas en todos los espacios públicos interiores, en todos los niveles de la esfera, bajo el orden de cobertura facial de TCHD y la orden de enmascaramiento en todo el estado.

5. ¿Qué requisitos van a desaparecer?

En nivel claro, se levantan todos los requisitos locales. En todos los demás niveles, las empresas y los individuos deben cumplir con los nuevos requisitos simplificados de mitigación como se describió anteriormente. Se han eliminado todos los requisitos específicos de la industria. Las empresas ya no necesitarán:

• Recopilar información de contacto con el cliente.
• Examinar a fondo a los clientes y empleados. Los empleados y clientes que han estado expuestos a un caso positivo conocido o que están presentando síntomas o signos de enfermedad deben permanecer en casa.
• Limpie las superficies cada hora o después de cada uso. Todas las industrias deben seguir ahora las directrices de limpieza y desinfección de los CDC.
• Prohibir algunas actividades, incluyendo buffet de autoservicio y los juegos inflables.
• Use guantes más allá de los estándares de la industria.
• Prohibir equipos y superficies compartidas.
• Requiere que los clientes estén sentados mientras comen y beben al aire libre. En los espacios interiores, las máscaras solo se pueden quitar cuando están sentados para comer o beber.
• Desinfectar productos antes de revenderlos.

6. Ahora que ya no se requiere la orientación específica del CDPHE para el sector, ¿todavía hay cosas que debería hacer para mantener a las personas seguras en mi entorno único? ¿Qué pasa en nivel claro

La propagación comunitaria sigue existiendo y no todos han tenido la oportunidad de vacunarse. Se insta encarecidamente a las empresas, organizadores de eventos, lugares de culto, gobiernos locales y otros a implementar las estrategias de mitigación de Covid-19 basadas en la ciencia apropiadas para su espacio y actividades siempre que sea posible.

7. ¿Cómo funciona la nueva métrica de la tasa de ingreso hospitalario?

La nueva métrica de marcación rastrea a los residentes recién ingresados en cualquier hospital, por día, por cada 100,000 residentes. En la fase I, esta métrica no se utiliza en absoluto. En su lugar, los condados tendrán un período de gracia de 30 días en nivel azul.

En la fase II, a partir del 16 de mayo, los condados serán asignados al nivel claro -un período de observación- en el que un condado sólo saldrá del nivel claro si supera los dos nuevos ingresos hospitalarios, por día, por cada 100,000 residentes, durante siete días consecutivos. La última fecha en que nuestros condados superaron este nivel fue 01/02/2021 para el condado Adams, 12/28/2020 para el condado Arapahoe y 12/08/2020 para el condado Douglas.

A diferencia de la capacidad hospitalaria, que es inherentemente regional, esta métrica es específica del condado y solo cuenta el número de residentes del condado recién ingresados en cualquier hospital. A diferencia de la tasa de incidencia y el porcentaje de positividad, esta nueva métrica tiene en cuenta la gravedad de los casos a medida que los tratamientos mejoran y las personas se vacunan.

Umbrales métricos para cada nivel:

	Nivel claro:  Nueva normalidad	NIVEL AZUL:  PRECAUCIÓN	NIVEL AMARILLO:  PREOCUPACIÓN	NIVEL NARANJA:  ALTO RIESGO	NIVEL ROJO:  RIESGO GRAVE	NIVEL PÚRPURA:  RIESGO EXTREMO
Métrico – Ingresos   hospitalarios por cada 100,000 residentes del condado durante un período de 7 días	0-2	2 – 3	3 - 4	4 – 5	> 5	>5 y la capacidad hospitalaria está amenazada

8. ¿Qué pasa si la tasa de ingreso hospitalario de un condado excede las métricas de nivel claro el 16 de mayo cuando comienza la fase II?

Todos los condados pasarán al nivel claro el viernes 16 de mayo, independientemente de su métrica de tasa de admisión hospitalaria. Tan pronto como comienza la fase II, comienza esta nueva métrica de tasa de ingreso hospitalario. Un condado necesita exceder la métrica de la tasa de ingreso hospitalario durante siete días consecutivos antes de ser trasladado a un nivel más restrictivo.

Datos: Tasa de ingreso hospitalarios

9. ¿Existe alguna restricción para los eventos al aire libre?

 En el nivel claro, no hay restricciones locales en eventos al aire libre. Bajo nivel azul, la capacidad de eventos al aire libre solo está limitada por el requisito de observar el distanciamiento de 6 pies. Consulte la tabla de capacidad para obtener más información. Excepto en nivel claro, todos los eventos al aire libre deben cumplir con los requisitos de mitigación para todos los sectores, incluido el distanciamiento de 6 pies.

En el nivel azul, complete el formulario para solicitar la aprobación de Salud Pública para organizar una reunión masiva  si:

• Usted está solicitando la aprobación de salud pública, según lo requerido por la Orden de Salud Pública 20-38 de CDPHE, para organizar un evento al aire libre con boletos y asientos en una instalación de más de 30,000 pies cuadrados. 

Su oficina local de permisos del condado o de la ciudad puede requerir planes COVID-19 y, bajo la Orden de Salud Pública 20-38 de CDPHE, los lugares de eventos al aire libre con boletos y asientos de más de 30,000 pies cuadrados requieren la aprobación de CDPHE, en consulta con la agencia local de salud pública. TCHD está disponible para proporcionar asistencia técnica sobre la planificación de eventos de cualquier tamaño. Envié un correo electrónico a covidbusinessrecovery@tchd.org. Los organizadores de eventos y los lugares de reunión deben consultar las directrices de los CDC para grandes eventos y reuniones para obtener más información sobre las estrategias  de mitigación para promover la seguridad durante esas actividades.

10. ¿Hay límites en los eventos en interiores?

En el nivel azul, complete el formulario para solicitar la aprobación de Salud Pública para organizar una reunión masiva si:

• Usted está solicitando la aprobación de salud pública, como se requiere en la Orden de Salud Pública 20-38 del CDPHE, para organizar un evento en interiores con más de 500 personas
• Usted es una escuela que solicita la aprobación de salud pública, según lo requerido por la Orden de Salud Pública 20-38 de CDPHE, para organizar un baile de graduación en interiores con más de 500 individuos, y en cumplimiento con la orientación del CDPHE sobre bailes y graduaciones.

En el nivel claro, no hay restricciones locales para los eventos en interiores. Consulte la tabla de capacidad para obtener más información. Excepto en nivel claro, todos los eventos en interiores deben cumplir con los límites de capacidad y los requisitos de mitigación para todos los sectores comerciales, incluido el distanciamiento de 6 pies.

Esta orden no requiere revisión del plan o aprobación por parte de TCHD para eventos en interiores. Sin embargo, su oficina local de permisos del condado o de la ciudad puede requerir planes COVID-19 para operar y, bajo la Orden de Salud Pública 20-28 de CDPHE:

• Si un evento en interiores acogerá a más de 100 personas, se debe mantener un distanciamiento de 6 pies entre los miembros que no pertenecen a una misma familia y/o los grupos de 10 o menos.
• Los eventos en interiores no pueden albergar a más de 500 personas. Los lugares pueden solicitar al TCHD una variante para superar las 500 personas, con la aprobación final del CDPHE.
• Estos requisitos no se aplican a:

1. Lugares de culto y ceremonias asociadas.
2. Servicios minoristas.
3. Restaurantes en los que se pueda comer sentado y que no tengan zonas sin asiento en las que puedan reunirse 100 o más personas (como pistas de baile o zonas comunes de reunión). 
4. Los bailes escolares y las graduaciones escolares que deseen superar estos umbrales están sujetos a revisión y aprobación por parte de las agencias locales de salud pública de acuerdo con la guía de CDPHE para bailes y graduación.

TCHD está disponible para proporcionar asistencia técnica en la planificación de eventos enviando un correo electrónico a covidbusinessrecovery@tchd.org. Los lugares de eventos, operadores y anfitriones deben limitar el número de asistentes a los eventos y continuar implementando estrategias de mitigación detalladas en la guía de eventos CDPHE  y la guía de los CDC para la organización de grandes eventos y reuniones en la mayor medida posible.

11. ¿Siguen los artistas teniendo que respetar una mayor distancia?

Los intérpretes sólo deben permanecer a 6 pies de los espectadores. A los artistas que realicen actividades que impliquen una mayor exhalación forzada, como el canto, se les recomienda encarecidamente que se distancien más de 1 metro de los espectadores.

12. ¿Se permiten buffet de autoservicio?

Los buffet de autoservicio no están prohibidos bajo esta orden, pero se les pide a los proveedores de servicios de alimentos que eliminen el autoservicio siempre que sea posible y que sigan las instrucciones de los CDC para los operadores de servicios de alimentos  y la guía de limpieza y desinfección de sus instalaciones por parte de los CDC. Los operadores buffet de autoservicio deben exigir a los clientes que usen guantes de un solo uso o que requieran el uso de desinfectante de manos antes y después de tocar utensilios compartidos. Los operadores también deben asegurarse de que los clientes y el personal puedan mantener un distanciamiento de 6 pies en todo momento, especialmente mientras se mueven por la instalación.

13. ¿Pueden las empresas ofrecer muestras?

El muestreo no está prohibido en virtud de esta orden

14. ¿Todavía necesito examinar los síntomas de los empleados o clientes?

Si bien se recomienda examinar los síntomas de los empleados y clientes, la orden no lo requiere. Las empresas deben exigir que los empleados y clientes que muestren síntomas o signos de enfermedad, o que hayan estado en contacto con personas que hayan dado positivo se queden en casa. Los empresarios deben asegurarse de que las políticas de licencia por enfermedad pagada sean consistentes con la ley estatal y comunicar esas políticas, por escrito, a los empleados. Vea el aviso interpretativo y opinión formal de la Ley de Familias y Lugares de Trabajo Saludables [En Español]   del Departamento de Trabajo y Empleo de Colorado y poster de Derechos de Salud Pública en el Lugar de Trabajo de Colorado [En Español].

15. ¿Debo seguir proporcionando ajustes razonables a los empleados de alto riesgo o que hayan sido vacunados?

Consulte la guía de los CDC para personas con ciertas condiciones médicas y la guía de la Comisión de Igualdad de Oportunidades de Empleo de los Estados Unidos sobre lo que usted debe saber acerca de COVID-19 y la ADA, la Ley de Rehabilitación y otras leyes de EEO.

16. ¿El Programa de Certificación de 5 Estrellas sigue en vigor?

Cada Programa de Certificación 5 Estrellas es operado por el condado individual. Los condados pueden continuar sus programas cinco estrellas si así lo desean. Los programas y las empresas deben seguir el marco del Programa de CDPHE, incluidas todas las listas de verificación específicas de la industria, excepto que las empresas certificadas ya no están obligadas a examinar a los clientes sintomáticamente o tomar información de contacto de los clientes.

Algunos condados pueden decidir no continuar con su programa. Consulte la página web del Programa 5 Estrellas de su condado:

• Certifica mi negocio del condado Douglas:  certifyme@douglas.co.us
• Programa de Socios de Recuperación de Cinco Estrellas del Condado Arapahoe –  frouse@adcogov.org
• Programa de Certificación de Negocios 5 Estrellas del Condado Adams –  5star@arapahoegov.com

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Access to Care

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1. How do I know if I qualify for Medicaid, Children’s Health Plan Plus (CHP+), or Emergency Medicaid health insurance programs?

You can start by going to the Colorado PEAK website to complete a screening form to see if you are eligible. You can submit your application for these health insurance programs on the Colorado Peak website. You can also call our scheduling line at 303-363-3013 to set an appointment with one of our Family Health Coordinators to fill out an application in person.

2. What if I’m not eligible for Medicaid or CHP+?

If you apply through the Colorado PEAK website, it will show all of the available health insurance plans you do qualify for at this time. You can also find more information about Colorado health insurance at cohealthinfo.com.

3. What is Presumptive Eligibility (PE)?

Presumptive Eligibility (PE) is a program that provides health care coverage for at least 45 days for pregnant women and children under 19 years old. During the 45 day PE time period your eligibility is being determined for Medicaid and CHP+. Call the scheduling line to set up an appointment at 303-363-3013.

4. What are the differences between the public health insurance options (Medicaid, CHP+, and Emergency Medicaid)?

Medicaid and CHP+ provide medical and dental (dental for children only) coverage with participating providers for families, children, and pregnant women. Screening is performed for both programs when you complete an application based on each program’s income guidelines and other requirements. While Medicaid serves low-income families, CHP+ provides low-cost health and dental insurance for families who make too much for Medicaid. Depending on income and family size, you may need to pay an enrollment fee and co-pays for provider visits with CHP+.

Emergency Medicaid only covers labor and delivery costs for pregnant women that are undocumented individuals, as long as Emergency Medicaid eligibility requirements are met. Emergency Medicaid does not cover prenatal care costs. Clients with Emergency Medicaid must arrange payment for prenatal services with their prenatal care provider.

5. Do you have walk-in appointments available?

Clients are seen by appointment only. Call the scheduling line today to set an appointment at a Tri-County Health Department Presumptive Eligibility clinic near you 303-363-3013.

6. What will happen during my Presumptive Eligibility appointment?

A family health coordinator will collect your personal documents, assist you in the completion of your application, and forward the paperwork to the appropriate county or CHP+ office. If you are being seen for a pregnancy PE appointment, you will meet with a registered nurse (RN) in addition to the family health coordinator. The RN will perform a pregnancy test (if needed), review your medical history, perform a prenatal assessment, and provide you with additional resources that may support you in your pregnancy.

7. What if I have concerns or questions about my Medicaid or CHP+?

If you live in Adams, Arapahoe, Douglas, or Elbert counties in Colorado, you can call our Healthy Communities Outreach Line at 303-873-4404. The Healthy Communities Program can help you find a doctor, specialist, or help connect you with additional county resources.

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Aging

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1. How can I find the services I need for myself or an older adult in my life?

As we age, the range of services that are needed to support health, well-being and quality of life can become more diverse and complex. Finding and accessing available services and support systems to meet these complex needs can sometimes be confusing. In the metro-Denver area there are several resources designed to make this process easier.

The Network of Care is a comprehensive, community-based website to provide current information on services available to older adults, their families and their caregivers. It is sponsored by the Denver Regional Council of Government’s Area Agency on Aging, it also has a medical library, information about assistive devices, and links to other organizations and services. You can also get assistance by email, or by phone at 303 480-6700, outside metro-Denver call toll-free at 866-959-3017.

Senior Source, is an easy-to-navigate website that provides current information on available services, activities, events and issues of importance to older adults. It is sponsored by 9News, the Colorado Department of Human Services and well-respected community partners.

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Air Quality (Outdoor)

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1. How do I file an Air Pollutant Emission Notice?

Contact the Colorado Department of Public Health and Environment's (CDPHE) Air Pollution Control Department at 303-692-3100.

2. Where can I find updated air quality information?

State air quality information is updated every day by 4:00pm and is published on the Colorado Department of Public Health and Environment's Colorado Air Quality Summary Page.
Air Quality Summary Page

3. Does my neighbor need an approved appliance to burn wood inside?

You may call the Colorado Department of Public Health and Environment's indoor burning hotline to request information and or report suspected violations at 303-691-3280.

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Animal Bites and Rabies

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1. What is rabies?

Rabies is a disease that is caused by a virus that affects the nervous system. If not treated, rabies is almost always fatal. Rabies vaccination laws for pets have greatly reduced the occurrence of rabies among people and domestic animals in the United States. However, wild animals such as skunks, raccoons, bats and foxes still pose a significant public health threat.

2. How is rabies spread?

Rabies virus is found in the saliva of infected animals, and is most often spread from one animal to another by bite. The virus multiplies at the bite site and travels through the nerves to the brain. It also goes to the salivary glands. Rabies virus is not found in the blood of infected animals.
Rarely, rabies has been spread to organ recipients when they received tissues from organ donors who died of rabies. In a few instances rabies has been spread to people by aerosols (droplets in the air). You can also get rabies if saliva from a rabid animal gets in your eyes, nose, or mouth, or in an open sore or wound.

3. How do I know if an animal has rabies?

Animals with rabies often behave strangely. However, you cannot tell an animal has rabies just by looking at it. Rabid wildlife may come out in the daytime when they normally only come out at night. They may also approach or attack people, pets, or livestock instead of avoiding them. Rabid animals may have trouble walking, flying, eating, and drinking because the virus affects the nervous system. The only way to tell for sure if an animal has rabies is to test the animal for the virus.

4. Can rabies be prevented?

Rabies can be prevented. Vaccines are available for domestic animals and livestock. These vaccines can prevent companion animals such as dogs and cats from getting rabies from wildlife. Horses, cattle, and other livestock should also be vaccinated, especially since it is hard to know if pastured animals have been exposed to rabid animals. If our dogs and cats and other animals are vaccinated they will not get rabies,
and they will not be able to spread rabies to us. A veterinarian should administer rabies vaccines.
There are rabies vaccines for people too. Vaccines that prevent rabies can be administered after a rabid animal bites people; this is called post-exposure prophylaxis. People in some professions such as wildlife rehabilitators, animal control officers and veterinarians can receive rabies pre-exposure prophylaxis. These people are at higher risk of being bitten by rabid animals because of their jobs, and will benefit from getting the vaccine early in their careers before they are exposed. Unlike people, animals cannot be vaccinated for rabies after they are exposed to a rabid animal.

5. What do I do if an animal bites me?

The first thing to do if you are bitten by an animal is to wash the wound with soap and water for at least 15 minutes. If the animal is rabid this will help wash out some of the virus. Do this right away. Also make a note of what animal bit you, if it was acting strangely, and where the animal went. Then contact your healthcare provider, Tri-County Health Department, animal control and/or Colorado Parks and Wildlife.
If the animal that bit you is wildlife it can be captured and tested for rabies so you will know if you are at risk and need to be vaccinated for rabies. If the animal is a domestic animal or livestock it can be quarantined and watched to see if it becomes ill from rabies. Many people are bitten by animals each year, and very few of those animals are rabid. However, rabies is a very serious disease and you should consult with your local health department to see if they recommend rabies post-exposure prophylaxis for you.

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Animal-Related (Zoonotic) Diseases

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1. What is West Nile virus?

West Nile virus is an arthropod-borne virus (arbovirus) most commonly spread by infected mosquitoes. West Nile virus can cause febrile illness, encephalitis (inflammation of the brain) or meningitis (inflammation of the lining of the brain and spinal cord).

West Nile virus transmission has been documented in Europe and the Middle East, Africa, India, parts of Asia, and Australia. It was first detected in North America in 1999, and has since spread across the continental United States and Canada.

2. How do people get infected with West Nile virus?

Most people get infected with West Nile virus by the bite of an infected mosquito. Mosquitoes become infected when they feed on infected birds. Infected mosquitoes can then spread the virus to humans and other animals.

In a very small number of cases, West Nile virus has been spread through blood transfusions, organ transplants, and from mother to baby during pregnancy, delivery, or breastfeeding.

3. What is hantavirus?

Hantavirus is a rare but serious disease that humans can contract through contact with infected rodents or their urine, saliva, blood, or droppings. Since hantavirus was first identified in the United States in 1993, there have been over 600 cases nationally. Approximately 12 percent of deer mice carry hantavirus.
The deer mouse (Peromyscus maniculatus) is the primary reservoir for Sin Nombre Virus, the strain of hantavirus responsible for most human cases in the United States. The deer mouse is found throughout most of the United States.

4. How is hantavirus treated? Is there a vaccine for hantavirus?

There is no specific treatment, cure, or vaccine for hantavirus infection. However, if infected individuals are recognized early and receive medical care in an intensive care unit, they may do better. In intensive care, patients are given oxygen therapy or undergo an intubation procedure (insertion of a flexible tube in the airway) to help them through the period of severe respiratory distress.

If you have been around rodents and have symptoms of fever, deep muscle aches, and severe shortness of breath, see your doctor immediately. Be sure to tell your doctor that you have been around rodents.

5. What are common symptoms for hantavirus?

According to the Center for Disease Control, symptoms of hantavirus generally begin from one to seven weeks after exposure. Early symptoms include fever, fatigue, chills, and muscle aches. About half of patients will experience headaches, nausea, vomiting, dizziness, and abdominal pain. The disease progresses rapidly (four to 10 days after initial symptoms) to include coughing, shortness of breath, and severe difficulty breathing. Early medical attention greatly increases the chance of survival in cases of hantavirus pulmonary syndrome. If you or a family member develops any of the symptoms listed above after potential contact with rodents or rodent-infested spaces you should seek medical attention immediately and advise your health care professional of the potential exposure to hantavirus. The types of hantavirus that cause hantavirus in the United States cannot be transmitted from one person to another.

6. How and where does one contract hantavirus?

According to the Centers for Disease Control, cases of hantavirus occur sporadically, usually in rural areas where forest, fields, and farms offer suitable habitat for the virus’s rodent hosts. Structures around homes (for example: barns, outbuildings, and sheds) are potential sites where people may be exposed to the virus. In the United States, deer mice (along with cotton rats and rice rats in the southeastern states and the white-footed mouse in the Northeast) carry the virus. The rodents shed the virus in their urine, droppings, and saliva. The virus is mainly transmitted to people when they breathe in air contaminated with the virus. Participating in activities that can stir up dust in areas where rodents have been active will increase your risk of contracting hantavirus pulmonary syndrome.

Anyone who comes into contact with rodents that carry hantavirus is at risk of hantavirus. Rodent infestation in and around the home remains the primary risk for hantavirus exposure.

7. What is plague?

Plague is an infectious disease that affects rodents, certain other animals and humans. It is caused by the Yersinia pestis bacteria. These bacteria are found in many areas of the world, including the United States.

8. How do people become infected with plague?

People most commonly acquire plague when they are bitten by a flea that is infected with the plague bacteria. People can also become infected from direct contact with infected tissues or fluids while handling an animal that is sick with or that has died from plague. Finally, people can become infected from inhaling respiratory droplets after close contact with cats and humans with pneumonic plague.

9. Could one person get plague from another person?

Yes, when a person has plague pneumonia they may cough droplets containing the plague bacteria into air. If these bacteria-containing droplets are breathed in by another person they can cause pneumonic plague. Human-to-human transmission is rare and typically requires direct and close contact with the person with pneumonic plague.

10. How do people become infected with tularemia?

Typically, people become infected through the bite of infected insects (most commonly, ticks and deerflies), by handling infected sick or dead animals, by eating or drinking contaminated food or water, or by inhaling airborne bacteria.

11. What is tularemia?

Tularemia, also known as “rabbit fever,” is a disease caused by the bacterium Francisella tularensis. Tularemia is typically found in animals, especially rodents, rabbits, and hares. Tularemia is usually a rural disease and has been reported in all U.S. states except Hawaii.

12. How do I file a complaint about mosquitoes?

Contact any Tri-County office, or enter your complaint online.

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Baby Behavior

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1. My baby seems to cry a lot, what does it mean?

Babies use crying as a way to communicate many different things. They use crying to tell caregivers that they need something. It could mean they want to be close to you, need their diaper changed, are hungry or many other reasons. Click here to learn more about crying (español). For more information and support contact the Fussy Baby Network Colorado.

2. My baby seems to wake up often, is he getting enough sleep?

Babies sleep patterns are very different than adults. Newborns sleep about 14 to 16 hours in 24 hours but wake up often - this is normal. Click here to more about baby sleep patterns and how you can get more sleep during this time (español).

3. I don't understand why my baby is upset, what can I do?

Babies are born with the ability to communicate with their bodies and by making noises. Watching your newborn baby will help you learn what he or she needs. Sometimes they might suck on their hands showing they are hungry, other times they might cry and just want to be held. Learn more about the cues your baby is giving (español).

4. I have more questions about breastfeeding my baby, where can I find additional information?

All parents have questions about caring for their baby including questions about breastfeeding. Tri-County Healthy Department supports breastfeeding and has so much to offer. Learn more about breastfeeding as well as a variety of helpful links to pamphlets, videos and more.

5. What are the best ways to keep my baby safe when sleeping?

There are many simple things you can do as a parent to make sure your baby is safe when sleeping. Read more from our Safe Sleep for Your Baby pamphlet (español).

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Bed Bugs

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1. What are bed bugs?

Adult bed bugs are about the size of an apple seed, are brown with a flat, oval-shaped body and can be smelly, emitting a “musty-sweetish” odor produced through glands on the lower side of the body. Bed bugs are considered a public health pest and are not known to transmit or spread disease.

2. Can bed bugs spread disease?

Bed bugs have not been shown to transmit diseases and are not considered a public health hazard. Bed bugs can be an annoyance because their presence may cause itching and loss of sleep. In some instances, the itching can lead to excessive scratching which may increase the chance of a secondary skin infection.

3. What will a bed bug bite look like?

Bed bugs bites have different effects on every person. When a bed bug feeds on the blood of a person or animal, saliva is injected into the bite wound, which contains proteins that may cause some form of an allergic response. Some people show no signs of bed bug bites, some people have small bite marks, and others have allergic reactions. However, most people experience some level of inflammation, swelling, reddening, and itchiness at the bite site. Bed bug bites are not considered dangerous, but severe allergic reactions may require medical attention. Scratching bed bug bites may lead to secondary skin infections as well.

4. What does a bed bug look like?

Bed bugs range from 1mm to 7mm long (less than 1/4 of an inch - roughly the size of Lincoln’s head on a penny), are wingless, and have a flat head and a flat, oval body. Young bed bugs are yellow-white in color and change to a light to reddish brown as they mature. For more information and pictures you can visit: Colorado State University Extension website. You can also contact an entomologist for help identifying bed bugs.

5. How do I know if I have bed bugs?

One of the easiest ways to identify a bed bug infestation is by the tell-tale bite marks on the face, neck, arms, hands, or any other body parts. However, these bite marks may take as long as 14 days to develop. Other signs of bed bugs may include the presence of bed bug exoskeletons, actual bed bugs in the fold of mattresses and sheets, rusty-colored blood spots on bedding and or a sweet musty odor.

6. How do I get rid of bed bugs?

If you suspect that you have an infestation, contact your landlord or professional pest control company that is experienced with treating bed bugs. Getting rid of a bed bug infestation involves a combination of cleaning, room-modification, and insecticide administration by a knowledgeable, licensed pest control operator. Bed bug infestations are commonly treated with insecticides containing “pyrethrins”. All pesticides should be applied per the label’s instructions and treat areas where bed bugs are known to live. Wash all draperies, bedding and clothing in hot water and place them in a hot dryer for at least 20 minutes. Bed bugs and their eggs can be vacuumed up with a nozzle attachment. Vacuum all the crevices on mattresses, bed frames, baseboards and any objects close to the bed. Steam clean and vacuum carpets. Vacuum daily and be sure to immediately empty your vacuum in an outside trash can. Be vigilant and conduct regular inspections. For more information click on Bed Bugs: The Facts.

7. My home / apartment has been sprayed for bed bugs, but they are back! What should I do?

Bed bugs can be difficult to get rid of and bed bug control usually requires multiple visits by a licensed pest control operator and diligence on the part of those who are experiencing the infestation. For more information click on Bed Bugs: The Facts.

8. The place I’m renting has bed bugs, what should I do?

It is best to read your lease first, as it may contain information as to who is responsible for treating pests. If your land lord is responsible, contact your land lord. If you are responsible, contact a licensed pest control company that is experienced with treating bed bugs. Regardless of who is responsible, getting rid of a bed bug infestation involves a combination of cleaning, room-modification, and insecticide administration. For more information click on Bed Bugs: The Facts.

9. Can Tri-County Health Department make my landlord get rid of bed bugs in my rental property?

Tri-County Health Department does not have a Housing Ordinance and does not have legal authority over private property including rental properties. Tri-County can document a bed bug problem and provide educational resources on how to prevent and eliminate a bed bug infestation, but is not able to mandate (require) action by a landlord. If you are renting, it is important to thoroughly read your lease to identify who is responsible for pest control. Tri-County Health Department cannot provide legal services. For further legal questions you can contact Colorado Legal Services at 303-837-1313.

10. What is a good pest control company?

Unfortunately, Tri-County Health Department cannot recommend a pest control company. You can find many companies in the Yellow Pages or through an internet search. The Colorado Department of Agriculture at 303-239-4140 can also provide a list of licensed pest control operators.

11. I travel often. How do I prevent bringing bed bugs home from hotels?

Use luggage racks to hold your luggage, instead of setting it on the bed or on the floor. Avoid unpacking your clothes into hotel dresser drawers. Keep your clothes in your luggage (on a luggage rack) or hang clothes in the closet. Check the mattress and the headboard before sleeping. Once you return home, unpack directly into the washing machine, using hot water followed by drying items in a hot dryer for at least 20 minutes. Thoroughly inspect your luggage for any signs of bed bugs.

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Birth Certificates

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1. What do I need to get a birth certificate for my child?

•    Photocopy of the requestor's valid identification

•    Completed birth certificate application 

•    Payment

2. Who can obtain birth certificate?

•    The person named on the birth record, with approved forms of identification

•    Members of the immediate family (parents, grandparents, siblings or children), with required proof of relationship. To prove your relationship, we accept:

        - Birth certificates.

        - Marriage certificates.

        - Court-approved guardianship paperwork.

•    Legal guardian of those named above

•    Others demonstrating a direct and tangible interest in the record

3. How are birth certificates used?

•    School registration

•    Obtaining a Driver’s License

•    Travel 

•    Social Security Card

•    Employment

•    Genealogy and/or family history

•    Marriage (domestic and international)

•    Signing up for youth sports programs

•    Domestic or international adoption

•    Access to other personal records

4. How long does it take to get the birth certificate in person?

In-person requests normally take from 10-15 minutes

5. Do we have to go to the county that the birth occurred in? Or can I go to ANY Vital Records?

If the person is born in Colorado, you may obtain the birth certificate at ANY Vital Records in the state of Colorado

6. Why does the birth certificate print with mother’s maiden name?

The State of Colorado made it this way for security purposes and because the mother’s name may change due to marriage, but the maiden name will always stay the same

7. I don’t have an ID or document, how can I apply for my birth certificate?

•    You can apply online through a third party website www.vitalchek.com

•    Go directly to the state office and go through an appeal process

•    You may contact us for additional information at 720-200-1401

8. I was not born in Colorado. Can I get a birth certificate from your office?

No. You must contact the State Vital Records Office in the state in which you were born or you can also apply through VitalChek, a secure third party website.

9. When will I receive my child’s Social Security Card?

On average, it takes approximately 6-8 weeks from the time baby was registered at the hospital. However, it can vary depending on the state where you live. If you have not received your child’s social security card within six to eight weeks, please visit or contact your local Social Security office.

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Body Art

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1. What are some health risks associated with body art procedures?

Tattooing and piercing puts artists at risk of coming in contact with their client's blood. This means artists may also be exposed to bloodborne pathogens, such as hepatitis B virus, hepatitis C virus, or human immunodeficiency virus (HIV). These pathogens can make you sick and they can possibly make your family sick, if they are exposed. Some of these diseases are permanent and can be fatal. The Centers for Disease Control and Prevention and the National Institute for Occupational Safety and Health have developed guidance for artists to reduce the risks they may encounter:

2. Do I need a license to perform Body Art?

While individual artists are not required to be licensed at this time, beginning January 1, 2017 all establishments in Adams, Arapahoe, and Douglas counties where body art procedures are being conducted are required to obtain a Tri-County Health Department Body Art Establishment license.

3. What are the local regulations for Body Art facilities?

Tri-County Health Department Rules and Regulations for Body Art Establishments Regulation No. BA-16, Effective date: January 1, 2017.

4. How do I open a Body Art facility in Tri-County Health Department’s jurisdiction?

You must complete and submit a Body Art Establishment License Application to Tri-County Health Department. A pre-opening inspection by Tri-County Health Department is required; any violations noted during the inspection must be corrected and all applicable fees must be paid prior to the approval of the license and operation of the establishment.

5. Can I open up a Body Art facility in my own home?

Section 5-516 of the Tri-County Health Department Rules and Regulations for Body Art requires that all body art establishments shall be completely separated from areas used for human habitation. If you wish to open a Body Art facility, contact your local TCHD Environmental Health office for more information.

6. What can be done about someone tattooing from their home/unlicensed facility?

Contact your local TCHD Environmental Health office so a Body Art inspector can investigate and take appropriate action.

7. Can I report a Body Art facility if they are performing body art on underage persons?

Contact TCHD and the local police agency where the offense occurred for enforcement. See Colorado Revised Statutes 25-4-2103, Parental Consent for Minors.

8. What is the easiest way to obtain the hepatitis B vaccine?

The hepatitis B vaccine is a 3 shot series and can usually be obtained by contacting your healthcare provider. Tri-County Health Department offers the hepatitis B vaccine as well. You can also make an appointment with the Health Department to receive the vaccine by calling 303-451-0123.

9. Can Tri-County Health Department recommend a Body Art facility?

While Tri-County Health Department cannot provide recommendations of where to have a body art procedure performed, our website does list the prior inspection results for those facilities within our jurisdiction.

10. Is blood borne training required by the Tri-County Health Department?

Yes. If you will be performing body art procedures, a bloodborne pathogen course certification documentation is required within 90 days of being hired as a body artist. Body artists are also required to possess and demonstrate knowledge of Universal Precautions, disinfection and sterilization techniques, procedures for infection and exposure control, and are also required to have a waste management plan. These topics are taught in most bloodborne pathogen training courses.

Note: Other courses, upon notification by the Body Artist prior to taking the course, may be approved after review by TCHD; these courses must meet the definition of bloodborne pathogen course from BA-16, Section 1-103(f). Call your local TCHD Environmental Health office for more information.

11. How often will my Body Art facility be inspected?

Unannounced inspections are conducted once per calendar year, at a minimum; depending on the number and nature of any violations found during a routine inspections, Tri-County Health Department may inspect the facility at an increased frequency. In addition to routine inspections, the Body Art facility may be inspected pursuant to any complaints received by the Department.

12. What are the inspection fees?

See the Environmental Health Fees section of this website for the current license fees.

13. Will Tri-County Health Department pro-rate the inspection fee?

No. Tri-County Health Department does not pro-rate any fees.

14. Will the Tri-County Health Department accept partial payments?

No. Please arrange to pay the entire fee at one time. In addition to cash and check payment, Tri-County Health Department will accept credit card payments over the phone and through our online payment site .

15. How do I know that my tattoo procedure will be conducted in a sanitary manner?

The FDA has extensive online resources for body art consumers.
You can also view prior inspection reports on the Tri-County Health Department website. By reviewing these reports, you can gain a better understanding of what to look for and what questions to ask.

16. I recently got a tattoo and I think the area is becoming infected. What should I do?

Signs of infection can include: thick yellow or green discharge coming from the body art site, continued oozing or bleeding, red streaks or hot sensation around the site, pain that increases over time, or unusual swelling. If you experience any of these symptoms, contact a physician immediately.

17. Are there any concerns about getting a tattoo while pregnant?

If you are pregnant, consult with your health care provider before getting a tattoo.

18. Are there any concerns about getting x-rays if I have tattoos?

Consult your physician for specific effects of x-rays on tattoos.

19. What are the risks of using a home piercing kit?

Home piercing kits are readily available on the internet but may put users at an increased risk of infection and contracting certain diseases.

20. Can I donate blood after getting a tattoo?

The American Association of Blood Banks will not currently accept blood donations until one year after a person has received a tattoo.

21. Does Tri-County Health Department inspect at temporary body art events?

Yes. On-site inspections will be conducted during the event to ensure compliance. Artists participating in temporary body art events must comply with all applicable sections of the Tri-County Health Department Rules and Regulations for Body Art Establishments Regulation No. BA-16.  A Temporary Event License Application must be completed and submitted by the event coordinator to TCHD at least thirty (30) days prior to the proposed start date of the event. For more information, contact your local TCHD Environmental Health office.

22. Does Tri-County Health Department inspect mobile body art establishments?

Yes. Section 10-1001 of the Tri-County Health Department Rules and Regulations for Body Art Establishments requires mobile body art establishments to obtain a Body Art Establishment License. Mobile body art establishments must comply with all applicable sections of the Tri-County Health Department Rules and Regulations for Body Art Establishments Regulation No. BA-16 and must receive an annual licensing inspection from Tri-County Health Department. The Body Art Establishment License Application can be found here: Body Art License Application. For more information, contact your local TCHD Environmental Health office.

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Breastfeeding

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1. What support does Tri-County Health Department offer for pregnant and breastfeeding women?

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) promotes breastfeeding as the optimal infant feeding choice and supports mothers through many programs. Contact your local WIC office for more information on the following programs: free breastfeeding classes, Pump Loan Program, Breastfeeding Peer Counselor Program (español), and/or free breastfeeding counseling by specially trained staff including international board-certified lactation consultants (IBCLC).

2. Are there any laws in Colorado that support breastfeeding mothers?

There are two laws in Colorado that support breastfeeding. The Colorado Revised Statutes 25-6-302 established that a mother may breastfeed in any place she has a right to be. The Workplace Accommodations for Nursing Mothers Act requires an employer to: 1) provide reasonable unpaid break time, or allow an employee to use paid break and/or meal time, to express breast milk for her nursing child up to 2 years after the child's birth, or 2) Make reasonable efforts to provide a nursing mother with a private location in close working proximity to the work area in which to express milk.

Contact the Colorado Breastfeeding Coalition at 303-869-1888 for more information about Colorado legislation.

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Breastfeeding Resources for Health Care Providers

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1. How do I know who to refer to within the Tri-County Health Department WIC program?

TCHD has several WIC staff trained in lactation assessment and management. Our staff includes International Board Certified Lactation Consultants (IBCLC), Certified Lactation Counselors (CLC), Registered Dietitians (RD), Lactation Management Specialists (WIC staff who have received specialized training and successfully passed an exam), breastfeeding peer counselors, and experienced WIC educators. The RD is the WIC office supervisor. Call the WIC office closest to you and ask to speak with the Registered Dietitian. 

2. How can my medical office become more breastfeeding friendly?

In today's society, the decision to breastfeed is influenced by many factors, including information given by physicians. Studies have shown that provider encouragement significantly increases breastfeeding initiation and duration among women of all social and ethnic backgrounds. A provider that has knowledge of breastfeeding best practices and an office environment that supports breastfeeding can play a major role in helping families meet their breastfeeding goals. Both the American Academy of Pediatrics and the Academy of Breastfeeding Medicine have resources detailing how providers can improve support and create a breastfeeding friendly office space.

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Child Care

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1. Does Tri-County Health Department issue licenses for childcare facilities?

No. Child care centers are licensed by the Colorado Department of Human Services, Division of Child Care. However, these licensed child care facilities are required to have an inspection by the state or local health department and comply with the Regulations Governing the Health and Sanitation of Child Care Facilities in the State of Colorado prior to licensing and at least once every two years of operation.

2. When are health inspections conducted?

Depending on your type of facility, health inspections are either conducted once per year, or once every other year. 

3. Does Tri-County Health Department routinely inspect home day cares?

No, but we do investigate complaints related to such facilities. The only in home facilities that Tri-County regulates are group homes. If you have questions about either starting a home day care or having your child attend a home day care, please contact the Colorado Department of Human Services – Child Care Division at 303-866-5948.

4. How can I get a copy of past health inspection reports?

Inspections of restaurants, child care facilities, public swimming pools and spas, and tattoo / piercing facilities in Adams, Arapahoe, and Douglas County are available online.

5. What resources are available about serving nutritious foods in our childcare center?

Tri-County Health Department has Nutrition staff who can assist you. Contact our Nutrition Division.

6. What sort of foods is my center permitted to serve?

The types of foods a center is permitted to serve is dependent upon the type of equipment that the center has. Contact your local Tri-County Environmental Health office for guidance. We also encourage serving healthy foods.

7. What is the difference between a sanitizer and a disinfectant?

A sanitizer reduces the bacterial count, including disease causing microorganisms, to a safe level and is required to be used on surfaces in childcare settings such as toys, tabletops, and food preparation surfaces. A disinfectant eliminates most or all disease causing microorganisms (with the exception of bacterial spores) and is required to be used on surfaces in childcare settings such as diaper changing tables and restrooms, as well as areas contaminated with High Hazard Body Fluids such as blood, urine, vomit, or feces. See our Sanitizer and Disinfectant Guidance for Childcare Centers.

8. What are the requirements for sanitizing and disinfecting with bleach?

See our Sanitizer and Disinfectant Guidance for Childcare Centers. If you still have questions, please contact one of our four Tri-County Environmental Health offices.

9. Does Tri-County offer training for child care center staff?

Yes. Contact your Tri-County Environmental Health office to schedule a training. There is a fee associated with training.

10. We will be constructing a new facility, what do we need to complete?

A plan review packet must be filled out and submitted for review, along with the fee associated with the review. Details are provided in our plan review packet.

11. I’m interested in buying an existing child care center, what do I need to do before purchasing it?

If the establishment has not yet been purchased, a site evaluation can be completed by an Environmental Health Specialist who will provide you with a list of structural and equipment violations that must be corrected if the change of ownership does occurs. If the establishment has already been purchased, a Change of Ownership inspection is required and any structural or equipment violations must be corrected for approval of the establishment to operate. Fees do apply for these inspections. Contact your local Tri-County Environmental Health Department office to schedule an inspection and for information on fees associated with these inspections. You will also need to contact the Colorado Department of Human Services, Division of Child Care to find out about their requirements and to get licensed by them.

12. We will be adding a room or changing one of our rooms. What do I need to do?

This room must first be inspected and approved by Tri-County prior to utilizing it. Contact your local Tri-County Environmental Health office to schedule site evaluation inspection. The room should be ready for use upon inspection. Please allow at least one to two weeks prior to your scheduled opening date for this inspection to be conducted. There is a fee associated with this inspection.

13. Who can I contact if I have questions about adding equipment?

Contact your local Tri-County Environmental Health office.

14. When will I be invoiced for my health inspection?

Invoices are mailed out towards the end of the calender year, usually in late November or early December.

15. My child care center was built before 1978. What are the concerns regarding lead paint and renovations / repairs?

Half a million U.S. kids are estimated to be affected by lead paint. Often, exposure carries with it some level of irreversible physical and intellectual damage. These cases are directly linked to renovations and repairs on pre-1978 buildings where lead dust was created and not adequately contained and cleaned. Children should not be exposed to any amount of this dangerous metal and providers can help this effort by making sure their child care centers are lead-safe.

Renovators and contractors doing work that disturbs paint in child-occupied facilities and homes built before 1978 are required to work in “lead-safe” ways. The EPA lead web site tells about lead’s hazards, preventing lead exposure, living safely in pre-1978 buildings, and what “lead-safe” means. The page “Operators of Child Care Facilities” informs operators in older buildings that they either 1) get lead-safe certified if they are doing repairs/remodels themselves, or 2) that they advisedly hire a lead-safe certified firm. A concise EPA handout on providers’ responsibilities is available.

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Childhood Lead Poisoning Prevention

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1. What are symptoms of lead poisoning in a child?

Children with lead poisoning may not look or act sick. Sometimes symptoms may be mistaken for other illnesses, such as an upset stomach. Possible signs of lead poisoning include: fatigue or loss of energy, poor appetite, hyperactivity, weight loss, irritability or crankiness, difficulty sleeping, reduced attention span and constipation or stomach aches

2. How does a child get exposed to lead?

Usually lead poisoning happens when a person eats or breathes in small amounts of lead in paint dust or common household items. Children are at higher risk of poisoning because they typically crawl and play on the floor, where lead dust from lead based paint settles. Also, to explore their world, they frequently mouth objects. If these items contain lead or are covered with lead dust, the child may ingest the lead.

3. What in my home may contain lead?

Houses built before 1978 may have lead paint. When the paint breaks down, it forms dust that people can inhale or ingest. Children can ingest this dust by crawling on the floor and mouthing objects. Parents who work with lead may bring lead dust home on their clothes or shoes, so they should remove clothing before entering the home. Other sources of lead in the home include: soil contaminated with lead, brass keys and fixtures, old plumbing leaking lead into tap water, food made or stored in lead-glazed ceramics, lead fishing sinkers and bullets, ceramic floor tile, plastic and painted furniture, old bathtubs, stained glass, imported painted toys, toy jewelry, Vinyl mini-blinds, Alternative medicines, spices, candy, makeup and toys from other countries, dishware from other countries, and health supplements from other countries.

4. What can I do to protect myself and my family from exposure to lead?

Visit the Colorado Department of Public Health and Environment for several examples of how risk can be reduced.  Lead can be in everyday items in your home. Old or imported items are more likely to have lead based finishes and paint in them. If you would like any of your household items tested for lead, contact Kayla Lesperance at 303 363 3030.

5. What services does Tri-County Health provide if my child has an elevated blood lead level (EBLL)?

When a child has a confirmed blood lead level greater than or equal to 5µg/dL, Tri-County Health department will conduct an investigation which could include a home visit. These services are free of charge, contact Kayla Lesperance at (720) 435-3490 for more information.

6. What foods should I feed my child to reduce the absorption of lead in her body?

Offer your child foods high in:

Iron - lean meats, fish, cereals high in iron, dried fruits such as raisins and prunes
Calcium - milk, yogurt cheese, green leafy vegetables
Vitamin C - citrus fruits and juices, tomatoes, tomato juice, green peppers

7. If my child has an elevated blood lead level (EBLL), what is the one most effective thing I can do to prevent further exposure?

Since the lead is often on the child’s hands first, an effective method to reduce your child’s lead exposure is to wash their hands with bar soap and water at least 6 times per day. Their hands should always be washed before eating and sleeping. Please note that antibacterial hand soap or hand sanitizer that you just rub on your hands (no water involvement) does not remove lead. On the other hand, bar soap and water is effective.

8. How can I find a Colorado certified lead contractor to permanently remove lead-based paint in my home or hire a certified lead professional who can do a lead evaluation of my home?

Go to the Colorado Department of Public Health and Environment Lead Page, to find a certified abatement professional and certified lead professional.

9. Are there regulations for testing painted surfaces like walls and windows in a home prior to renovations, remodeling projects, repairs, and painting jobs?

The Environmental Protection Agency's (EPA) Lead Renovation, Repair and Painting Rule (RRP Rule) requires that firms performing renovation, repair, and painting projects that disturb lead-based paint in homes, child care facilities and pre-schools built before 1978 have their firm certified by EPA (or an EPA authorized state), use certified renovators who are trained by EPA-approved training providers and follow lead-safe work practices. For more information on this rule, see the EPA’s RRP Rule website or call the EPA's Denver Lead Program Office at 303-312-6966.

10. Can family members bring home lead from their job and lead poison my child?

Yes they can. Shower and change your clothes and shoes after working around lead-based products. This will keep lead dust from being tracked through your automobile and home, which will lower the chance of your family being exposed. For more information on protecting a family member from lead exposures at work, see the Centers for Disease Control's (CDC) website Information for Workers web page--How You Can Keep Yourself and Your Family Safe from Lead .

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Childhood Lead Poisoning Prevention for Healthcare Providers

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1. How should the skin be cleaned prior to collecting capillary blood lead samples?

A venous blood lead test is recommended because capillary blood lead tests can be
falsely elevated due to contamination by lead from the skin surface. To minimize contamination by lead from the skin surface, the Centers for Disease Control and Prevention (CDC) recommends following the steps below for a capillary blood lead test.

1. Select examination gloves. Use non-powdered gloves because some forms of talc used to powder gloves may have lead contamination.
2. Wash the child’s hands thoroughly with soap and water, and then dry them with a clean, low-lint towel. Plain, unprinted, non-recycled towels are best.
3. Grasp the finger that has been selected for puncture between your thumb and index finger with the palm of the child’s hand facing up.
4. If not done during washing, massage the fleshy portion of the finger gently.
5. Clean the ball or pad of the finger to be punctured with an alcohol swab. Dry the fingertip using sterile gauze or a cotton ball.

2. What type of sample, venous or capillary, is necessary to confirm an elevated blood lead level?

If the first sample is a venous and the lead concentration measures greater than or equal to 5 micrograms per deciliter of blood, there is no need to re-test the blood. This indicates a confirmed elevated blood lead level. If the first sample is a capillary, and it is greater than or equal to 5 micrograms/ deciliter, it needs to be confirmed by following up with a venous sample or a second capillary sample collected between 1 day and less than 12 weeks after the first test.

3. Which children in colorado should be tested for lead?

For more information visit the Colorado Department of Public Health and Environment's (CDPHE) Lead Screening Recommendations page.

4. How do I report an elevated blood lead level (EBLL) to Tri-County Health Department?

Contact Kayla Lesperance at (303) 363-3030. She will need to know the name of the child, date of birth, child's address, date of blood lead test, whether it was a venous or capillary sample, test result, and whether it was confirmed as being elevated. She will also need your name, clinic name, and clinic address. Feel free to leave this information on her confidential voice mail. Normally all blood lead test results are reported by the testing laboratory to the Colorado Department of Public Health and Environment (CDPHE). CDPHE then reports blodd lead level's of 5 microgram/deciliter or greater to the respective local health department for follow-up.

5. How frequently should children with EBLLs be tested?

Please consult the Colorado Department of Public Health and Environment (CDPHE) Childhood Blood Lead Retesting and Case Management Chart.

6. Does Tri-County have a standard Lead Exposure Risk Assessment Questionnaire to use to evaluate if a child is at risk of having an elevated blood lead level?

Yes, we do! Please use the Lead Exposure Risk Assessment Questionnaire for Children as well as its accompanying document, Lead Exposure Risk Assessment Explanations on Lead Sources.

7. What services does Tri-County provide for children with EBLLs?

When a child has a confirmed EBLL greater than or equal to 10 micrograms/deciliter, Tri-County Health Dept. Industrial Hygiene Program staff will schedule an onsite visit to identify lead sources in the home. Tri-County has trained staff to test paint, soil, and household objects for lead. We will provide both the parent and the physician with a report of our findings. These services are provided free of charge.

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Children With Special Needs

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1. Who is eligible for services?

Children from birth to age 21 who are at increased risk of serious chronic physical, developmental, behavioral or emotional conditions and who require health and related services of a type or amount beyond what is generally required.

2. What services are provided?

We offer care coordination services, through home visit or telephone consultation, to families residing in Adams, Arapahoe, and Douglas Counties, regardless of income. Our services include support and resources for parents and their child with special health care needs.

3. How do I make a referral?

Referrals to our HCP program at Tri-County Health Department, can be made by families, schools, medical and service providers, and other concerned people.

If you know of a child you think might benefit from our HCP program services, please call our office at 303-783-7139, or complete a referral, print it out and fax to the phone number at the top of the referral form. (Please do not use child’s name if making inquiries via email.)

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Clinical Scholar Program

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1. What schools are given priority for nursing student rotations at Tri-County Health Department?

Tri-County Health Department maintains contracts with Regis University, the University of Colorado, and the University of Northern Colorado to provide clinical faculty and placement for undergraduate nursing students on a routine basis. TCHD is contractually obligated to give these three universities priority when accepting students for public health rotations.

2. What sorts of experiences are available to nursing students at Tri-County Health Department?

Nursing students are presented with the opportunity to spend time in the majority of nursing departments including Family Planning, Immunizations, and our Outreach and Home Visiting programs as well as a variety of community sites that spotlight the work of Public Health.

3. Does the Division of Nursing at Tri-County Health Department accept volunteers?

The Division of Nursing does not accept volunteers at this time, however, please check with the Office of Emergency Preparedness or the Division of Nutrition for potential volunteer opportunities within the agency.

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Cockroaches

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1. What is the best way to monitor cockroach populations?

Traps offer the best way to monitor cockroach populations. By placing traps in several locations and inspecting them regularly, you can identify the areas of most severe infestation and know where to concentrate control efforts. Traps also can be very helpful in evaluating the effectiveness of control strategies. Retail cockroach sticky traps work well. These traps are open-ended and are lined inside with a sticky material.

2. What can I do to help minimize or get rid of cockroaches?

Cockroaches thrive where food and water are available to them. Even tiny amounts of crumbs or liquids caught between cracks provide a food source. Important sanitation measures include the following: store food in insect-proof containers such as glass jars or re-sealable plastic containers, keep garbage and trash containers with tight fitting lids and use liners. Remove trash, newspapers, magazines, piles of paper bags, rags, boxes, and other items that provide hiding places and harborage. Eliminate plumbing leaks and correct other sources of free moisture. Increase ventilation where condensation is a problem. Vacuum cracks and crevices to remove food and debris. Be sure surfaces where food or beverages have been spilled are cleaned up immediately. Vacuuming also removes cockroaches, shed skins, and egg capsules.

3. Do cockroaches spread diseases?

Different forms of gastroenteritis (food poisoning, dysentery, diarrhea, etc.) appear to be the principal diseases transmitted by cockroaches. These disease-causing organisms are carried on the legs and bodies of cockroaches, and are deposited on food and utensils as cockroaches forage.

4. My rental unit has cockroaches, what should I do?

It is best to read your lease first, as it may contain information as to who is responsible for treating pests. If your land lord is responsible, contact your land lord. If you are responsible, contact a licensed pest control company that is experienced with treating cockroaches. Regardless of who is responsible, getting rid of a cockroach infestation involves a combination of prevention and sanitation, monitoring and the use of control methods.

5. Can Tri-County Health Department make my landlord get rid of cockroaches in my rental property?

Tri-County Health Department does not have a Housing Ordinance and does not have legal authority over private property including rental properties. Tri-County can document a cockroach problem and provide educational resources on how to prevent and eliminate a cockroach infestation, but is not able to mandate (require) action by a landlord. If you are renting, it is important to thoroughly read your lease to identify who is responsible for pest control. Tri-County Health Department cannot provide legal services. For further legal questions you can contact Colorado Legal Services at 303-837-1313.

6. What is a good pest control company?

Unfortunately, Tri-County Health Department cannot recommend a pest control company. You can find many companies in the Yellow Pages or through an internet search. The Colorado Department of Agriculture at 303-239-4140 can also provide a list of licensed pest control operators.

7. How long after an exterminator visits and sprays/places traps/etc. should it take cockroaches to die off completely?

It depends on the size of the infestation, the treatment and the formulations used. Some infestations are so severe that many follow-up visits are required. As the homeowner or tenant, it is imperative you follow the instruction from the Pest Specialist as this will expedite getting positive results from the treatment.

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Community Health

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1. Is information for my city available?

It depends on the type of information you are looking for. Please give us a call at 720-200-1525, and we will discuss your needs.

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Cottage Food

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1. Is it true that I need to have my food handling/safety training done before I start selling?

Yes, the Colorado Cottage Foods Act requires “producers to be certified in safe food handling and processing by a third-party certifying entity, comparable to and including the United States Department of Agriculture or the Colorado State University Cooperative Extension Service, and must maintain a status of good standing in accordance with the certifying entity practices and procedures, including attending any classes required for certification.”

2. Do all employees in my business need safe food handling/processing training?

Yes. All employees directly handling food products are under the same guidelines of the Colorado Cottage Foods Act as stated above and need to have the same safe food handling/processing training and certification.

3. Are all pies allowed?

Many pies are allowed, however, potentially hazardous pies such as some pumpkin and cream pies are not allowed since they support pathogenic growth and therefore require refrigeration.

4. Would frozen jam/jelly be allowed?

No, frozen foods are not allowed cottage foods under the Colorado Cottage Foods Act.

5. What about using all your own home grown goods? Do I need a license to use them?

You are allowed to use home grown produce and herbs in the products you produce for sale. You do not need a license, but safe food handling/processing guidelines should be followed.

6. I want to sell canned little cakes and quick breads, is that allowed?

No, cakes and quick breads baked in a canning jar are not allowed, as they are not a safe product. Dry mixes that are labeled can be packed in a canning jar. The only canned products allowed under the Act are jams, jellies, and fruit butters (with the exception of jalapeno jelly and pumpkin butters which are not allowed).

7. Are traditionally fermented foods allowed, for instance, lacto-fermented pickles and such?

No, fermented foods are not covered under the Colorado Cottage Foods Act.

8. Why is jam production allowed but canned fruits are not allowed?

The preserved products allowed in Colorado as cottage foods (jams, jellies, some fruit butters) have different characteristics than canned fruits and vegetables. Higher amounts of sugar in these products lower the water activity and therefore inhibit the growth of microorganisms.

9. How do you label a wedding cake that is unpackaged?

For cakes that are not easily packaged, you must include all labeling requirements on the invoice and deliver the invoice with the cake directly to the consumer (purchaser). Smaller cakes must be boxed and the label must be included on the box.

10. When a home is mentioned, does that also apply to your apartment?

Yes, as long as the kitchen is in your primary residence. Do check on the policies for your HOA about operating a small business out of your home.

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COVID-19 Testing

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1. Should I get tested?

Anyone with COVID-19 symptoms like cough, fever, or other respiratory problems, regardless of vaccination status or prior infection, should call their healthcare provider for guidance and separate themselves from others. Non-vaccinated individuals who have been exposed to someone with COVID-19 should quarantine for 14 days from the last date they were exposed.

Public health recommends a full 14-day quarantine as the best way to reduce disease spread. However, CDC has two alternative options for shortening quarantine if you are having hardship by staying home. An exposed person may shorten quarantine in the following situations: 

• Quarantine can end after Day 10 if no symptoms have developed during daily monitoring; a test is not required. 
• Quarantine can end after Day 7 if no symptoms have developed during daily monitoring and if you have a negative molecular or antigen test. The test must be collected within 2 days of the planned end of quarantine (in other words, 5 days after exposure), and a negative test result must be back before ending quarantine.
• Under no circumstances should the quarantine end before 7 days have fully passed.

If you have received the full series of a COVID-19 vaccine and at least 14 days have passed since the final dose, you do not have to quarantine. However, you must monitor yourself for symptoms and if symptoms develop, isolate and get tested for COVID.

For information about FREE testing sites in the area, visit www.tchd.org/COVID-19Testing

Individuals with insurance

Call or email your healthcare provider, or a telehealth line or nurseline, to get their advice before going to any health facility.

Individuals with no insurance

Contact a free telehealth line or nurseline service

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Get text messages that support how to manage your symptoms, access care, and more by using the Colorado COVID Symptom Support tool. Review general questions and answers on the state’s FAQ page.

2. Where can I get tested?

Call your health care provider before going to the clinic or hospital to be tested. Ask your provider or local clinic if they offer telehealth visits, or call one of Colorado’s nurselines. Your healthcare provider may send you to a place that has testing available. Some testing sites require a referral and to schedule an appointment ahead of time. Check the details of each testing site online for the most up-to-date information.  

Testing Sites

• Review the TCHD COVID-19 testing web page with a listing of FREE testing sites.
• View the state's map of testing sites near you. 
• Find additional testing locations at 2-1-1 by searching your zip code a list of testing sites near you. 
• Some of the FREE testing sites offer walk-up options and do not require that you have a car. Check individual testing site information before going.

Community Health Centers 

These clinics accept patients regardless of insurance status.

• STRIDE Community Health Center provides telehealth and testing for the general public
• Clinica Family Health provides telehealth and testing for current patients and the general public at their Lafayette location
• Salud Family Health Centers provides telehealth and testing for current patients.
• Peak Vista Community Health Centers provides telehealth and testing for current patients and the general public in El Paso County.
• Sheridan Health Services provides an initial assessment by phone, televideo, or in-person.

3. What should I know about At-Home testing?

We have published at updated guide to At-Home COVID-19 Testing. It it you will find information on potential costs, the type of tests, and different testing providers. 

4. Who can order the free Binax At-Home Rapid Testing

Testing kits are free of charge to all Coloradans who interact with the public at their jobs. Each kit comes with 6 individual tests to enable ongoing screening. You will be able to self test every 5 days to monitor any potential contraction of COVID-19. You can reorder a new kit 20 days after your last order.

Complete the Enrollment Form and Get Your COVID-19 Test Kit Delivered Directly to You 

1. Verify your work and email address by filling out the State of Colorado's BinaxNOW™ COVID-19 Ag Card Testing at Home Enrollment Form. 
2. Within one business day, individuals will receive a confirmation email from the Colorado Department of Public Health and Environmen which includes a link to order a test kit, free of charge, directly to their homes. 
3. Upon receiving a test kit, individuals will log onto a telehealth portal and receive guided instruction by a trained representative from eMed, one of the nation’s leading digital health providers. Telehealth services are available in English and Spanish.

Watch the Binax At-Home How To video in Spanish

5. If I have no symptoms, should I get tested for COVID-19?

The CDC recommends COVID-19 Testing for: 

• People who have symptoms of COVID-19.
• Most people who have had close contact (within 6 feet for a total of 15 minutes or more over a 24-hour period) with someone with confirmed COVID-19.
  1. Fully vaccinated people with no COVID-19 symptoms do not need to be tested following an exposure to someone with COVID-19.
  2. People who have tested positive for COVID-19 within the past 3 months and recovered do not need to get tested following an exposure as long as they do not develop new symptoms.
• People who have taken part in activities that put them at higher risk for COVID-19 because they cannot physically distance as needed to avoid exposure, such as travel, attending large social or mass gatherings, or being in crowded or poorly-ventilated indoor settings.
• People who have been asked or referred to get tested by their healthcare provider, or state, tribal, local, or territorial health department.

CDC recommends that anyone with any signs or symptoms of COVID-19 get tested, regardless of vaccination status or prior infection. If you get tested because you have symptoms or were potentially exposed to the virus, you should stay away from others pending test results and follow the advice of your health care provider or a public health professional. 

More is available information on who should get tested and when from the CDC. 

A negative test on a particular day does not guarantee that a person will not develop COVID-19 at any point in the future. Quarantine can end after Day 7 if no symptoms have developed during daily monitoring and if you have a negative molecular or antigen test. The test must be collected within 2 days of the planned end of quarantine (in other words, 5 days after exposure), and a negative test result must be back before ending quarantine Find where you can get tested at www.tchd.org/COVID-19Testing

6. What is the difference between the tests available?

Watch this video to learn about the difference between the tests available.  

• Find where you can get tested at www.tchd.org/COVID-19Testing
• Learn more about testing basics by reviewing the FDA testing fact sheet and Rapid-testing FAQS. 
• Learn about when to get tested even if you don’t have symptoms.

7. Should I get tested if I think I have been re-infected?

People who have tested positive for COVID-19 within the past 3 months and recovered do not need to get tested following an exposure as long as they do not develop new symptoms. Check with your healthcare provider if you think you have been re-exposed after 3 months of your last positive COVID-19 test and have developed symptoms.

As COVID-19 continues to circulate, individuals who had a positive COVID-19 test may be re-exposed to the virus. Many questions about immunity after infection remain and scientific studies are underway to determine whether someone who had an infection before can get be reinfected. Find where you can get tested.

8. What are the symptoms of COVID-19?

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Older adults and people who have severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more serious complications from COVID-19 illness.

Symptoms may appear 2-14 days after exposure to the virus. 

People with these symptoms may have COVID-19:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

This list does not include all possible symptoms. CDC will continue to update this list as we learn more about COVID-19. Find where you can get tested at www.tchd.org/COVID-19Testing

9. Where can I get ongoing care including primary care if I am uninsured?

These community health centers provide primary care services as well as COVID-19 testing services.

Community Health Centers 

These clinics accept patients regardless of insurance status.

• STRIDE Community Health Center provides telehealth and testing for the general public
• Clinica Family Health provides telehealth and testing for current patients and the general public at their Lafayette location
• Salud Family Health Centers provide telehealth and testing for current patients.
• Peak Vista Community Health Centers provide telehealth and testing for current patients and the general public in El Paso County.

Other FREE testing locations are listed on our testing site at www.tchd.org/COVID-19Testing.

10. Are some private providers testing?

Private provider testing for the public

The following private providers have indicated that they are able to provide COVID-19 testing. For more information, please contact these companies directly. Because they are private providers and not operated by the State of Colorado, neither the state nor the Colorado Department of Public Health and Environment is responsible for the information about or operations of these testing sites:

National Jewish Health Testing Zip Clinic Advanced Urgent Care & Occupational Medicine NextCare Urgent Care Walgreens UCHealth

AfterOurs Urgent Care Testing Sites King Soopers Little Clinic Rocky Mountain Urgent Care CareNow Urgent Care OnPoint Urgent Care Colorado COVID-19 Drive-Up

You can find additional testing locations at www.tchd.org/COVID-19Testing.

11. How much does it cost to get a COVID-19 test?

COVID-19 testing is covered by all major insurance plans. Contact your health insurer for specific information. If you do not have insurance, review our list of free testing sites.

With Insurance	Without Insurance
Work with providers that are in-network for testing.  Try to find a provider in-network.  Out-of-network cost for testing can range from $100 to $200. In addition to the testing fee, some sites have provider and lab costs. Ask about pricing if you plan to pay  out of pocket.	Some testing sites will waive the cost for testing. Try to visit one of the free testing sites listed on our main free testing sites page. Always ask about pricing if you plan to pay out of pocket at non-free testing sites. Testing can range from $100 to $200. In addition to the testing fee, some sites have additional provider and lab costs.

For assistance with disputing medical bills first contact your insurer, and if problems continue to exist you can reach out  to the Colorado Consumer Health Initiative’s (CCHI) Consumer Assistance Program or the Colorado Division of Insurance. Find where you can get tested at www.tchd.org/COVID-19Testing

Additional Testing Cost Resources

• Policy Directives for COVID-19 Testing During the COVID-19 Public Health Emergency, Families First Coronavirus Response Act (FFCRA)
• Frequently asked questions regarding the FFCRA, the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act)

12. What about antibody/serologic testing?

Antibody tests look for past infection

Antibody or serology tests look for antibodies in your blood to determine if you had a past infection with the virus that causes COVID-19.

• Antibodies are created by your body’s immune system soon after you have been infected or vaccinated.
• Antibodies help you fight off infections and can protect you from getting that disease again. How long this protection may last is different for each disease and each person.

 A COVID-19 antibody test should not be used to diagnose a current infection with the virus. It can take up to 1 to 3 weeks after the infection for your body to make antibodies.

A positive COVID-19 antibody test means past infection

A positive antibody test is presumed to mean a person has been infected with the virus that causes COVID-19 at some point in the past. It does not mean they are currently infected.

You may test positive for antibodies even if you have never had symptoms of COVID-19. This can happen if you had an infection without symptoms, which is called an asymptomatic infection.

How long antibody protection lasts is uncertain

Having antibodies to the virus that causes COVID-19 may provide protection from getting infected with the virus again. But even if it does, we do not know how much protection the antibodies may provide or how long this protection may last. 

You should continue to protect yourself and others since you could get infected with the virus again.

• Get a COVID-19 vaccine.
• Wash your hands often or use hand sanitizer.
• Stay away from others who are sick.
• If you have not been fully vaccinated, please wear a mask when around others.

A negative COVID-19 antibody test means no antibodies detected

A negative antibody tests means you may not have ever had COVID-19 infection. Or, you could have had a current infection or been recently infected and your body had not made antibodies at the time your blood was drawn for the test.

Learn more

Read more about testing for past COVID-19 infections on the CDC website. 

13. Where can I find more testing resources and information?

Find where you can get tested at www.tchd.org/COVID-19Testing.

Additional testing resources and information

• Testing for COVID-19, Colorado Department of Public Health and Environment
• Testing for COVID-19, Centers for Disease Control and Prevention
• COVID-19 and Insurance in Colorado: https://www.colorado.gov/pacific/dora/covid-19-and-insurance

14. What should I bring when I get tested?

Most testing sites ask that you bring the following items to get tested: 

• A mask to protect yourself and the provider
• Proof of registration if you pre-registered
• A photo ID (if you have one) or proof of address
• Your medical insurance card (if you have one)

 Review the testing site’s website before you get tested. Not all items are required at every site and some sites may require additional information.

15. How do I get my results from my test?

The health care provider where you got tested will give you your testing results. Some sites have a phone number or portal for you to access and get your results. 

When you get tested ask how you will be able to get your test results.

16. How soon will I get my results?

Lab turn-around times vary based on where the test is being processed. When you get tested, ask what their test/lab turn-around time is. You can also ask when registering or pre-registering so you will know what to expect. Lab turn-around times can change.

17. What is the difference between a rapid test and quick lab turn-around time?

Rapid, point-of-care

• Diagnostic tests that use a mucus sample from the nose or throat but can be analyzed at the doctor’s office or clinic where the sample is collected and results may be available in minutes. These may be molecular or antigen tests.
  • Note that rapid, point of care test refers to the testing technology being used and is different than the lab turn-around time.

Lab turn-around time

• The amount of time the lab takes to process the test and to be able to provide the results.

18. How are rapid COVID-19 tests different from other tests?

• Rapid tests use a swab from the nose or throat. The swab is analyzed at the doctor’s office or clinic where you are tested. Test results from a rapid test should be available in one hour or less. 
• Polymerase Chain Reaction (PCR) COVID-19 tests are still the most accurate. PCR tests also use a swab from the nose or throat. PCR tests are not rapid and the swab must be sent to a laboratory to analyze the test. Wait times for PCR test results can be as short as 24- 48 hours. If laboratories are overwhelmed it can take a week or more to get results. 
• We encourage you to ask any testing provider how long it will take to get your results and how you will be contacted to get your results. 

19. What are the different types of rapid COVID-19 tests available?

• Molecular: Molecular tests diagnose COVID-19 based on detection of the virus’s genetic material. The rapid molecular test is highly accurate, but the supplies for this test can be limited. 
• Antigen: Antigen tests diagnose COVID-19 based on detecting different parts of the virus. Antigen tests are best used on people who have had COVID-19 symptoms for a few days. However, for people who want to get tested and do not have symptoms, antigen tests have a higher chance of missing an active infection. If you do not have symptoms but got a negative antigen test, your health care provider might order a molecular test to make sure you don’t have COVID-19. 

20. What should I know about rapid testing before getting a rapid test?

Rapid antigen testing can be useful to quickly help determine if you have COVID-19 is widely available in the Denver Metro Area. Many urgent care centers offer rapid testing. We encourage you to call the site before you go to find out if they offer rapid testing. 

Antigen tests with positive results are usually highly accurate. However, negative results may need to be confirmed with a molecular test. If you don’t have symptoms of COVID-19 but need to be tested, a molecular test may be the better test to use.  

To find a location near you, visit the Colorado COVID Testing Locator. 

21. What questions should I ask the site that is conducting rapid testing?

• What type of rapid test are you offering, molecular or antigen?
• Is the rapid test being offered authorized by the FDA?
• Is the rapid testing covered by insurance?
• Which insurances does the test site accept? You should also check with your insurance company before you are tested that the site and the test will be covered.
• Are there any additional costs associated with the testing that may not be covered by my insurance?

22. What are the requirements for travel?

Some states and countries require a negative test before entry. Often, these tests must be completed within 24-72 hours before arrival. In some cases, the tests must be a molecular test and rapid antigen tests will not be accepted. Find out which type of test the travel location will accept. It is a good idea to check with your airline before you go to make sure you can enter/exit your destination easily. Learn more about testing requirements for travel traveling at the Centers for Disease Control Testing and Air Travel Webpage.

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COVID-19 Testing in Spanish

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1. Si no tengo síntomas, ¿debería hacerme la prueba de COVID-19?

A medida que la capacidad de prueba continúa expandiéndose, los proveedores de atención médica pueden considerar la posibilidad de realizar pruebas a personas que no presentan síntomas. El objetivo de la prueba sería identificar a las personas positivas a COVID-19 que no sabían que estaban infectadas. Las pruebas asintomáticas pueden ser útiles para cualquier persona que:

• Trabaja en una ocupación de alto riesgo, como trabajadores de la salud o en primeros auxilios.
• Vive en centros de atención a largo plazo u otros entornos institucionalizados.
• Ha estado en contacto directo con alguien conocido que haya tenido COVID-19.

Sin embargo, los resultados de las pruebas deben interpretarse con cuidado. Una prueba positiva debe tratarse como un caso de COVID-19 y esas personas deben permanecer en casa y alejadas de los demás durante 10 días después de la recolección de la prueba (suponiendo que no se desarrollen síntomas).

Una prueba negativa en un día en particular no garantiza que una persona no desarrolle COVID-19 en ningún momento en el futuro. Además, una prueba negativa no puede sacar a alguien de la cuarentena si ha estado en contacto cercano con alguien que se sabe que tiene COVID-19. Encuentre dónde puede hacerse la prueba en www.tchd.org/884/Sitios-de-prueba-en-los-condados.

2. ¿Debo hacerme la prueba?

Cualquier persona con síntomas de COVID-19 como tos, fiebre u otros problemas respiratorios debe llamar a su proveedor de atención médica para recibir orientación y separarse de los demás. Cualquiera que haya estado en contacto con alguien con COVID-19 debe estar en cuarentena durante 14 días a partir de la última fecha en que estuvo expuesto.

Debe esperar unos siete días después de pensar que estuvo expuesto antes de hacerse la prueba para asegurarse de que haya suficiente virus para que la prueba encuentre COVID-19 en su cuerpo. Incluso si su prueba de COVID-19 es negativa antes del final de las dos semanas de cuarentena, debe quedarse en casa durante los 14 días completos, en caso de que se enferme después de la prueba. Descubra dónde puede hacerse la prueba en www.tchd.org/884/Sitios-de-prueba-en-los-condados.

Personas con seguro

Llame o envíe un correo electrónico a su proveedor de atención médica, o a una línea de telesalud o enfermería para obtener su asesoramiento antes de ir a cualquier centro de salud.

Personas sin seguro

CovidLine es una línea directa gratuita para la detección de COVID-19 y el servicio de telesalud para los residentes de los condados de Adams, Arapahoe y Douglas que pueden no tener seguro. Línea directa telefónica de CovidLine:

• Local: 720-902-9449
• Gratuita: 855-963-3721

Herramienta de ayuda para síntomas COVID de Colorado

Reciba mensajes de texto que le indiquen cómo controlar sus síntomas, acceder a la atención médica y más mediante el uso de la herramienta Colorado COVID Symptom Support. https://symptomsupport.covid19.colorado.gov/intake-form. Revise las preguntas y respuestas generales en la página de preguntas frecuentes del estado.

3. Si no tengo síntomas, ¿debería hacerme la prueba de COVID-19?

A medida que la capacidad de prueba continúa expandiéndose, los proveedores de atención médica pueden considerar la posibilidad de realizar pruebas a personas que no presentan síntomas. El objetivo de la prueba sería identificar a las personas positivas a COVID-19 que no sabían que estaban infectadas. Las pruebas asintomáticas pueden ser útiles para cualquier persona que:

• Trabaja en una ocupación de alto riesgo, como trabajadores de la salud o en primeros auxilios.
• Vive en centros de atención a largo plazo u otros entornos institucionalizados.
• Ha estado en contacto directo con alguien conocido que haya tenido COVID-19.

Sin embargo, los resultados de las pruebas deben interpretarse con cuidado. Una prueba positiva debe tratarse como un caso de COVID-19 y esas personas deben permanecer en casa y alejadas de los demás durante 10 días después de la recolección de la prueba (suponiendo que no se desarrollen síntomas).

Una prueba negativa en un día en particular no garantiza que una persona no desarrolle COVID-19 en ningún momento en el futuro. Además, una prueba negativa no puede sacar a alguien de la cuarentena si ha estado en contacto cercano con alguien que se sabe que tiene COVID-19. Encuentre dónde puede hacerse la prueba en www.tchd.org/884/Sitios-de-prueba-en-los-condados.

4. ¿Cuál es la diferencia entre las pruebas disponibles?

Mire este video para conocer la diferencia entre las pruebas disponibles. Es importante que se haga la prueba si estuvo cerca de alguien que tiene COVID-19, incluso si no tiene síntomas. Encuentre dónde puede hacerse la prueba en www.tchd.org/884/Sitios-de-prueba-en-los-condados

Obtenga más información sobre los conceptos básicos de las pruebas revisando la hoja de datos de pruebas de la FDA.

Preguntas frecuentes sobre pruebas rápidas

5. ¿Cuáles son los síntomas del COVID-19?

Las personas con COVID-19 han reportado una amplia gama de síntomas, que van desde síntomas leves hasta enfermedades graves. Los adultos mayores y las personas que tienen afecciones médicas subyacentes graves, como enfermedades cardíacas o pulmonares o diabetes, parecen tener un mayor riesgo de desarrollar complicaciones más graves por la enfermedad COVID-19.

Los síntomas pueden aparecer de 2 a 14 días después de la exposición al virus.

Las personas con estos síntomas pueden tener COVID-19:

• Fiebre o escalofríos
• Tos
• Falta de aire o dificultad para respirar.
• Fatiga
• Dolores musculares o corporales
• Dolor de cabeza
• Pérdida del gusto u olfato
• Dolor de garganta
• Congestión o secreción nasal.
• Náuseas o vómitos
• Diarrea

Esta lista no incluye todos los síntomas posibles. CDC continuarán actualizando, esta lista a medida que aprendamos más sobre COVID-19. Encuentre dónde puede hacerse la prueba en www.tchd.org/884/Sitios-de-prueba-en-los-condados

6. ¿Debo hacerme la prueba si creo que me he vuelto a infectar?

Consulte con su proveedor de atención médica si cree que se ha vuelto a exponer.

A medida que COVID-19 continúa circulando, las personas que dieron positivo en la prueba de COVID-19 pueden volver a exponerse al virus. Aún quedan muchas preguntas sobre la inmunidad después de la infección y se están realizando estudios científicos para determinar si alguien que tuvo una infección antes puede volver a infectarse. Encuentre dónde puede hacerse la prueba en www.tchd.org/884/Sitios-de-prueba-en-los-condados

7. ¿Dónde puedo hacerme la prueba?

Llame a su proveedor de atención médica antes de ir a la clínica o al hospital para hacerse la prueba. Pregúntele a su proveedor o clínica local si ofrecen visitas de telesalud o llame a una de las líneas de enfermería (only in English) de Colorado.

Actualmente, no analizamos ni recolectamos muestras directamente para realizar pruebas. Su proveedor de atención médica puede enviarlo a un lugar que tenga pruebas disponibles. Algunos sitios de prueba requieren una referencia y programar una cita con anticipación. Consulte los detalles de cada sitio de prueba en línea para obtener la información más actualizada.

Sitios de prueba

• Revise la página del sitio de prueba
• Encuentre ubicaciones de prueba adicionales en 2-1-1 buscando en su código postal una lista de sitios de prueba cerca de usted.
• Algunos de los sitios de prueba GRATUITOS (link Spanish page) ofrecen opciones sin cita previa y no requieren que tenga un automóvil. Verifique la información del sitio de prueba individual antes de ir.

Centros de salud comunitarios

Estas clínicas aceptan pacientes independientemente del estado de su seguro.

• STRIDE Community Health Center ofrece telesalud y pruebas para el público en general
• Clinica Family Health ofrece telesalud y pruebas para pacientes actuales y el público en general en su ubicación de Lafayette
• Salud Family Health Centers ofrece telesalud y pruebas para los pacientes actuales.
• Peak Vista Community Health Centers ofrece telesalud y pruebas para pacientes actuales y el público en general en el condado de El Paso.
• Sheridan Health Services proporciona una evaluación inicial por teléfono, televídeo o en persona.

8. ¿Dónde puedo obtener atención continua, incluida la atención médica/primaria, si no tengo seguro?

stos centros de salud comunitarios brindan servicios de atención primaria, así como servicios de pruebas de COVID-19.

Centros de salud comunitarios

Estas clínicas aceptan pacientes independientemente del estado del seguro.

• STRIDE Community Health Center ofrece telesalud y pruebas para el público en general
• Clinica Family Health ofrece telesalud y pruebas para pacientes actuales y el público en general en su ubicación de Lafayette
• Salud Family Health Centers ofrece telesalud y pruebas para los pacientes actuales.
• Peak Vista Community Health Centers ofrece telesalud y pruebas para pacientes actuales y el público en general en el condado de El Paso.

Otras ubicaciones se enlistan en nuestro sitio de pruebas en www.tchd.org/884/Sitios-de-prueba-en-los-condados

9. ¿Están realizando pruebas algunos proveedores privados?

Pruebas de proveedores privados para el público

Los siguientes proveedores privados han indicado que pueden proporcionar pruebas de COVID-19. Para obtener más información, comuníquese directamente con estas empresas. Debido a que son proveedores privados y no son operados por el estado de Colorado, ni el estado ni el Departamento de Salud Pública y Medio Ambiente de Colorado son responsables de la información o las operaciones de estos sitios de prueba:

National Jewish Health Testing Zip Clinic Advanced Urgent Care & Occupational Medicine NextCare Urgent Care Walgreens UCHealth

AfterOurs Urgent Care Testing Sites King Soopers Little Clinic Rocky Mountain Urgent Care CareNow Urgent Care OnPoint Urgent Care Colorado COVID-19 Drive-Up

Puede encontrar ubicaciones de pruebas adicionales en www.tchd.org/884/Sitios-de-prueba-en-los-condados

10. ¿Cuánto cuesta hacerse una prueba de COVID-19?

La prueba de COVID-19 está cubierta por la mayoría de planes de seguro. Comuníquese con su aseguradora de salud para obtener información específica. Si no tiene seguro, revise nuestra lista de sitios de prueba gratuitos.

Con sequro	Sin sequro
Trabaje con proveedores dentro de la red para realizar pruebas. Intente encontrar un proveedor dentro de la red. El costo de las pruebas fuera de la red puede ser entre $ 100 y $ 200. Además de la tarifa de la prueba, algunos sitios tienen costos adicionales de proveedores y  laboratorio. Pregunte sobre los precios si planea pagar de su bolsillo.	Algunos sitios de prueba no cobrarán la prueba. Intente visitar uno de los sitios de prueba gratuitos que se enumeran en la pestaña "Próximos eventos de prueba" en esta página. Pregunte sobre los precios si planea pagar de su bolsillo. Las pruebas pueden costar entre $ 100 y $ 200. Además de la tarifa de la prueba, algunos sitios tienen costos adicionales de proveedores y  laboratorio.

Para obtener ayuda con la disputa de facturas médicas, comuníquese primero con su aseguradora y, si los problemas continúan, puede comunicarse con el Programa de Asistencia al Consumidor de la Iniciativa de Salud para el Consumidor de Colorado (CCHI), only in English o la División de Seguros de Colorado, Encuentre dónde puede hacerse la prueba en www.tchd.org/884/Sitios-de-prueba-en-los-condados

Recursos adicionales de costos de prueba

• Directivas de política para las pruebas de COVID-19 durante la emergencia de salud pública de COVID-19, Ley de respuesta al coronavirus de Families First (FFCRA)
• Preguntas frecuentes, sobre la FFCRA, la Ley de Ayuda, Alivio y Seguridad Económica por Coronavirus (la Ley CARES)

11. ¿Qué pasa con las pruebas de anticuerpos / serológicas?

Tenga cuidado al decidir hacerse la prueba de anticuerpos COVID-19. Las pruebas que se comercializan varían mucho en calidad y precisión y es difícil para el público determinar qué pruebas son mejores.

Tenga cuidado con los correos electrónicos y las publicaciones que venden pruebas de anticuerpos. Existen múltiples estafas o empresas sin escrúpulos que intentan engañar al público con información errónea. En este momento, la FDA no ha autorizado, ninguna prueba de COVID-19 se use y procese por completo en el hogar.

La Administración de Alimentos y Medicamentos (FDA) está realizando estudios de investigación con los Centros para el Control y la Prevención de Enfermedades (CDC) y los Institutos Nacionales de Salud (NIH) para evaluar ciertas pruebas de anticuerpos y estos resultados no se han publicado.

En este momento, las pruebas de anticuerpos no deben usarse para diagnosticar la infección actual por COVID-19. Tener una prueba de anticuerpos positiva no significa necesariamente que tenga protección inmunológica contra la infección.

Independientemente del resultado de una prueba de anticuerpos, siga las mismas pautas para protegerse contra el COVID-19 y siga las instrucciones para quedarse, en casa si tiene síntomas. 

Revise la hoja de datos básicos de pruebas de la FDA para obtener más información sobre los diferentes tipos de pruebas. Encuentre dónde puede hacerse la prueba en www.tchd.org/884/Sitios-de-prueba-en-los-condados.

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COVID-19 Vaccine

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1. Should I worry about myocarditis as a side effect of the vaccine?

It is an extremely rare side effect, and only an exceedingly small number of people will experience it after vaccination. Importantly, for the young people who do, most cases are mild, and individuals recover often on their own or with minimal treatment. In addition, we know that myocarditis and pericarditis are much more common if you get COVID-19, and the risks to the heart from COVID-19 infection can be more severe. Symptoms of myocarditis that should prompt seeking medical evaluation include new symptoms of chest pain, shortness of breath, or feeling of your heart having a fast, fluttering, or pounding heartbeat that occurs within a week after COVID-19 vaccination. Your provider can help determine the cause of these symptoms and whether any treatment is needed.

The COVID-19 vaccine is recommended by the CDC and national physician organizations. We strongly encourage everyone age 12 and older who are eligible to receive the vaccine to get vaccinated, as the benefits of vaccination far outweigh any harm, especially with the troubling Delta variant increasingly circulating.

Read more on the CDC’s webpage about Myocarditis and Pericarditis Following mRNA COVID-19 Vaccination.

U.S. Department of Health and Human Services
U.S. Centers for Disease Control and Prevention
American Academy of Family Physicians
American Academy of Pediatrics
American College of Obstetricians and Gynecologists
American College of Physicians
American Heart Association
American Hospital Association
American Medical Association
American Nurses Association
American Public Health Association
Association of Public Health Laboratories
Association of State and Territorial Health Officials
Big Cities Health Coalition
Council of State and Territorial Epidemiologists
Infectious Diseases Society of America
National Association of County and City Health Officials

2. Can I get the vaccine right now?

Coloradans 16 years and older can get a COVID-19 vaccine. Find a vaccine provider near you at www.tchd.org/COVIDvaccine

3. How do we know if vaccines are safe?

• The FDA requires that vaccines undergo a rigorous scientific process, including three phases of clinical trials, before they authorize or approve the vaccine. The COVID-19 vaccines are subject to the same safety standards as other vaccine trials. 

• The independent Data and Safety Monitoring Board overseeing Phase 3 trials of the Pfizer, Moderna, and Janssen (Johnson & Johnson) vaccines has not identified or reported any serious safety concerns. All phase 3 studies have Data Safety and Monitoring Boards. The boards are made up of independent scientists hired by the company to look at the safety data and check at regular intervals whether the company should cancel or continue with the study.  

• Additionally, two independent advisory committees will review a vaccine’s safety data before it is made available to the public. These committees are the Vaccines and Related Biological Products Advisory Committee (VRBPAC), which advises the FDA, and the Advisory Committee on Immunization Practices (ACIP), which advises the CDC.

4. What are the side effects of the vaccines?

• You may experience mild to moderate side effects after receiving the vaccine. Side effects typically go away on their own after a few days. The most commonly reported side effects are: 

  • Pain, swelling, and redness at the injection site.

  • Pain, tenderness and swelling of the lymph nodes in the same arm of the injection.

  • Fatigue.

  • Headache.

  • Muscle pain.

  • Chills.

  • Joint pain.

  • Nausea/vomiting.

  • Fever.

• Different people may experience different side effects, even if they receive the same vaccine. 

• The process of building immunity can cause symptoms. These symptoms are normal and show that your body’s immune system is responding to a vaccine. Other routine vaccines, like the flu vaccine, have similar side effects.

• If you experience discomfort after the first dose of the vaccine, it is very important that you still receive the second dose a few weeks later for full protection.

• For in-depth information about the side effects of the vaccines, see the CDC’s report on the Pfizer vaccine and the Moderna vaccine.

5. Can I get COVID-19 from a vaccine?

No. It is not possible to get COVID-19 from a vaccine, but you may feel some side effects like fever, chills, and fatigue. The current mRNA vaccines use temporary pieces of genetic code from the virus to stimulate your body’s immune response. This cannot cause COVID-19. The goal of the vaccine is to provide your body with the tools it needs to fight the COVID-19 virus if you were to get infected.  

6. How was the vaccine able to get developed so quickly?

• In developing a vaccine for COVID-19, researchers had to work quickly, but not at the risk of anyone’s safety. Medical researchers did not cut any corners or skip any steps. Safety and effectiveness were the top priorities. 

• The timeline for developing COVID-19 vaccines was possible for several reasons: 

  • Researchers relied on years of previous research in other viruses and vaccines to help inform a vaccine development process for COVID-19. 

  • Everyone involved dedicated all their resources and time to developing a COVID-19 vaccine. This includes research institutions, pharmaceutical companies, government agencies, and philanthropic organizations. 

  • Many governments around the world, including the U.S. government, and private funders invested in the vaccine, which allowed pharmaceutical companies to focus on research right away. 

  • Finally, because of the financial support, researchers were able to conduct different parts of the development process on parallel tracks instead of one after another. Usually, each phase in a clinical trial ends before the next phase begins, with several months to a year or more in between each phase. Because of the emergency presented by the pandemic, researchers developed the vaccines on parallel tracks, meaning that they completed the necessary steps at the same time or with some overlap. No steps were skipped in the process of developing the COVID-19 vaccines. 

7. If I have recovered from COVID-19 and completed my isolation period, do I still need to get vaccinated with a COVID-19 vaccine?

It is currently unknown how long natural immunity lasts after recovering from COVID-19. Early evidence suggests natural immunity from COVID-19 may not last very long in some people, and cases of reinfection have been reported. So even if you have had COVID-19 and recovered, you should plan to get a vaccine when it is your turn.  

8. How are the vaccines being allocated?

Vaccine allocations are being distributed proportionately based on county population. At this time, the Colorado Department of Public Health and Environment is making all vaccine allocation decisions due to a limited number of available doses and a short turnaround time between when doses are available in the vaccine ordering system and when orders are required to be placed. We anticipate that vaccine allocation may shift to the local level. Enrolled providers are able to communicate directly with the state on anticipated needs; however, there are a limited number of doses available each week.

9. Do I need to be a U.S. citizen to get the vaccine?

You do not need to be a U.S. citizen, and you will not need to prove lawful presence to get a COVID-19 vaccine in Colorado. Further, public health will never share your information for any immigration or law enforcement purposes.

10. Will the vaccines have any effect on fertility?

Currently, there is no scientific reason or evidence to suggest COVID-19 mRNA vaccines have any effect on fertility. Clinicians and researchers will continue to closely monitor for any issues. Please talk with your doctor about any concerns.

11. How do I become a vaccine provider?

The state is enrolling all vaccine providers. For more information visit the state’s website.

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COVID-19 Vaccine FAQs in Spanish

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1. ¿Puede recibir la vacuna de inmediato?

• Los residentes de Colorado de 16 años o más pueden recibir la vacuna de COVID-19. Encuentre el proveedor de vacunas más cercano en www.tchd.org/COVIDvaccine

2. .¿De qué forma saben si las vacunas son seguras?

• La FDA exige que las vacunas pasen por un proceso científico riguroso, que comprende tres etapas de ensayos clínicos, antes de autorizar o aprobar la vacuna. Las vacunas de COVID-19 se encuentran sometidas a las mismas normas de seguridad que otros ensayos de vacunas. 
• El Consejo de Supervisión de Datos y Seguridad independiente que monitorea los ensayos de etapa 3 de las vacunas Pfizer, Moderna y Janssen (Johnson & Johnson) no ha identificado o comunicado ningún problema de seguridad grave. Todos los estudios de etapa 3 cuentan con consejos de supervisión y seguridad de datos. Los consejos se componen de científicos independientes que contrata la empresa para examinar los datos de seguridad y verificar periódicamente si la empresa debe cancelar o seguir con el estudio.  
• Además, dos comités consultivos independientes revisarán los datos de seguridad de una vacuna antes de que se ponga a disposición del público. Estos comités son el Comité Consultivo de Vacunas y Productos Biológicos Relacionados (VRBPAC, por sus siglas en inglés), que asesora a la FDA, y el Comité Consultivo sobre Prácticas de Inmunización (ACIP, por sus siglas en inglés), que asesora a los CDC.

3. ¿Cuáles son los efectos secundarios de las vacunas?

• Puede sentir efectos secundarios de leves a moderados tras vacunarse. Los efectos secundarios normalmente desaparecen por sí solos al cabo de unos días. Los efectos secundarios que se informan con mayor frecuencia son: 
  • Dolor, inflamación y enrojecimiento en el lugar de la inyección.
  • Dolor, sensibilidad e inflamación de los ganglios linfáticos en el mismo brazo de la inyección.
  • Fatiga.
  • Cefalea.
  • Dolor muscular.
  • Escalofríos.
  • Dolor en las articulaciones.
  • Asco/vómitos.
  • Fiebre.
• Distintas personas pueden sentir distintos efectos secundarios, incluso si reciben la misma vacuna. 
• El proceso de desarrollar inmunidad puede presentar síntomas. Estos síntomas son normales y demuestran que el sistema inmunitario de su cuerpo reacciona ante una vacuna. Otras vacunaciones de rutina, como la vacuna antigripal, poseen efectos secundarios parecidos.
• Si nota alguna molestia tras la primera dosis de la vacuna, es muy importante que reciba la segunda dosis algunas semanas después para una máxima protección.
• Para conocer información detallada acerca de los efectos secundarios de las vacunas, consulte el informe sobre la vacuna Pfizer y la vacuna Moderna de los CDC.

4. ¿Puede contagiarse de COVID-19 por una vacuna?

• No. No es posible contagiarse de COVID-19 por una vacuna, pero es posible que note algunos efectos secundarios como fiebre, escalofríos y fatiga. Las actuales vacunas de ARNm ocupan fragmentos temporales de código genético del virus para provocar la respuesta inmunológica de su cuerpo. Esto no puede generar COVID-19. El objetivo de la vacuna es facilitarle a su cuerpo las herramientas necesarias para combatir el virus del COVID-19 en caso de que se contagie.  

5. ¿Cómo se pudo crear la vacuna tan rápido?

• Al crear una vacuna para el COVID-19, los investigadores tuvieron que trabajar con rapidez, pero sin poner en peligro la seguridad de nadie. Los investigadores médicos no redujeron gastos ni se saltaron ningún paso. La seguridad y eficacia fueron las prioridades principales. 
• El plazo para crear las vacunas de COVID-19 fue posible por diversos motivos: 
  • Los investigadores se basaron en años de investigaciones previas en otros virus y vacunas para ayudar a comunicar un proceso de creación de vacunas para el COVID-19. 
  • Todos quienes participaron dedicaron todos sus recursos y tiempo a la creación de una vacuna de COVID-19. Esto abarca centros de investigación, farmacéuticas, organismos gubernamentales y organizaciones filantrópicas. 
  • Muchos gobiernos de todo el mundo, incluido el gobierno de los Estados Unidos y financiadores privados, invirtieron en la vacuna, lo cual facilitó a las farmacéuticas enfocarse en la investigación inmediatamente. 
  • Por último, debido al apoyo financiero, los investigadores fueron capaces de llevar a cabo distintas partes del proceso de desarrollo en vías paralelas en vez de una tras otra. Normalmente, cada etapa de un ensayo clínico termina antes de que se inicie la siguiente, con un intervalo de varios meses a un año o más entre cada etapa. A causa de la emergencia que presentó la pandemia, los investigadores crearon las vacunas en vías paralelas, lo cual implica que finalizaron las fases necesarias simultáneamente o con cierta superposición. No se saltaron fases en el proceso de creación de las vacunas de COVID-19.

6. Si se ha recuperado del COVID-19 y finalizado su período de cuarentena, ¿aún debe vacunarse con la vacuna de COVID-19?

En la actualidad se desconoce cuánto tiempo perdura la inmunidad natural tras recuperarse del COVID-19. Las primeras pruebas indican que la inmunidad natural contra el COVID-19 puede no perdurar mucho tiempo en algunas personas, y se han comunicado casos de recaída. Así que, incluso si ha tenido COVID-19 y se ha recuperado, debe pensar en vacunarse cuando sea su turno.  

7. ¿De qué forma se reparten las vacunas?

Las asignaciones de vacunas se distribuyen de manera proporcional en función de la población del condado. En la actualidad, el Departamento de Salud Pública y Medio Ambiente de Colorado adopta todas las decisiones de distribución de vacunas debido al reducido número de dosis disponibles y al tiempo de entrega breve entre el momento en que las dosis se encuentran disponibles en el sistema de pedido de vacunas y el momento en que es necesario realizar los pedidos. Prevemos que la distribución de vacunas puede cambiar a nivel local. Los proveedores registrados se pueden comunicar de manera directa con el estado sobre las necesidades previstas; sin embargo, existe una cantidad reducida de dosis disponibles cada semana.

8. ¿Debe ser ciudadano estadunidense para recibir la vacuna?

No es necesario que sea ciudadano estadounidense y no deberá demostrar su presencia legal para recibir la vacuna de COVID-19 en Colorado. Además, salud pública nunca compartirá su información con fines de inmigración o policiales.

9. ¿Tendrán las vacunas alguna repercusión en la fertilidad?

En este momento, no hay ningún motivo científico o pruebas que indiquen que las vacunas de ARNm de COVID-19 tengan alguna repercusión en la fertilidad. Los médicos e investigadores seguirán supervisando de cerca cualquier problema. Por favor, converse con su médico acerca de cualquier inquietud.

10. ¿Cómo ser proveedor de vacunas?

El estado registra a todos los proveedores de vacunas. Para conocer más información, visite el sitio web del estado.

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Death Certificates

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1. What do I need to get a death certificate?

•    Photocopy of the requestor's valid identification

•    Completed death certificate application

•    Proof of direct and tangible interest if applicable

•    Payment

2. Who can obtain death certificate?

Access to copies of Colorado death certificates is restricted to the decedent's parents, grandparents, stepparents, siblings, spouse, adult children, stepchildren or grandchildren of the deceased, legal representatives of any of the above, legal representatives of the deceased, probate researchers, genealogists representing family members with appropriate credentials, others who may demonstrate a direct and tangible interest when information is needed for determination or protection of a personal property right. Proof of relationship or direct and tangible interest is required.

3. Who is an informant?

The informant is the person who provided information about the deceased person to the funeral home so that the death record could be filed.

4. What is direct and tangible interest / examples of tangible interest?

Colorado is a closed record state, therefore direct and tangible interest is required to release a record; meaning proof that the person requesting the death certificate is eligible for the record.

Examples can be a title with both parties listed, a bank account with both parties listed, beneficiary paperwork, lease agreements, social security paperwork, car/home title, etc.

5. What types of death certificates are available?

We offer 3 types of death certificates:

•    Standard death certificate will be the entire records legal information as well as medical will be listed on the death certificate.

•    Legal death certificate will only have legal information such as decedents name, address, social security number etc.

•    Death verification certificate will have minimal information verifying that the person passed away such as name, date of birth, date of death etc.

6. Can I order the death certificate online?

You can apply online through a secure third party website www.vitalchek.com.

7. How are death certificates used?

There are several reasons why you may need to obtain a death certificate. Most often, it’s to serve as proof for legal purposes. These reasons may include:

•    Accessing pension benefits,

•    Claiming life insurance,

•    Settling estates,

•    Getting married (if a widow or widower needs to prove that their previous partner has passed), or

•    Arranging for a funeral.

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Dietetic Internship

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1. How can I learn more about the Tri-County dietetic internship?

We will have prospective intern meetings each fall, so please watch our website for more details. If you will be in the Denver area at another time, you may contact us to request an individual meeting. However, visiting Tri-County before you apply is completely optional. You are also encouraged to follow us on Facebook.

2. How can I make my internship application stand out?

You are encouraged to obtain as much dietetic and/or food-service related experience (paid or unpaid) as you can. You can also demonstrate initiative by showing your involvement in clubs and other school or civic organizations. If you have special skills or training, such as speaking a second language, experience writing a grant, or culinary training, please list this on your application. Be sure to have someone else proofread your application.

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Dietetic Internship Preceptors

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1. What is the time commitment for being a preceptor?

This will vary based on the length of the intern's rotation, but will include time for setting expectations with the intern, explaining and reviewing projects you may have the intern work on, discussing your usual protocol and decision making process for patient care, co-signing chart notes, and time to complete an evaluation on the intern at the end of their rotation with you. On the other hand, many interns are able to complete large projects and give back to the facility through their in-kind service, which can reduce the net time needed for precepting.

2. What kind of training or experience do I need to be a preceptor?

It is preferable to have at least one year of experience as a Registered Dietitian, although that is no longer a requirement of ACEND. Optional online preceptor training is available through the Commission on Dietetic Registration and carries eight free continuing education credits. The Tri-County Dietetic Internship Director can also meet with you for site specific training and to review the rotation checklist and materials.

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Family Planning

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1. Do I need an appointment or can I just walk in?

Exams are by appointment only. Appointments for all services are HIGHLY encouraged. Walk-ins welcome, however wait times may vary. We cannot guarantee walk-ins will be seen the same day. Call 303-363-3018 to schedule an appointment up to a week in advance.

2. How much will my exam and birth control cost?

We offer low cost or no cost confidential services. Fees for birth control services and supplies are based on a sliding scale according to income level.

3. Are your services confidential?

Yes, our services are confidential. We will not give out your personal information without a signed consent.

4. Do you provide emergency contraception? How does it work? When should I use it?

Yes, we provide two types of emergency contraception at our clinics, Plan B One-Step® and ella®.

Plan B One-Step® contains the hormone levonorgestrel. Plan B One-Step® contains a higher dose of levonorgestrel than regular birth control pills, but works in a similar way to prevent pregnancy, mainly by stopping the release of an egg from the ovary. Plan B One-Step® may also work by preventing fertilization of an egg or by preventing attachment (implantation) to the uterus (womb). You should use Plan B One-Step® within 72 hours (3 days) after you have had unprotected sex or experienced birth control failure. Plan B One-Step® is available without a prescription.

ella® works by decreasing progesterone in the body which can stop or delay ovulation and may also change the lining of the uterus preventing the egg from implanting after ovulation. ella® should be taken up to 120 hours (5 days) after unprotected sex or birth control failure. ella® is only available by prescription.

The sooner you take any emergency contraception, the better it works.Emergency contraception is a backup method of birth control you can use when:
• Your regular birth control was used incorrectly or failed
• You did not use any birth control method

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Farmers Markets

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1. Do I need a license to sell food at a farmer’s market?

While some foods may be sold without a license, most foods requiring preparation or refrigeration do require the vendor to hold a Retail Food Establishment License.

2. Is my Temporary Event Retail Food Establishment License valid at farmers markets?

A “Temporary Event” is defined as a single community event or celebration that operates for a period of time of not more than fourteen (14) consecutive days and may include town celebrations, fairs, and festivals. Farmers markets are specifically excluded. Therefore, a Temporary Event Retail Food Establishment License is not valid at a farmers market.

3. Is my Food License issued by the City and County of Denver valid in Tri-County Health Department’s jurisdiction?

A License issued by the City and County of Denver is valid only in the City and County of Denver. A State of Colorado Retail Food Establishment Mobile License is valid anywhere in the State of Colorado except in the City and County of Denver.

4. Do I need a license to roast and sell chilies?

Chili roasting operations are required to have a Retail Food Establishment License. The chilies must be washed in potable water at a commissary, and a handwashing facility must be available at the site where the chilies are roasted and sold. Contact your local Tri-County Environmental Health office for details.

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Food & Nutrition in Child Care

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1. How can our child care program or provider network access professional development training about food and nutrition?

Contact Amanda Gersabeck at 720-200-1515 to discuss options for a training session.

2. Where can I find free lesson plans to use with young children in my child care program?

Check out our Teacher’s Corner page, which has numerous ready-to-go curricula making the task of bringing food and physical activity education to children easy and fun.

3. What are some fresh ideas for preschooler lunches?

Download a month's worth of lunch menu ideas for young children here: A Month of Lunch Ideas.

4. Do you have ideas for a snack rotation schedule that our child care program can use?

Yes, tasty snack ideas young children will enjoy can be found here: A Month of Snack Ideas.

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Food Safety Education

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1. Is a Food Handlers Card required to work in a restaurant in Colorado?

Most restaurants are required to have a certified food protection manager or supervisor to oversee food preparation. Only ANSI Certified Food Protection Manager courses meet the requirement. There is no required training for every food handler, but it is recommended that food handlers take a professional food safety training class. Most of the places that provide ANSI Certified Food Protection Manager training also provide food handler training at a cheaper cost.

2. Where do I get food safety training to qualify as a Cottage Food vendor?

From the list on the Cottage Food web page, one may choose from a variety of on-line courses, or hands-on, in person instruction in an operator’s restaurant.

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Food Trucks and Push Carts

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1. My mobile food truck is licensed in Denver; can I sell food in Tri-County?

No; your Denver license is valid only in the City and County of Denver. To sell in Tri-County, you must obtain a State of Colorado Retail Food Establishment License, which authorizes you to sell anywhere in Colorado except the City and County of Denver. Please note that the food truck requirements of Denver differ from those of Tri-County Health Department, and that some jurisdictions have travel time and/or distance limitations on commissaries.

2. Is a plan review required for mobile food trucks?

Mobile food trucks and trailers that have never been licensed by Tri-County Health Department must go through a plan review. To determine the type of plan review that is appropriate for you contact the plan review hotline at 303 846 6230. Mobile food trucks that have been previously licensed by Tri-County and push carts may be inspected and licensed at any Tri-County Environmental Health office by appointment.

3. Can I operate my mobile food truck or cart from my home?

No; mobile food trucks, trailers, and push carts are required to operate from an approved commissary.

4. What is a commissary, and why do I need one?

A commissary is a facility approved by the health department as a base of operations for a mobile food establishment where food, containers, and supplies are kept, handled, prepared, packaged or stored, and where fresh water is replaced, and waste water is disposed of. Most commissaries are licensed fixed restaurants used by agreement between management of the restaurant and the mobile food operator. A Commissary Agreement must be completed and submitted for licensing. The Colorado Co Pack Directory maintains a list of approved kitchens whose sole purpose is to rent time to the public.

5. How do I file a complaint about a food truck or push cart?

Contact any Tri-County office, or enter your complaint online.

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Green Living

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1. How do I recycle batteries?

All types of batteries can be brought to Tri-County Health Department Offices for free recycling.

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Health Inspections

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1. How do I see restaurant / pool / tattoo / child care inspections?

Public health inspections are public record. Inspections are available online for all restaurants, child care, public / semi-public pools, and body art / tattooing in our area from July 2013 to the present. Inspection reports prior to July 2013 are available by written request.

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Healthy Communities

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1. How do I know if I qualify for Medicaid or Children’s Health Plan Plus (CHP+) Health Insurance programs?

You should start out by going to Colorado Peak to create an account and complete an insurance screening form. Once you complete an online application, it will tell you if you qualify for Medicaid or CHP+, and if you do not, it will show all of the available Health Insurance plans you do qualify for at this time, and the amount of money the government will subsidize for you.

2. How can I make an appointment to have someone help me complete my Medicaid or CHP+ Health Insurance application at Tri-County Health Department?

You can call 303-363-3013 to make an appointment in our Aurora, Alton/Colfax, Castle Rock Commerce City, Englewood, Lone Tree, or Northglenn offices.

3. I already have Medicaid or CHP+ Health Insurance and I need help with insurance services. Who can I call for help?

If you live in Adams, Arapahoe, Douglas, or Elbert Counties in Colorado, and you have a child or are a pregnant women on Medicaid or CHP+, you can call the Tri-County Health Department Healthy Communities Program for assistance with these items at 303-873-4404, We are open Monday through Thursday, from 7:30 a.m. through 5 p.m. and closed for lunch from noon - 12:30 and Friday 8 a.m. through 5 p.m. and closed for lunch noon - 1 p.m. We are closed on holidays.

4. Can the Tri-County Health Department Healthy Communities Program update my address, phone number, or make other changes to my benefits?

Unfortunately our program cannot make these changes for you. You have two options to report changes to the County. The best option is to go to Colorado Peak and create an account. Once you have an account, you can make these changes directly. You can also contact your County technician by phone, but this can sometimes take a long time and require multiple phone calls. If you need help finding your technician’s contact phone number, you can call the main phone number on the back of your health insurance card, or call Healthy Communities at 303-873-4404.

5. I currently have Medicaid and just gave birth. I need to report the birth of my baby so they are added to my account and can go see a doctor and dentist. How do I make sure my baby is added?

You have several options for this. The fastest and easiest way to add your baby is to go to Colorado Peak and create an account if you don’t have one. Once you have created an account, or if you have one already, log in and report the addition of a new baby. These changes will happen very quickly. You can also call Healthy Communities to report the addition of a new baby and we can assist you in having them added. This method will take a little longer and will require several phone calls.

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Healthy Foods & Hot Topics

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1. Whom should I turn to for nutrition and diet advice?

A Registered Dietitian (RD) is a nutrition expert to look for to answer your nutrition and diet questions with up-to-date, evidence-based information. Ask your primary care provider for a referral to an RD for individual nutrition advice or find an RD near you at the Colorado Academy of Nutrition and Dietetics. Online, look for articles and nutrition blogs written by RDs for a source of credible information.

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Healthy Homes

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1. Is mold harmful to my family?

Typical reactions to mold are allergy-like symptoms that occur in individuals who are allergic to mold. Symptoms can include coughing, sneezing, and other upper respiratory symptoms. Symptoms can be more severe in the elderly, infants, asthmatics, or anyone with a compromised immune system.

2. How do I clean up mold?

To clean up the mold, first you need to stop the water infiltration into the area. This is imperative; mold will continue to grow as long as the area remains wet. Physically remove any large quantities of visible mold and dry the area with fans, being careful to not distribute the mold spores to the occupied area of the home. You may need to contain the contaminated area with plastic sheeting. Once it is dry, a detergent should be used to clean up the mold. You should not use anything to apply the detergent that will disturb the spores, such as a garden hose. If you’ve got a large area to clean up (greater than 10 ft2), you should consider hiring a mold remediation company to do it. Companies can be found by searching the online Yellow Pages under terms such as “mold remediation” and “mold removal”.

Other Mold Resources:
- A Brief Guide to Mold, Moisture and Your Home
- Homeowner's Guide to Moisture Management
- Mold Remediation in Schools and Commercial Buildings (Although it was written for schools and commercial buildings, the concepts apply to the home setting as well)

3. Is air sampling for mold recommended?

We generally do not recommend air sampling for mold spores, because of the potential for getting “false negatives”. False negative results occur because of how mold spores are generated. The mold organism casts off the mold spores in blooms; it is difficult to predict when this is going to happen. Once the spores are in the air, they eventually settle onto the ground and other horizontal surfaces, such as furniture. Air is typically sampled for 5 minutes at the most, so there is a possibility of not collecting the mold spores while they are suspended in the air. A good rule of thumb is if you can see mold, then you have mold.

4. I have mold in my apartment and my landlord won’t do anything about it. What are my options?

There are no local, state, or federal regulations regarding mold. Consequently, Tri-County Health Department staff can’t force your landlord to clean up the mold. We can only send a letter to the landlord which explains the potential adverse health effects associated with mold exposure and recommend the landlord clean up the mold. We’ll need the landlord’s name and address, your address, as well as the locations of the mold in the apartment. Contact your local Tri-County Environmental Health office.

Note: Tri-County Health Department cannot provide legal services. For further legal questions you can contact Colorado Legal Services at 303-837-1313.

5. Can you check the air quality in our home? Our family is experiencing symptoms.

Tri-County does not currently have trained staff to check the air quality of your home. Visit this EPA website for more information.

6. I want to measure the radon levels in my home. How do I do this?

There are at least three methods available to test radon levels: 1) Tri-County Health Department has a radon meter that we can use to test the radon levels; or 2) You can purchase a radon test canister at your local hardware store; or 3) You can order a test kit online from the Kansas State University National Radon Program.

7. How does Tri-County Health Department test for radon and is there a fee?

Tri-County Health Department places a radon meter in your home and measures the radon levels for comparison to the EPA standard of 4.0 pCi/l (picocuries per liter). The house needs to be closed up (no doors or windows left ajar) for at least 12 hours prior to sampling. We provide you with a written report that summarizes the results. This is a free service for residents but we charge a fee for businesses and non-county government agencies.

8. Can I purchase a radon test kit and do the test myself?

Yes. Radon test canisters are available at hardware stores (Lowes, Ace Hardware, for example), but you should call first to ensure the store carries them. Sometimes the canisters have an expiration date, so you should check the date before purchasing the kit. Normally you would test in the lowest livable space in your home, which is typically the basement, regardless of whether it’s finished or not. Follow the instructions included in the kit regarding canister placement for the test. It’s generally recommended that you do a short-term test first, which lasts 2 to 4 days. For a short term test, the house should be closed up for 12 hours prior to the test. This means close all windows and doors, but you can open a door if necessary to enter and leave the house.

9. I tested my home for radon and the level came back high. What do I do?

The EPA standard of 4 picocuries per liter of air is an annual standard. If you aren’t in a hurry (for example, selling or buying the tested home), then re-test the home for 3 months to a year using a long term radon test kit, to get a better idea of what the average level is. If you don’t have the time, then re-test with another short term radon test kit. If the average of the two short term tests OR the result of the long term test is 4 pCi/l or higher, hire a radon mitigator to install a mitigation system. For a list of companies certified in Colorado click on: Certified Radon Measurement and Mitigation Contractors.

Other Radon Resources:
- Citizens Guide to Radon
- Dealing with Radon in Real Estate Transactions
- Consumer’s Guide to Radon Reduction-- How to Fix Your Home

10. What is Asbestos?

Asbestos is a mineral fiber that occurs in rock and soil. Because of its fiber strength and heat resistance, asbestos has been used in a variety of building construction materials for insulation and as a fire retardant. Asbestos has also been used in a wide range of manufactured goods, mostly in building materials (roofing shingles, ceiling and floor tiles, paper products, and asbestos cement products), friction products (automobile clutch, brake, and transmission parts), heat-resistant fabrics, packaging, gaskets, and coatings.

For more information see EPA's Asbestos website.

11. What are the health effects from exposure to asbestos?

There are three main exposure routes for asbestos fibers: (1) inhalation, (2) ingestion, and (3) skin contact. However, inhalation is the primary route of entry leading to asbestos-related disease. Asbestos fibers may be released into the air by the disturbance of asbestos-containing material during product use, demolition work, building or home maintenance, repair, and remodeling. Three of the major health effects associated with asbestos exposure are: lung cancer, mesothelioma (a rare form of cancer that is found in the thin lining of the lung, chest and the abdomen and heart) and asbestosis (a serious progressive, long-term, non-cancer disease of the lungs).

For more information on these and other health effects of asbestos exposure see the Agency for Toxic Substances and Disease Registry, the National Institute for Occupational Safety and Health and the National Cancer Institute.

12. I want to know if material in my home contains asbestos. How can I test for this?

The Colorado Department of Public Health and Environment (CDPHE) has a list of registered consulting firms that can assist with asbestos testing.

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Heart Healthy Tri-County

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1. How do I access the free screenings in Family Planning and WIC?

Ask your nurse practitioner or nurse during your next family planning visit or your WIC educator at your upcoming WIC appointment.

2. How are these programs funded?

Heart Healthy Tri-County services are funded through the Colorado Public Health and Environment’s Cancer, Cardiovascular Disease, and Pulmonary Disease (CCPD) Grant Program, as well as the Women's Wellness Connection Grant Program.

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Heart-Health Screenings in the Community

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1. Do I have to make an appointment or can I just walk-in?

You must call to make an appointment, but most of the time same-day appointments are available. Please call Clinton Whatley at 303-363-3034 to set up your appointment.

2. Do I need to bring my insurance card or proof of address to the screening?

No proof of insurance or residency is needed.

3. How much does the screening cost?

This is a FREE screening. There is no cost.

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HIV Linkage to Care

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1. Will I be denied insurance because I am HIV+?

No. Under the Affordable Care Act, insurance companies cannot deny coverage or charge more to cover people with pre-existing conditions such as HIV. HealthCare.gov

2. What if I can’t afford medication?

Linkage to Care care coordinators are available to provide assistance with financial applications that may help you pay for medication and other medical care.

3. Where can I meet with the Linkage to Care Coordinator?

Care coordinators can meet you in a location that is convenient and comfortable for you.

4. Why is Linkage to Care important?

LTC is designed to recognize and reduce barriers to healthcare that people living with HIV experience. According the CDC, "the ultimate goal of HIV treatment is to achieve viral suppression, meaning the amount of HIV in the body is very low or undetectable. This is important for people with HIV to stay healthy, live longer and reduce their chances of passing HIV to others. Yet today in the United States, fewer than a third of people living with HIV have their virus suppressed" (CDC, 2016). CDC HIV Care Continuum

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HIV Testing

Show All Answers

1. Do I need an appointment?

You may make an appointment by calling 303-363-3018. All of our clinics also offer walk-in appointments. Clients are seen on a first come, first serve basis and wait times may vary. Walk-ins are not available on Fridays. Please see our clinic schedule for times and locations.

2. How much do tests cost?

 For those who meet the risk criteria, HIV and Hepatitis C testing are provided at no cost.

3. How am I tested for HIV and Hepatitis C?

HIV and Hepatitis C tests are a rapid finger stick test.

Denver Health STD Clinic

4. How long does it take to be tested?

Results are ready for the HIV Rapid test in 10 minutes, with the entire appointment taking 15 - 30 minutes. Results are ready for the Hepatitis C test in 20 minutes, with the entire appointment taking 20 - 30 minutes. 

5. How do you test for HIV?

We offer the UniGold Antibody HIV Test which is a finger poke test with results available in 10 minutes.

6. If my test results are negative, do my partners still need to be tested?

Yes. Just because one partner tested negative for HIV or STIs does not mean that other partners are negative as well.

7. I’m under 18, do I need my parent’s permission to be tested?

Confidential HIV testing is provided to anyone 13 years of age and older. Chlamydia and gonorrhea testing is available to anyone who is sexually active.

8. How long does it take HIV to show up on a test?

It varies. The majority of people who have been exposed to HIV will have an accurate test result at 3 months after exposure.

9. What if my HIV test result is positive?

In the event of a positive test result, trained HIV test counselors will be available to provide a confirmatory test at no cost, answer questions, and provide referrals to community resources.

10. I am HIV-positive, but am not receiving medical care. Can your program help me?

Yes, our Linkage to Care (LTC) program works with people who are newly diagnosed with HIV or who have lapsed in care. LTC is a free service that connects people to specialty health care, financial assistance, and referrals. Call 303-363-3048 to learn more or enroll in the program today.

11. What if my Hepatitis C test result is positive?

In the event of a positive test result, trained Hepatitis C test counselors will be available to answer questions and provide referrals to community resources and for follow up viral load testing.

12. What if I need more testing done than HIV, chlamydia, and gonorrhea?

Denver Health offers confidential and affordable testing and treatment for STIs. For more information call 303-602-3540 or visit their website. Denver Health STD Clinic

13. How do I get treatment for chlamydia and gonorrhea?

For those who test positive in our clinics, treatment is available through Denver Health. For more information about treatment, call 303-602-3540.

14. If my partner has chlamydia or gonorrhea, can I get treated without being tested first?

For more information about partner treatment please call Denver Health at 303-602-3540.

15. How do I prepare for the STI test?

The STI test is a urine test. You will be asked to wait at least one hour since last urination to leave a sample.

16. How long does it take chlamydia and gonorrhea to show up on a test?

Our test can detect an infection penile or vaginal infection within 1-3 weeks.

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Home Page Footer FAQS

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1. What do I do if an animal bites me?

The first thing to do if you are bitten by an animal is to wash the wound with soap and water for at least 15 minutes. If the animal is rabid this will help wash out some of the virus. Do this right away. Also make a note of what animal bit you, if it was acting strangely, and where the animal went. Then contact your healthcare provider, Tri-County Health Department, animal control and/or Colorado Parks and Wildlife.

If the animal that bit you is wildlife it can be captured and tested for rabies so you will know if you are at risk and need to be vaccinated for rabies. If the animal is a domestic animal or livestock it can be quarantined and watched to see if it becomes ill from rabies. Many people are bitten by animals each year, and very few of those animals are rabid. However, rabies is a very serious disease and you should consult with your local health department to see if they recommend rabies post-exposure prophylaxis for you.

2. How do people get infected with West Nile Virus?

Most people get infected with West Nile virus by the bite of an infected mosquito. Mosquitoes become infected when they feed on infected birds. Infected mosquitoes can then spread the virus to humans and other animals.

In a very small number of cases, West Nile virus has been spread through blood transfusions, organ transplants, and from mother to baby during pregnancy, delivery, or breastfeeding.

3. How do I open a Body Art Facility?

You must complete and submit a Body Art Establishment License Application to Tri-County Health Department. A pre-opening inspection by Tri-County Health Department is required; any violations noted during the inspection must be corrected and all applicable fees must be paid prior to the approval of the license and operation of the establishment.

4. Does TCHD issue licenses for child care facilities?

No. Child care centers are licensed by the Colorado Department of Human Services, Division of Child Care. However, these licensed child care facilities are required to have an inspection by the state or local health department and comply with the Regulations Governing the Health and Sanitation of Child Care Facilities in the State of Colorado prior to licensing and at least once every two years of operation.

5. What support does TCHD offer for pregnant and breastfeeding women?

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) promotes breastfeeding as the optimal infant feeding choice and supports mothers through many programs. Contact your local WIC office for more information on the following programs: free breastfeeding classes, Pump Loan Program, Breastfeeding Peer Counselor Program (español), and/or free breastfeeding counseling by specially trained staff including international board-certified lactation consultants (IBCLC).

6. Do I qualify for WIC?

Your family may qualify if you are a pregnant, breastfeeding, or a postpartum woman, have infants / children up to 5 years old and you live in Colorado. To qualify, you must also meet household income guidelines.

7. How much will my family planning exam and birth control cost?

We offer low cost or no cost confidential services. Fees for birth control services and supplies are based on a sliding scale according to income level.

8. Do I need to make an appointment for immunizations?

Appointments are available at several Tri-County offices. To schedule an appointment call 303-451-0123. Walk-in clinics are offered at select Tri-County offices.

9. How can I learn more about the TCHD dietetic internship?

We will have prospective intern meetings each fall, so please watch our website for more details. If you will be in the Denver area at another time, you may contact us to request an individual meeting. However, visiting Tri-County before you apply is completely optional. You are also encouraged to follow us on Facebook. 

10. What can I do to protect myself and my family from lead exposure?

Visit the Colorado Department of Public Health and Environment for several examples of how risk can be reduced.  Lead can be in everyday items in your home. Old or imported items are more likely to have lead based finishes and paint in them. If you would like any of your household items tested for lead, contact Kayla Lesperance at 303 363 3030.

11. How do I measure the radon levels in my home?

There are at least three methods available to test radon levels: 1) Tri-County Health Department has a radon meter that we can use to test the radon levels; or 2) You can purchase a radon test canister at your local hardware store; or 3) You can order a test kit online from the Kansas State University National Radon Program. 

12. What items are accepted at Household Chemical Roundup events?

Acceptable items collected during the Household Chemical Roundup events include paint and paint products, motor oil, antifreeze, automotive fluids and fuels, vehicle batteries, household batteries, solvents, house and garden chemicals, fluorescent light bulbs, compact fluorescent lights (CFLs), cleaning supplies, items containing mercury, propane tanks, and passenger vehicle and pickup truck tires off the rim.

Household Chemical Roundup events cannot accept waste from businesses, and are not able to accept radioactive waste, smoke detectors, electronic waste of any kind, oil drums, asbestos, sharps/medical waste or explosives.

13. How do I get a permit to build or repair an on-site wastewater treatment (septic) system?

An OWTS permit is required for new installations, expansions, and repairs (with some exceptions). To obtain a permit, the following will be required for new systems/new soil treatment areas (STA’s): completed permit application, payment of permit fee, system design, soils information, test pit logs, percolation tests (if used), and a site plan. Tri-County Health Department (TCHD) will accept the applications at our Environmental Health Offices. TCHD staff will then review the information and make a site visit. If the application, design (if applicable) and site meet our requirements, TCHD will issue a permit to construct, expand or repair the OWTS.

14. Is a plan review required for mobile food trucks?

Mobile food trucks and trailers that have never been licensed by Tri-County Health Department must go through a plan review. To determine the type of plan review that is appropriate for you contact the plan review hotline at 303 846 6230. Mobile food trucks that have been previously licensed by Tri-County and push carts may be inspected and licensed at any Tri-County Environmental Health office by appointment.

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Home Visitation - Adams County

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1. How do I get a nurse home visitor or refer someone to the program in Adams County?

Our families are referred by Adams County because they have had some interaction with Child and Family Services. This program is specifically funded by Adams County and families must be referred by their county caseworker.

2. What will the nurse do to help my family?

The nurse will work with your family to help meet your goals for success with education, support and resources. The focus of the home visits is based on the needs of your family. The nurse can provide parenting information, health information and family resources in the community. The nurse can also help you find a doctor or apply for Medicaid.

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Home Visitation - Arapahoe County

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1. How do I get a nurse home visitor or refer someone to the program in Arapahoe County?

All of our families are referred by Arapahoe County either because they are active in Colorado Works or they have some interaction with Child and Family Services. These programs are specifically funded by Arapahoe County, and families must be referred by their county caseworker.

2. What does the nurse do to help my family?

The nurse will work with your family to help you meet your goals for success with education, support and resources. The focus of the home visits is based on the needs of your family. The nurse can provide parenting information, health information and family resources in the community. The nurse can also help you find a doctor or apply for Medicaid.

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Household Hazardous Waste

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1. What items are accepted at Household Chemical Roundup events?

Acceptable items collected during the Household Chemical Roundup events include paint and paint products, motor oil, antifreeze, automotive fluids and fuels, vehicle batteries, household batteries, solvents, house and garden chemicals, fluorescent light bulbs, compact fluorescent lights (CFLs), cleaning supplies, items containing mercury, and propane tanks. Household Chemical Roundup events cannot accept waste from businesses, and are not able to accept radioactive waste, smoke detectors, electronic waste of any kind, oil drums, asbestos, sharps/medical waste, tires, flares, or explosives.

2. How can I dry latex paint on my own?

Latex paint is not a hazardous waste, and can be safely disposed of with your regular household garbage once it is dried out and no longer liquid. To dry latex paint, remove the lid from the paint cans, mix in an absorbent to speed the drying process (such as kitty litter, dirt or sand) and allow the paint to dry completely before disposing with your regular trash pickup.

3. Where can you recycle electronic and computer waste?

Under Colorado law, residential and business electronics are banned from being disposed of in a landfill and must be recycled. Electronics are made from valuable resources such as precious metals, copper, and engineered plastics, all of which require considerable energy to process and manufacture. A list of Registered Electronic Recycling Facilities and their locations can be found online, and also on Google Maps.

4. How can I recycle compact florescent light (CFL) bulbs?

Many hardware supply stores and other retailers offer in-store recycling. CFLs can also be taken to your local household chemical roundup event for recycling. Visit Earth 911 to find a store in your area. CFLs contain small amounts of mercury-containing powder. If you have accidentally broken a bulb, have people and pets leave the room. Air out the room for 5-10 minutes by opening a door or window (remember to shut off central heating and air if you have one). Do not vacuum. Wear gloves and collect broken glass and visible powder using a stiff paper or cardboard. Use a disable wet wipes or damp towel to pick up any residue. Detailed instructions can be found on the Environmental Protection Agency website.

5. How do I dispose of medication?

Effective July 1, 2016 only select law enforcement agencies and Walgreen locations are able to accept medication/pharmaceutical waste. Please follow link to find a list of drop-off locations in the State of Colorado. For more information about proper disposal of medication visit the CDPHE website https://www.colorado.gov/pacific/cdphe/colorado-medication-take-back-program or call 303-692-2903 for the Colorado Department of Public Health and Environment (CDPHE) - Medication Take-Back Program

Pharmaceutical Fact Sheet

6. How do I dispose of mercury?

Mercury is a silver-white to gray substance that can be found in thermometers and switches. The best way to dispose of mercury or a mercury containing device is to bring it for treatment to your local household chemical roundup. The safest way to transport your thermometer is to bring it in a ridged container and/or in the original case. It can also be put in a plastic Ziploc bag. More information on mercury can be found in the Mercury Thermometer Fact Sheet. Information to clean up a mercury spill can be found in the Mercury Spill Cleanup Guidance.

7. What are the dates for the Household Chemical Roundups?

Tri-County Health Department organizes Household Chemical Roundups for Douglas County by appointment only to collect hazardous wastes and dispose of them properly. For dates visit the Douglas County tab at www.tchd.org/hcroundup. Events for Adams and Arapahoe County are organized by the towns, which should be contacted for further information.

8. Where can I dispose of household hazardous waste when there is not a chemical roundup?

Adams, Arapahoe, and Douglas counties do not have a permanent site to drop-off household chemicals. An alternative is Rooney Road Recycling in Golden, Colorado. The household hazardous waste facility at the Rooney Road Recycling Center is open on Wednesdays and Saturdays, from 8 a.m. to 2 p.m. by appointment only (303-316-6262). There is a $90 fee to residents outside of Jefferson County. Other resources can be found on the Other Options tab on Household Chemical Roundup page.

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Immunizations

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1. How can I get a copy of my Immunization record?

If your record is in the Colorado registry, you can request a copy from the Colorado Immunization Registry. If you have received Immunizations at Tri-County Health Department, you can contact the Colorado Immunization Registry or Tri-County Health Department at 303-451-0123.

Colorado Immunization Registry

2. How do you keep patients safe during COVID-19?

It is safe and strongly recommended to continue getting routine vaccines during the COVID-19 pandemic. Continued vaccination is important to prevent outbreaks of diseases like measles and whooping cough. Read this information from the CDC. 

Screening: All clients are screened for COVID-19 symptoms and recent exposure over the phone immediately before entering the clinic. A no-touch thermometer automatically checks temperatures of everyone entering the clinic. Staff are screened before starting their workday, including a temperature check.

Masks required: Everyone in clinic age 12 and up is required to wear face coverings. Children ages 2-11 are encouraged to wear a face mask, if tolerated. Glass barriers are set up at the check-in counters. Nurses also wear standard personal protective equipment when within six feet of patients. In addition to a face mask, they wear goggles or a face shield and gloves. 

Social distancing: Clinic capacity is reduced to allow for proper social distancing. Waiting areas are marked at least 6 feet apart. 

Disinfecting: High-touch surfaces like door handles and countertops are cleaned every hour. Exam rooms are cleaned after each client encounter.

If you have questions or concerns about these protocols, call 303-451-0123 and ask to speak to a nurse.

3. Do I need to make an appointment?

Appointments are available at several Tri-County offices. To schedule an appointment call 303-451-0123. 

The Aurora East clinic has Walk-In clinics every Tuesday and Thursday, 8:30-11:30 a.m. & 1-3:30 p.m. On the 2nd Saturday of each month there is a Shots for Tots and Teens clinic from 10 a.m.-1 p.m.

The Westminster office has a Park & Call clinic, Fridays: 8:30-11 a.m., 1-3:30 p.m., no appointment needed. Park in a designated spot. Call the number on the sign. Wait in your vehicle. There are also Shots for Tots and Teens clinics on various Saturdays, 10 a.m.-1 p.m. Call for details.

4. Can you bill my insurance?

Private insurance accepted at all Tri-County Immunization Clinics. Unable to bill Kaiser and select private insurances.  Medicaid, Medicare, and CHP+ accepted.  Out of pocket costs vary for non-contracted insurances or non-routine vaccines. Please see our price list.

5. What shots does my child need and when?

The recommended immunization schedule is designed to protect infants and children early in life, when they are most vulnerable and before they are exposed to potentially life-threatening diseases. Check the schedule for the age or age range when each vaccine or series of shots is recommended. Childhood Immunization Schedule

6. Can I protect my child by using an alternate vaccine schedule?

It is important to remember that your child is unprotected against a disease until he or she receives the appropriate vaccine. Children do not receive any known benefits from following schedules that delay vaccines. Infants and young children who follow immunization schedules that spread out shots-or leave out shots- are at risk of developing diseases during the time that shots are delayed. Some vaccine-preventable disease are still common in the U.S. (such as pertussis, or whooping cough), and children may be exposed to these diseases during the time they are not protected by vaccines.

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Land Use

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1. What is a land use case referral?

When a property owner or consultant applies to a County or City to develop a piece of property, that County or City will then send the case materials to various agencies for comments. Tri-County Health Department provides comments related to public and environmental health regulations, best practices for the proposed land use and recommendations to improve the public health outcomes of the proposal.

2. What types of things does Tri-County Health Department consider during a land use case referral review?

The Land Use Team reviews land development proposals for regulatory requirements and opportunities to improve public health outcomes through the use of best practices. Team members will consider wastewater, water, environmental factors, potential environmental hazards and healthy community design principles.

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Landfills & Solid Waste

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1. Where is the nearest household solid waste site to me?

Household Waste Disposal Sites

2. Where is the nearest industrial solid waste site to me?

Industrial Solid Waste Disposal Sites

3. What kind of waste is not permitted in landfulls?

Any waste regulated under Colorado Hazardous Waste Regulations 6 CCR 1007-3, liquids (unless first solidified), residentially generated tires, residentially generated lead acid (automobile) batteries, residentially generated waste motor oil and residentially generated electronics.

4. Are there extra precautions that need to be taken when digging or building around an old landfill site?

Yes, municipal landfills built prior to modern construction practices often were not built to properly vent landfill gas that builds up when the buried waste breaks down. This lack of proper venting can cause landfill gas (methane) to build up and travel the path of least resistance to migrate through the soil. This can lead to potential explosive conditions. When excavating soils for building near an old landfill there is a potential for methane gas to migrate to the disturbed soils. Please contact your local Tri-County Environmental Health office or your local zoning department to determine if there are precautions to be taken in a particular area.

5. What should I do about trash buildup in my neighbors yard?

Contact your local Tri-County Environmental Health office to file a complaint.

6. How should I properly dispose of my medical waste?

Small amounts of household medical wastes may disposed of in landfills. Sharps should be stored in a rigid, puncture-proof container. Other medical wastes should be double bagged to prevent possible contamination to haulers that may handle the waste.

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Lowry Landfill

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1. What is Lowry Landfill Superfund Site and where is it located?

Lowry Landfill Superfund Site is located east of Aurora, Colorado near the intersection of Quincy Avenue and Gun Club Road in Arapahoe County, 15 miles southeast of downtown Denver. From 1965 until 1980, it accepted municipal and liquid industrial waste from businesses and residences in the Denver metro area. The 507-acre site was declared a Superfund site in 1984, when the U.S. Environmental Protection Agency placed it on its National Priorities List. The landfill is owned by the City and County of Denver and operated by Waste Management of Colorado, Inc.

2. Are there health risks for a person that lives by the Lowry Landfill Superfund Site?

The Lowry Landfill Superfund Site is a prescribed containment remedy. The U.S. Environmental Protection Agency conducts mandatory five-year reviews to ensure all containment activities are working as designed. The latest five-year review, completed in September 2017, confirmed that the remedy of Operable Units 2, 3, 4, and 5 are protective of human health and the environment.  Operable Units 1 and 6 require continued monitoring and a protectiveness determination will be made by the U.S. Environmental Protection Agency after further information is obtained.   Private non-community drinking water wells north of the site have been monitored and sampled since 2006 for 1,4-dioxane which has been detected north of the Lowry Landfill Site boundary and does not pose a threat to people living in the vicinity.

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Main

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1. Where can I find the answers to my frequently asked questions?

Use the FAQs module to easily find answers to the questions you ask the most.

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Medical Records

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1. Do you accept faxed authorizations from other healthcare providers / facilities?

Yes, as long as they are legible and they contain the required information in a valid authorization, which is:

• Client’s full name and date of birth
• Name of the organization from which the records are being requested
• Name and address of the organization or person to receive the record
• Specific information to be sent such as type of documents/reports needed, dates of treatment or medical condition
• Purpose for which the information may be disclosed
• Expiration date or event
• Signature of the patient or the patient’s legal representative. If the patient’s personal representative signs the authorization, the supporting legal documentation must be provided
• Date the form is signed

2. Who should sign a release of records for a minor?

The parent or legal guardian of the minor must sign the release of records for a minor.

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Meth Cleanup

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1. What is methamphetamine?

Methamphetamine - meth for short - is a extremely addictive stimulant drug. It is a powder that can be made into a pill or a shiny rock (called a crystal). The powder can be eaten or snorted up the nose. It can also be mixed with liquid and injected into your body with a needle. Crystal meth is smoked in a small glass pipe.

2. Who can I hire to complete meth sampling for me?

As of June 15, 2015 all individuals and firms must be certified by the Colorado Department of Public Health. For certified meth sampling, please reference the list of Certified Individuals and Firms.

3. Is the home I want to purchase contaminated with meth?

The Tri-County Health Department maintains an internal database of all known meth contaminated properties in our counties. Call the Commerce City Environmental Health Office at 303 288 6816 to obtain information housed in this database.

4. What can I do if I believe my home has been contaminated with meth?

Call the Commerce City Environmental Health Field Office at 303 288 6816 to determine if records of meth activity at your address exist.

5. What should I do if I believe my neighbors are cooking meth?

Notify law enforcement if you have credible reason to believe that someone is cooking meth.

6. Is the seller of a home required to disclose any knowledge of meth activity?

A seller is required to disclose to a potential buyer if they have knowledge of meth contamination. If, however, the home has been properly remedied and the seller has a Certificate of Compliance the seller is no longer required to disclose.

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Mosquitoes & West Nile Virus

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1. What is West Nile virus?

West Nile virus is an arthropod-borne virus (arbovirus) most commonly spread by infected mosquitoes. West Nile virus can cause febrile illness, encephalitis (inflammation of the brain) or meningitis (inflammation of the lining of the brain and spinal cord).

West Nile virus transmission has been documented in Europe and the Middle East, Africa, India, parts of Asia, and Australia. It was first detected in North America in 1999, and has since spread across the continental United States and Canada.

2. How do people get West Nile virus?

Most people get infected with West Nile virus by the bite of an infected mosquito. Mosquitoes become infected when they feed on infected birds. Infected mosquitoes can then spread the virus to humans and other animals.

In a very small number of cases, West Nile virus has been spread through blood transfusions, organ transplants, and from mother to baby during pregnancy, delivery, or breastfeeding.

3. How soon do people get sick after getting bitten by an infected mosquito?

The incubation period is usually 2 to 6 days but ranges from 2 to 14 days. This period can be longer in people with certain medical conditions that affect the immune system.

4. What are the symptoms of West Nile virus disease?

No symptoms in most people. Most people (70-80%) who become infected with West Nile virus do not develop any symptoms.

Febrile illness in some people. About 1 in 5 people who are infected will develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea, or rash. Most people with this type of West Nile virus disease recover completely, but fatigue and weakness can last for weeks or months.

Severe symptoms in a few people. Less than 1% of people who are infected will develop a serious neurologic illness such as encephalitis or meningitis (inflammation of the brain or surrounding tissues). The symptoms of neurologic illness can include headache, high fever, neck stiffness, disorientation, coma, tremors, seizures, or paralysis.

Recovery from severe disease may take several weeks or months. Some of the neurologic effects may be permanent. About 10 percent of people who develop neurologic infection due to West Nile virus will die

5. How can people reduce the chance of getting infected?

The most effective way to avoid West Nile virus disease is to prevent mosquito bites:
•Use insect repellents when you go outdoors. Repellents containing DEET, picaridin, IR3535, and some oil of lemon eucalyptus and para-menthane-diol products provide longer-lasting protection.
•Wear long sleeves and pants from dusk through dawn when many mosquitoes are most active.
•Install or repair screens on windows and doors. If you have it, use your air conditioning.
•Help reduce the number of mosquitoes around your home. Empty standing water from containers such as flowerpots, gutters, buckets, pool covers, pet water dishes, discarded tires, and birdbaths.

6. What repellent should I use?

Tri-County recommends a variety of effective repellents. The most important step is to pick one and use it according to the label. There are those that can protect you for a short while in the backyard or a long while in the woods. DEET, picaridin, IR3535 and the plant-based oil of lemon eucalyptus are all repellents recommended by Centers for Disease Control. All contain an EPA-registered active ingredient and have been evaluated for efficacy and safety.

7. How do birds get infected with West Nile virus?

West Nile virus is transmitted to birds through the bite of infected mosquitoes. Mosquitoes become infected by biting infected birds. Some birds that are predators (such as hawks and owls) or scavengers (such as crows) may become infected after eating sick or dead birds that were already infected with West Nile virus

8. Do birds infected with West Nile virus die or become ill?

Yes. Since West Nile virus was discovered in the United States in 1999, the virus has been detected in over 300 species of dead birds. Although some infected birds, especially crows and jays, frequently die of infection, most birds survive.

9. What should I do if I find a dead bird?

This type of reporting can help with the early detection of illnesses like West Nile virus, known to cause death in birds. Please report a dead bird to us by calling us or filling out a dead animal/bird report form on line. You may be informed to simply dispose of the bird’s carcass (body), don’t handle it with your bare hands. Use a shovel, gloves or an inverted plastic bag to place the carcass in a garbage bag, which can then be disposed of in your outdoor trash .

10. Where can I report a problem with mosquitoes?

Contact any Tri-County office, or enter your complaint online.

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Nurse Family Partnership

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1. How much does the program cost for clients?

Nurse-Family Partnership is FREE to all eligible women.

2. Who can participate in visits?

Nurse-Family Partnership encourages fathers, family members and even friends to be involved in the visits and learn how they can best support you.

You and your nurse decide who gets involved.

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On-site Wastewater Treatment Systems

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1. How do I get a permit to build a new, or repair an on-site wastewater treatment system (OWTS)?

An OWTS permit is required for new installations, expansions, and repairs (with some exceptions). To obtain a permit, the following will be required for new systems/new soil treatment areas (STA’s): completed permit application, payment of permit fee, system design, soils information, test pit logs, percolation tests (if used), and a site plan. Tri-County Health Department (TCHD) will accept the applications at our Environmental Health Offices. TCHD staff will then review the information and make a site visit. If the application, design (if applicable) and site meet our requirements, TCHD will issue a permit to construct, expand or repair the OWTS.

2. Under what conditions must an on-site wastewater treatment system (OWTS) be designed by a Colorado Licensed Professional Engineer?

A Colorado Licensed Professional Engineer must design a system if any of the following occur: (a) the following soil types are identified within 4 feet below the depth of the proposed soil treatment area (STA): 0, 3A, 4, 4A, 5, R-O, R-1, R-2; treatment levels TL2, TL2N, TL3, and TL3N as specified in tables 10 and 11 of Regulation O-17 (b) groundwater, bedrock, or other limiting layer is present within 4 feet below the depth of the proposed STA, (c) the ground slope at the area of the proposed STA is greater than 20%, or (d) the proposed system is a commercial system, (e) the proposed system utilizes pressure distribution.

3. How do I get a Use Permit?

Review our Use Permit Questions and Answers and visit our On-Site Waste Treatment System page for more information and related forms.

4. Who can do Use Permit inspections?

Use permit inspections must be done by a "third party" certified Use Permit Inspector.  These inspectors do not work for Tri-County Health Department (TCHD).  These inspectors are certified by the National Association of Wastewater Technicians (NAWT).

5. I am selling my property and need to get my waste water system certified. What should I do?

The seller of the property is required to obtain a use permit prior to the sale of the property (see question #3).    

6. What is the minimum lot size for an on-site wastewater treatment system (OWTS)?

Tri-County Health Department (TCHD) does not have a minimum lot size requirement. Local planning agencies do have minimum lot sizes in their zoning codes. They typically recommend a minimum of one acre for lots supplied by central water and 2.5 acres for lots with wells.

7. How often do I need to pump my septic tank?

Tri-County Health Department (TCHD) requires that septic tanks be inspected every four years and pumped when scum and sludge accumulate to greater than 25% of the effective volume of the tank. Dosing tanks shall be inspected and pumped if sludge accumulation is observed. If your OWTS receives higher than average use as determined by your TCHD licensed cleaner, you may want to consider a more frequent pumping interval. All pumping and evaluation of septic tanks should be done by a licensed cleaner. We also have a guide on septic care and maintenance.

8. Will I be able to irrigate or have horses where my Soil Treatment Area (STA) is located?

Tri-County Health Department recommends that an STA be left largely untouched by homeowners. Irrigated landscaping is not recommended, since it has the possibility to saturate an STA causing the septic system to fail prematurely. You may consider planting buffalo grass or other natural grasses which do not require irrigation. Mow any grasses planted on the STA area regularly. Horses or other livestock should not be placed on an STA, because compaction of the soils may occur causing premature failure of your absorption area. We also have a guide on septic care and maintenance.

9. Can I install a bathroom in a garage, barn, etc., and connect it to my existing on-site wastewater treatment system (OWTS)?

Tri-County Health Department (TCHD) generally allows connection to the existing septic system, provided the owner notifies TCHD in advance, and TCHD approves the connection. An inspection of the new plumbing and applicable fee(s) is required. Prior to final approval, the existing record drawing of the system must also be amended to show new buildings and plumbing. For more information, contact one of our four Environmental Health offices prior to starting your project.

10. I am unsure where my on-site waste water treatment system (OWTS) is located. Do you have records of my system?

Tri-County Health Department (TCHD) maintains online records for existing septic systems in Adams, Arapahoe, and Douglas Counties which contain record drawings identifying OWTS locations. Please keep in mind that TCHD may not have records of all septic systems due to age or permit status.  In this case it may be necessary to contact a licensed installer or a certified Use Permit inspector or surveyor to locate your system.  

11. I accidentally damaged some components of my septic system. Who should I call to inspect and repair the damage? Do I need a permit?

In this situation it would be best to have the system evaluated by a licensed septic contractor. If the damage is relatively minor such as damage to a single pipe or chamber, it likely will not require a permit, but the repair will need be done by a licensed contractor, and all repairs will need to be inspected by Tri-County Health Department (TCHD) prior to being covered. Inspection fees may apply. If the damage is more extensive such as damage to the tank or extensive damage to the soil treatment area (STA), it may require a repair permit. Consult with your contractor and TCHD. 

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Parents of Teens

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1. Does talking to my teen about birth control make her/him more likely to have sex sooner?

Parents really make a difference when we talk with our kids. In fact, teens often name their parents as the biggest influence in their decisions about sex. And teens who report having good conversations with their parents about sex are more likely to delay sexual activity, have fewer partners, and use condoms and other contraceptives when they do have sex. TALK TO YOUR KIDS!

2. How can I help my teen understand the impact of unprotected sex on his/her future life plans?

Parents have to let their teens know that having sex — especially unprotected sex — can have serious, negative consequences. It can lead to unintended pregnancy and sexually transmitted infections. Unintended pregnancy can derail education and career plans — for young women and young men. Pregnant teens are more likely to drop out of high school than girls who don’t get pregnant. Sexually transmitted infections can cause discomfort, infertility, and life-threatening illness such as genital cancers and AIDS. Teens need to know the basics of reproduction, birth control, and safer sex. In order to be helpful, parents must know about these subjects, too!

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Pools and Spas

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1. How do I make a complaint about a pool?

If you find an unsanitary condition existing at a public pool or spa, contact your local Tri-County Environmental Health office.

Report a Problem

2. What are the minimum and maximum pool chemistry requirements?

The minimum and maximum pool chemistry requirements are located on page 24 of the 
Swimming Pool Regulations 

Swimming Pool Regulations

3. How can I get a copy of the swimming pool and spa regulations?

http://co-tricountyhealth2.civicplus.com/728/State-Regulations

Swimming Pool Regulations

4. I am designing a public pool. What are the design requirements?

If you are designing a public pool or spa you will need to complete and submit a plan review packet, along with applicable fees to your local Tri-County Environmental Health office. When designing a public pool or spa, you will need to be familiar with the Regulations for Swimming Pools and Spas. For all other questions please call one of our Tri-County Environmental Health offices and ask to speak with the Pool and Spa Plan Review Specialist. Click here for:

Pool Regulations & Plan Review Packet

Pool Regulations & Plan Review Packet

5. I am designing a private (non-public) pool? What are the design requirements?

Private pools and spas are exempt from the state regulations. As such, you are not required to submit to the health department a plan review or any fees for the design and construction of private pools and spas. Although exempt from regulation, Tri-County Health strongly suggests that the designers of private pools and spas follow the regulations and the plan review requirements governing public pools and spas: http://co-tricountyhealth2.civicplus.com/727/Pools-Spas-Water-Features

Pools and Spas

6. What is a considered a "private" pool?

Private swimming pools are those that are associated with single family dwellings, condominiums or apartment houses, and are intended only for the use of the residents of those facilities (HOA pools are also considered private pools).

7. How do I sign up for the Certified Pool Operator (CPO) class?

Tri-County does not currently offer CPO classes. To find a course near you please visit the National Swimming Pool Foundation's CPO Course Finder. Or contact the National Swimming Pool Foundation at (719) 540-9119

8. Why does the pool area smell of chlorine?

The chlorine smell is the actually chemicals that form when chlorine mixes with urine, feces, sweet, and dirt from swimmers bodies. These chemicals, not chlorine, can cause your eyes to get red and sting or make you cough or make your nose run. A pool that is properly chlorinated will not have a strong chemical smell.

9. What should I do if I find a dead animal in the pool?

If the pool’s chemicals have been maintained properly, most dead animals do not pose a health risk to swimmers. However, it is highly recommended to follow the guidance from the CDC when a dead animal is found in the pool.

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Radon

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1. What if my home does not have a basement, do I still need to test for radon?

Yes, radon can enter any home through cracks in the foundation or crawl space. Every home should be tested for radon.

2. Where should the test kit be placed?

Test kits should be placed on the lowest livable level of the home, even if it’s unfinished. Test kits in a single story home should be placed in the most frequently occupied room in the house, but not the kitchen or bathroom.

3. My home was built with radon resistant new construction (RRNC), what is that?

Builders that build with RRNC place the piping needed for a radon mitigation system inside the walls of the home. This is also called a passive system, and makes future installation of a radon mitigation system easier, and more aesthetically pleasing. Radon testing is still recommended for homes built with RRNC.

4. What are the costs associated with radon mitigation?

The average cost to install a radon mitigation system is $1,200. This can vary depending on the size of your home and location of the mitigation system.

5. How do I know if my radon mitigation system was installed correctly?

The discharge point of the system must be at least 10 feet above grade, 10 feet away or 2 feet above any opening to the interior of the home, AND terminate above the eave of the roof. The system fan should be located in either the attic, garage (provided there is no living space above the garage), or outside of the home. Please reference this comprehensive radon checklist for more information.

6. I want to measure the radon levels in my home. How do I do this?

There are at least three methods available to test radon levels: 1) Tri-County Health Department has a radon meter that we can use to test the radon levels; or 2) You can purchase a radon test canister at your local hardware store; or 3) You can order a test kit online from the Kansas State University National Radon Program.

7. How does Tri-County Health Department test for radon and is there a fee?

Tri-County Health Department places a radon meter in your home and measures the radon levels for comparison to the EPA standard of 4.0 pCi/l (picocuries per liter). The house needs to be closed up (no doors or windows left ajar) for at least 12 hours prior to sampling. We provide you with a written report that summarizes the results. This is a free service for residents but we charge a fee for businesses and non-county government agencies.

8. Can I purchase a radon test kit and do the test myself?

Yes. Radon test canisters are available at hardware stores (Lowes, Ace Hardware, for example), but you should call first to ensure the store carries them. Sometimes the canisters have an expiration date, so you should check the date before purchasing the kit. Normally you would test in the lowest livable space in your home, which is typically the basement, regardless of whether it’s finished or not. Follow the instructions included in the kit regarding canister placement for the test. It’s generally recommended that you do a short-term test first, which lasts 2 to 5 days. For a short term test, the house should be closed up for 12 hours prior to the test. This means close all windows and doors, but you can open a door if necessary to enter and leave the house.

9. I tested my home for radon and the level came back high. What do I do?

The EPA standard of 4 picocuries per liter of air is an annual standard. If you aren’t in a hurry (for example, selling or buying the tested home), then re-test the home for 3 months to a year using a long term radon test kit, to get a better idea of what the average level is. If you don’t have the time, then re-test with another short term radon test kit. If the average of the two short term tests OR the result of the long term test is 4 pCi/l or higher, hire a radon mitigator to install a mitigation system.

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Restaurants and Grocery

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1. Do I need a Retail Food license?

A Retail Food license is required if your operation meets the definition of a "Retail Food Establishment". A Retail Food Establishment means a retail operation that stores, prepares,
or packages food for human consumption or serves or otherwise provides food for
human consumption to consumers directly or indirectly through a delivery
service, whether such food is consumed on or off the premises or whether there is
a charge for such food.

2. Are retail food licenses transferable?

No, Retail Food Establishment Licenses are valid for specific owner, location, and Colorado Department of Revenue account number.

3. How do I open a restaurant or grocery store?

All foods sold or served to the public must be from an approved facility. All must have at minimum a 3 compartment sink, a handwashing sink, a water heater, a mop sink, and a restroom containing a toilet and a handwashing sink. All equipment must be commercial, and all floors, walls and ceilings must be smooth and easily cleanable. If you intend to build your establishment, you must submit a plan review form and have it approved prior to the start of construction.
If you instead plan to purchase an existing establishment, you will need to have a change-of-ownership inspection conducted. Having secured an approved facility, you will need to obtain a Sales Tax License from the Colorado Department of Revenue, complete and submit an Application for a Retail Food Establishment License, available from your local Tri-County Health Department office, along with the appropriate license fee.

4. Do plans need to be submitted for the construction of a retail food establishment?

Yes, plans must be submitted, reviewed, and approved before the start of construction. Review more on the Restaurant Plant Review Form.

5. What is a potentially hazardous food?

Food that will support the growth of bacteria.

6. Are retail food workers required to have a food handler card?

Most restaurants are required to have a certified food protection manager or supervisor to oversee food preparation. Only ANSI Certified Food Protection Manager courses meet the requirement. There is no required training for every food handler, but it is recommended that food handlers take a professional food safety training class. Most of the places that provide ANSI Certified Food Protection Manager training also provide food handler training at a cheaper cost.

7. How do I report a food-borne illness?

Report suspected food-borne illness on-line, or by contacting your local Tri-County office. Please be sure to identify the establishment by name and street address.

8. Do I need a license to roast and sell chilies?

Chili roasting operations are required to have a Retail Food Establishment License. The chilies must be washed in potable water at a commissary, and a handwashing facility must be available at the site where the chilies are roasted and sold. Contact your local Tri-County office for details.

9. How do I report a dirty kitchen, restroom, dining room, or unsanitary conditions or practices?

Contact any Tri-County office, or enter your complaint online. Please have the name and address of the facility available.

10. Is it a violation for a restaurant employee to handle money and then handle food without washing their hands in between?

While this practice is not encouraged, it is not a violation of the regulations to handle packaged or plated food and money. The potential for disease transmission is minimal because bacteria do not survive well on money. Money has not been found to be a carrier of disease causing organisms.

11. Can I rent time in someone else’s approved kitchen?

Yes, an individual may become licensed to operate from any approved facility. There are commercial kitchens whose primary business is renting time to the public. Other operations will produce and package a food product to your specifications. A list is available from the Colorado Department of Agriculture.

12. What are the requirements for equipment used in commercial food establishments?

Equipment used in retail food establishments must fabricated of safe materials, and be of commercial design meeting American National Standards Institute (typically, National Sanitation Foundation or Underwriters Laboratories Commercial approved). Domestic equipment is not allowed except in very limited circumstances, as it does not hold up under the heavy use in a commercial kitchen.

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Rocky Mountain Arsenal Oversight Program

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1. What is the status of the Rocky Mountain Arsenal (RMA) cleanup? Where can I get more information on RMA?

The cleanup of the RMA has taken over 30 years is essentially complete and the majority of the site has been transformed into a National Wildlife Refuge . The refuge is accessible to the public for sightseeing, wildlife viewing, catch & release fishing, and environmental education. There are still some cleanup activities and waste containment areas such as landfills that have been capped and covered with clean soil. These areas are not accessible to the public and remain the responsibility of the US Army. The cleanup of groundwater at RMA is also ongoing and may take many years to complete.

2. Is my well water safe to drink? Should I be worried about any RMA contaminants in my groundwater?

Some residents in the communities north and northwest of RMA had shallow private wells that were impacted by groundwater contamination from RMA. These wells were documented through Tri-County Health Department’s (TCHD) Off-Post Private Well Sampling Program and the residents were provided potable water taps from South Adams County Water and Sanitation District. TCHD still conducts an extensive groundwater monitoring program to track groundwater quality in private wells.

3. Can you provide me any sampling information on my existing well on my property?

This map shows a large area that has previously demonstrated some potential for contamination. If you are concerned about your well and you are located in the indicated area, please call Tri-County Health Department's Commerce City Office, 303-288-6816, for more specific information.

4. Can Tri-County Health Department test my well water and do I have to pay for this?

Tri-County Health Department can provide two types of tests for your well water. For testing, contact the Commerce City Office at 303 288 6816. A routine test is free and covers the hardness, specific conductance, nitrate, and fluoride levels in your well water. A BAC-T test costs the well owner $15.00 and determines if there is a bacterial problem with the well water. These tests do not analyze for RMA contaminants. Tri-County Health Department, in cooperation with the State, is tracking new well permits to insure that new wells are not being installed where known RMA contamination is present.

5. What is 1,4-dioxane and why did Tri-County Health Department notify me about this contaminant?

1,4-dioxane has recently been identified as a potential chemical of concern by EPA. Tri-County Health Department (TCHD) is assisting the Army and the Environmental Protection Agency (EPA) in sampling private wells to gain a better understanding of the distribution and potential source of this chemical. At the present time there is a state standard for the treatment of this water but there is no federal or state standard for this chemical in drinking water. The EPA is working on developing an appropriate standard.

6. Can I use my well water to water my garden?

Yes, this should be very safe with respect to Rocky Mountain Arsenal chemicals.

7. Can I still get a tap from South Adams County Water and Sanitation District?

Yes, if diisopropyl methylphosphonates (DIMP) should be found in your well water above the State standard of 8.0 parts per billion. The Army will verify the results and would provide you with a tap or a replacement well.

8. Can you provide me with groundwater information on a property for a Phase I site assessment?

Yes if your property falls within the following area please call 303-288-6816. If it is outside this area, please call our Water Quality Specialist at 303-220-9200.

9. I have experienced an odor. What should I do?

Please call the Tri-County Health Department at 303-288-6816 if you smell an odor coming from the Rocky Mountain Arsenal. This is considered highly unlikely since all intrusive work has been completed.

10. I see dust coming from Rocky Mountain Arsenal. Should I be concerned?

Yes, please call Tri-County Health Department at 303-288-6816 if you see dust coming from the Rocky Mountain Arsenal. This is considered unlikely since all intrusive work has been completed. Also please call Tri-County Health Department if smoke is observed. This is considered more likely since prescribed burns are periodically scheduled.

11. Is it safe to buy a house near RMA?

Yes. TCHD and many people considered it safe to purchase houses near RMA since all new subdivisions have major utility supplied water. Older houses may have wells. Most if not all new wells are installed in the Arapahoe Formation which is deep and safe. TCHD is not aware of any new houses being built with water being supplied from shallow alluvial groundwater sources.

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Rodent and Rat Control

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1. How do I deal with a rodent problem?

Remove clutter from your yard and keep wood piles at least 18 inches off the ground. Keep trash in metal or heavy plastic cans with tight fitting lids. Regularly clean up after pets and if you feed your pets outside, pick up any spilled food. Keep the interior of your home clean and seal up any cracks or holes. Depending on the extent of the problem, traps or poisons may be
used. Traps (with peanut butter for bait) are a good way to get rid of rodents and avoid accidental poisoning of pets or children.

2. How do I clean up rodent droppings and nests?

When cleaning up any rodent droppings, do not use a vacuum or a broom. First and most important is to spray the droppings with a 10% bleach solution (1part bleach and 9 parts water). Allow the solution to fully saturate the droppings. Wear gloves, use paper towel to wipe up the droppings and then discard into the garbage. Please visit the CDC rodent webpage for more detailed information regarding rodent clean up and click on the "cleaning up after rodents" link.

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Senior Dental Program

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1. How do I know if I qualify for the program?

If you are age 55 or older (no exceptions), living in Arapahoe County, and are on a limited income, you may qualify for the program. Please call 303-783-7106 for more information about income requirements.

2. Do you accept insurance, Medicaid, or Medicare?

We do accept Medicaid, but no other insurance or Medicare.

3. How long before I can get an appointment?

Please ask this question when you call for an application at 303-783-7106. The time varies but is often two to three months.

4. Do you have emergency services?

No, we do not provide emergency dental services. If you are having a dental emergency, please go to an urgent care center or to the emergency room of a hospital.

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Septic Installers / Cleaners

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1. Do I need a license to install and repair septic systems?

Yes, Tri-County Health Department (TCHD) requires that all on-site wastewater treatment system (OWTS) installers be licensed with our Department. In order to obtain a license, TCHD must receive a completed application, affidavit of citizenship, and license fee. In addition, the applicant must take and pass the system’s contractor exam. The exam covers various sections of the Onsite Wastewater Treatment System Regulations and you can take an exam at one of our four Environmental Health offices during business hours (8am-5pm M-F, closed from noon – 1:00pm). The license is valid from January 1 to December 31 and must be renewed every year.  Starting October 1, 2019, all licensed installers will be required to attend a National Association of Wastewater Technicians (NAWT) Installer Course and obtain a certification prior to receiving a TCHD license. 

2. How do I become a licensed septic system pumper/cleaner?

In order to become licensed as a septic system pumper/cleaner with Tri-County Health Department (TCHD) contact one of our four Environmental Health offices. You will need to fill out an application, pay a fee, and complete an affidavit of citizenship. The license is valid from January 1 to December 31 and must be renewed every year. Starting October 1, 2019, all licensed cleaners will be required to attend a National Association of Wastewater Technicians (NAWT) Vacuum Truck Course or Operation and Maintenance I Course prior to receiving a TCHD license.

3. How do I become a Certified Use Permit Inspector?

All on-site wastewater treatment system (OWTS) use permit inspectors must be certified by the National Association of Wastewater Technicians (NAWT). This can be accomplished by visiting the Colorado Professionals in Onsite Wastewater (CPOW) website and signing up for the two day NAWT Inspector course. You can also view NAWT’s website. Recertification must occur every two years by attending 8 credit hours of NAWT courses or attending 8 credit hours of other NAWT approved OWTS courses. Copies of the initial certification and/or subsequent re-certifications must be submitted to Tri-County Health Department (TCHD). NAWT maintains online lists of certified use permit inspectors.

4. Can Tri-County Health Department (TCHD) recommend an Septic System Professional such as an installer or pumper?

TCHD cannot recommend a Septic System Professional. However, TCHD provides a document titled “Tri-County Health Department Guide to Selecting an Onsite Wastewater Treatment System Installation and Service Professional”, to assist you in selecting a professional.

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Sewage & Chemical Spills

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1. Does my carpet need to be discarded after a sewage backup in my home?

The padding should be removed and discarded. The carpet may be professional cleaned or removed. Please refer to the Homeowner Guidance on Cleaning Up After Residential Sanitary Sewer Backups.

2. How do I neutralize my soil after sewer water has surfaced in my yard?

Secure the area so children and animals do not have access. Apply lime to the soil for 24 hours. Maintain pH at 12 for 2 hours and then 11.5 for 22 hours. Remove, bag, and dispose of soil in the dumpster. For large releases contact a professional.

3. What do I do if automotive fluids or chemicals were released into a State Waterway?

Contact the Colorado Spill Response Line at 877-518-5608.

4. How do I report an automotive or chemical fluid spill at a residence or business?

Contact Tri County Health Department at 720-200-1900.

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STI Testing

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1. Do I need an appointment or can I just walk- in?

You can either make an appointment or walk in to one of our clinics, however we recommend an appointment when possible to make sure you are seen more quickly. Appointments can be made to to a week in advance. Annual exams are by appointment only. 303-363-3018

2. How am I tested for STIs?

STIs are tested for with a urine test, swab or pap. 

3. How much will testing cost?

Testing is on a sliding scale based on income and is low cost or no cost. If positive, treatment is free. 

4. How long does it take for STIs to show up on a test?

Our test can detect a penile or vaginal infection within 1 - 3 weeks from exposure. 

5. If my test results are negative, do my partners still need to be tested?

Yes. Just because one partner tested negative for STIs does not mean that other partners are negative as well.

6. I'm under 18, do I need my parent's permission to be tested?

STI testing is available to anyone who is sexually active, regardless of age. If you are under 18, you do not need parent or guardian permission to be tested. 

7. Are your services confidential?

Yes, our services are confidential. We will not give out your personal information without a signed consent.

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TB

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1. How do I know if I’m infected with TB?

Most people don’t know that they have TB until they either get sick or have a TB test. This is because people do not always get sick right away after they are exposed to it and the bacteria can stay sleeping in the body for years. Talk to your doctor if you know or think you have TB. If you don’t have a doctor, you can schedule a TB skin test with us.

2. What do I do if I have a positive TB skin test?

The skin test is a screening tool—not a diagnostic test—that is helpful to determine whether further testing for TB is needed. If someone has a positive skin test, this could mean the person has been infected with TB bacteria and will need further testing (such as a chest x-ray or blood test) to determine if this is the case. We refer our clients to the Denver Health Tuberculosis Clinic for this follow-up testing.

The Denver Health Tuberculosis Clinic provides low-cost diagnostic testing and treatment. If they diagnose you with TB, your treatment will be offered for free. Please call (303) 602-7240 to schedule an appointment with the Denver Health TB clinic.
Denver Metro Tuberculosis Clinic at Denver Health

3. What is latent TB infection and how is it treated?

Latent TB infection means that you have the bacteria in your body, but it is “sleeping” and not making you sick right now. This is because your immune system is able to fight the bacteria to stop them from growing. However, the bacteria have the potential to wake up and make you sick in the future. You can take medicine to prevent getting sick with TB later in life. Treatment for latent TB is usually 4-9 months of daily oral medicine. Your doctor or clinic will decide if you need treatment and what kind of medication is best for you. Latent TB treatment in the Tri-County area is managed through the Denver Metro TB Clinic.

4. What is active TB disease and how is it treated?

Active TB disease means that there is TB bacteria in your body that is growing and making you sick. This is because your immune system is not able to fight the TB bacteria to stop it from growing. Active TB can almost always be cured with medicine.
Treatment usually consists of a combination of medications and usually lasts between 6-12 months. Your doctor or clinic will decide if you need treatment and what kind of medication is best for you. Active TB cases in the Tri-County area are managed through the Denver Metro TB Clinic.

5. What are the symptoms of active TB disease?

Common symptoms include:
A cough lasting longer than 3 weeks
Fever
Night sweats
Chills
Unintended weight loss
Chest pain
Coughing up blood
Weakness or fatigue
Loss of appetite

6. What are some risk factors for getting TB?

Living or traveling to countries that have a high rate of TB
Spending time with family members or friends that have active/infectious TB
Having a condition that makes your immune system weaker, such as cancer or HIV
Living or working in facilities such as jails, detention centers, homeless shelters, or healthcare facilities.

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Teachers' Corner

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1. Where can I find nutrition education lesson plans that meet some of the current educational standards?

Visit the documents on the Teacher's Corner page for a variety of evidence-based school nutrition lesson plans.

2. Are registered dietitians available to teach nutrition classes in your school?

Yes, TCHD has registered dietitians that can teach on a variety of nutrition topics in the classroom or as part of health fairs, career fairs, and other events. For more information please contact Sue Howk at 720-200-1509.

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Teen Services

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1. How much will my visit and birth control cost?

We offer low cost or no cost confidential services. Fees for birth control services and supplies are based on a sliding scale according to income level.

2. How old do I need to be to get birth control from your clinic?

Birth control/family planning services are available to anyone regardless of age, marital status, income or proof of residence.

3. Do I need an appointment at your clinic, or can I just walk-in.

Exams are by appointment only. Appointments for all services are HIGHLY encouraged. Walk-ins welcome, however wait times may vary. We cannot guarantee walk-ins will be seen the same day. Call 303-363-3018 to schedule an appointment up to a week in advance.

4. Do you require parental consent for birth control?

No, parental consent is not required to obtain birth control and the services provided can be kept confidential.

5. What types of birth control does your clinic offer?

FREE Condoms, Birth Control Pills, Nuvaring, Depo injection, Nexplanon, IUDs, and Emergency Contraception (Plan B and Ella).

6. Do you provide Emergency Contraception? How does it work? When should I use it?

Yes, we provide two types of emergency contraception at our clinics, Plan B One-Step® and ella®.

Plan B One-Step® contains the hormone levonorgestrel. Plan B One-Step® contains a higher dose of levonorgestrel than regular birth control pills, but works in a similar way to prevent pregnancy, mainly by stopping the release of an egg from the ovary. Plan B One-Step® may also work by preventing fertilization of an egg or by preventing attachment (implantation) to the uterus (womb). You should use Plan B One-Step® within 72 hours (3 days) after you have had unprotected sex or experienced birth control failure. Plan B One-Step® is available without a prescription.

ella® works by decreasing progesterone in the body which can stop or delay ovulation and may also change the lining of the uterus preventing the egg from implanting after ovulation. ella® should be taken up to 120 hours (5 days) after unprotected sex or birth control failure. ella® is only available by prescription.

The sooner you take any emergency contraception, the better it works.Emergency contraception is a backup method of birth control you can use when:
• Your regular birth control was used incorrectly or failed
• You did not use any birth control method

7. What is NuvaRing? How does it work?

NuvaRing is a flexible 2” ring that you insert vaginally once a month. Once inside the ring releases a continuous low dose of hormones to prevent pregnancy.

8. Do I need a physical exam?

With a healthcare professional you will discuss your health history and birth control needs. For individuals 19 and under, it is typically not necessary to have a hands on exam/physical exam.

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Temporary Food

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1. Is my Temporary Event Retail Food Establishment License valid at farmers markets?

A “Temporary Event” is defined as a single community event or celebration that operates for a period of time of not more than fourteen (14) consecutive days and may include town celebrations, fairs, and festivals. Regularly scheduled series of events such as farmers markets, sporting events, and flea markets are specifically excluded. Therefore, a Temporary Event Retail Food Establishment License is not valid at a farmers market.

2. How long is my Temporary Event Retail Food Establishment License good for?

Your Temporary Event Retail Food Establishment License is valid for the calendar year it was purchased in expiring on December 31st.

3. Can I operate my temporary food booth from my home?

No; temporary food operations are required to operate from an approved commissary.

4. What is a commissary, and why do I need one?

A commissary is a facility approved by the health department as a base of operations for a mobile food establishment where food, containers, and supplies are kept, handled, prepared, packaged or stored, and where fresh water is replaced, and waste water is disposed of. Most commissaries are licensed fixed restaurants used by agreement between management of the restaurant and the mobile food operator. A Commissary Agreement must be completed and submitted for licensing. The Colorado Co-Pack Directory maintains a list of approved kitchens whose sole purpose is to rent time to the public.

5. What is the difference between a Mobile Retail Food Establishment License and a Temporary Retail Food Establishment License?

While both must report to an approved commissary, the Temporary Retail Food Establishment may operate only at temporary events, and have far less stringent equipment requirements. A Mobile Retail food Establishment is tied to a specific mobile truck, trailer, or pushcart, and may operate at any event, any location, and at any time, within the travel time and/or distance constraints of their commissary.

6. Why must the operators of fixed, licensed, retail food establishments obtain an additional Retail Food Establishment License to participate in temporary events?

The license they hold is valid for the location indicated on their license only. To operate from another location, an additional license is required.

7. How much is a Temporary Event Retail Food Establishment License?

The temporary event retail food license is currently $330. Please note: This is a Tri-County Health Department Temporary Retail Food license. Temporary Event Retail Food licenses from counties outside of TCHD will NOT be accepted. Statutory language has changed allowing counties to set their own fees for Special Events and began September 1, 2016.

8. When do vendor applications need to be submitted?

Vendor applications must be submitted at least two (2) weeks prior to the start of the event. Vendors not meeting this deadline will be assessed a $50 late fee.

9. When should temporary event coordinator applications be submitted?

At least 30 days prior to the start of the event.

10. Do I need a license to roast and sell chilies?

Chili roasting operations are required to have a Retail Food Establishment License. The chilies must be washed in potable water at a commissary, and a handwashing facility must be available at the site where the chilies are roasted and sold. Contact your local Tri-County office for details.

11. Do I need a Temporary Event Retail Food Establishment License if I have a licensed mobile food truck, trailer, or push cart?

No, as long as you operate as a mobile food truck, trailer, or push cart. If you set up a temporary food booth in addition to your licensed mobile food unit, you will need to obtain a Temporary Event Retail Food Establishment License.

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Tobacco - Baby and Me

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1. What is the Baby & Me - Tobacco Free Program?

The Baby & Me - Tobacco Free Program provides support to help moms quit smoking during their pregnancy and to stay quit after delivery. After the birth of the baby, moms who continue to be smoke free receive a monthly voucher for free diapers or wipes for their baby's first year.

2. Who qualifies to participate in the program?

Any pregnant woman who is currently smoking, or was smoking three months prior to becoming pregnant, is eligible for the program, regardless of income level. A woman can live in any Colorado county and participate in the Tri-County Health Department Baby and Me - Tobacco Free program.

3. How do I sign up for the program?

Contact Heidi Williams at 720-200-1573 to be pre-screened and for information specific to the most convenient Baby and Me - Tobacco Free office location.

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Tobacco Prevention

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1. Are there free resources to help me quit smoking?

Yes. The Colorado QuitLine telephone number is 1-800-QUIT-NOW. Call today! Colorado QuitLine

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Tri-County Health Department's Simplified Dial Order

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1. There is a Statewide public health order and a TCHD local public health order, which rules do I follow?

Counties under local orders and statewide orders must comply with the strictest requirements of both. All individuals, employers and employees are required to comply with the requirements of Statewide Public Health Order 20-38. TCHD’s order allowed Counties to opt-out of its requirements. 

• Douglas County has opted-out of TCHD’s local public health order and is no longer subject to its requirements. Douglas County individuals, employers and employees must continue complying with all requirements under Statewide public health orders.
• Adams County and Arapahoe County will remain under TCHD’s local public health order and the Statewide public health order and must comply with the strictest requirements of both.

2. With CDPHE’s industry specific guidance no longer required, are there still things I should be doing to keep people safe in my unique setting? What about in Level Clear when all requirements go away?

Community spread still exists and not everyone has had the opportunity to get vaccinated. Businesses, event hosts, places of worship, local governments, and others are strongly urged to implement the science-based COVID-19 mitigation strategies appropriate for their space and activities whenever possible.

3. How does the new hospital admission rate metric work?

The new dial metric tracks newly admitted residents to any hospital, per day, per 100,000 residents. In Phase I, this metric is not used at all. Instead, counties will have a 30-day grace period in Level Blue.

In Phase II, which began May 16, counties that remained under our Public Health Order were assigned to Level Clear – an observation period – where a county will only be moved out of Level Clear if they exceed two new hospital admissions, per day, per 100,000 residents, for seven consecutive days. The last date that our counties exceeded this level was 01/02/2021 for Adams County, 12/28/2020 for Arapahoe County, and 12/08/2020 for Douglas County. 

Unlike hospital capacity, which is inherently regional, this metric is County-specific and only counts the number of County residents newly admitted to any hospital. Unlike incidence rate and percent positivity, this new metric accounts for the severity of cases as treatments improve and individuals are vaccinated. 

Metric Thresholds for Each Level:

	Level Clear: New Normal	LEVEL BLUE: CAUTION	LEVEL YELLOW: CONCERN	LEVEL ORANGE: HIGH RISK	LEVEL RED: SEVERE RISK	LEVEL PURPLE: EXTREME RISK
Metric –  Hospital Admissions per 100,000 County Residents Over a 7-Day Period	0-2	2 - 3	3 - 4	4 - 5	> 5	>5 and Hospital Capacity is Threatened

4. Are there any restrictions on outdoor events?

In Level Clear, there are no local restrictions on outdoor events. Events must comply with CDPHE’s Public Health Order 20-38. In addition events must follow the CDPHE Guidance for Outdoor Events with additional information on mitigation strategies to promote safety during those activities. 

Your local county or city permitting office may require COVID-19 plans and TCHD is available to provide technical assistance on event planning for events of any size. Email covidbusinessrecovery@tchd.org.

5. Are there any limits on indoor events?

In Level Clear, there are no local restrictions on indoor events. Event venues, operators and hosts should limit the number of attendees at events and continue implementing mitigation strategies detailed in CDPHE event guidance and CDC Guidance for Organizing Large Events and Gatherings to the greatest extent practical.

This Order does not require plan review or approval by TCHD for indoor events. However, your local county or city permitting office may require COVID-19 plans to operate and, under CDPHE’s Public Health Order 20-28. TCHD is available to provide technical assistance on event planning by emailing covidbusinessrecovery@tchd.org. 

6. Do I still need to symptom screen employees or customers?

While it is encouraged to symptom screen employees and customers, it is not required by the Order. Businesses must require employees and customers showing any symptoms or signs of sickness, or who have been in contact with people who have tested positive to stay home. Employers must ensure paid sick leave policies are consistent with state law and communicate those policies, in writing, to employees. See the Colorado Department of Labor and Employment’s Paid Leave Under the Healthy Families and Workplaces Act Interpretive Notice & Formal Opinion [En Español] and Colorado Workplace Public Health Rights Poster [En Español].

7. Do I need to continue providing reasonable accommodations to employees at high risk or who have been vaccinated?

Consult CDC guidance for People with Certain Medical Conditions and U.S. Equal Employment Opportunity Commission guidance on What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws.

8. Is the Five-Star Certification Program still in place?

Each Five-Star Certification Program is operated by the individual county. Counties can continue their Five-Star Programs if they choose. Programs and businesses must continue following CDPHE’s Program framework, including all industry specific checklists, except that certified businesses are no longer required to symptom screen customers or take customers contact information. 

Some counties may decide not to continue their program. See your county’s 5-Star Program webpage:

• Douglas County’s Certify My Business – certifyme@douglas.co.us 
• Arapahoe County’s Five-Star Recovery Partner Program – frouse@adcogov.org 
• Adams County’s 5 Star Business Certification Program – 5star@arapahoegov.com 

 

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Tri-County Health Department's updated Face Covering Order

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1. What are the differences between TCHD’s Face Covering Order and the Statewide Masking Order?

• The TCHD Face Covering Order continues to prioritize the safety of all residents by requiring a mask in all indoor public spaces while the Statewide Masking Order allows counties with one-week disease incidence rates of 35 or fewer cases per 100,000 to opt-out of most masking requirements.
• The TCHD Face Covering Order also protects individuals by requiring all individuals, regardless of vaccination status or group size, to continue to wear masks when in public indoor spaces while the Statewide Masking Order allows groups smaller than 10, regardless of vaccination status, and groups of vaccinated individuals of any size to gather indoors without masks in several public settings. 
• All individuals, employers and employees are required to comply with the requirements of the Statewide Masking Order. Counties and municipalities were permitted to opt-out of TCHD’s Face Covering Order when first issued. 
  • Several jurisdictions opted-out of TCHD’s local Order and are no longer subject to its requirements. All individuals, employers and employees must continue complying with all Statewide Masking Order requirements. See Appendix A of TCHD’s Face Covering Order for a complete list of jurisdictions that opted out.  
  • Jurisdictions that did not opt out remain under TCHD’s Face Covering Order and the Statewide Masking Order and the strictest requirements of both must be followed.

2. Why do I need to continue wearing a mask if I have been vaccinated? Doesn’t the vaccine protect me?

The COVID-19 vaccines currently available greatly reduce your chance of getting sick or hospitalized from COVID-19 but no vaccine, including these vaccines is 100% effective. Hence, continuing to wear a mask even if you have been vaccinated will eliminate the small risk that a vaccinated person could still spread COVID-19.

3. Does TCHD’s Face Covering Order have exceptions to mask wearing if individuals have been vaccinated?

At this time, the order requires individuals, regardless of vaccination status, to wear a mask in all public indoor spaces. However, it does allow individuals to follow CDC’s Interim Public Health Recommendations for Fully Vaccinated People. While we expect this guidance to continue to evolve, it is currently limited to personal settings only and fully vaccinated people should continue to take precautions in public like wearing a well-fitted mask and physical distancing.

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Vector Surveillance Program

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1. Why doesn’t Tri-County Health Department spray for mosquitoes?

Tri-County Health Department’s role is education of the public and surveillance of the
presence of diseases. Traps are set in locations with the highest historical mosquito activity
and regularly monitored for the species of mosquitoes known to carry West Nile Virus
(WNV). Those mosquitoes are separated out and sent to the state lab for testing for WNV. If
there are surges in the mosquito populations or testing comes back positive for WNV, the local
municipality or county agency, which is responsible for the treatment of the area, is notified,
and they focus on larvaciding (killing the mosquito before it develops into an adult) as a
principle means of controlling the mosquito populations. Only in extreme cases, would there
be any need to spray (called adulticiding), as larvaciding has been proven to be the most
effective method at controlling mosquitoes.

2. How do I report a problem with mosquitoes?

Contact any Tri-County office, or enter your complaint online.

3. There is standing water on my neighbor’s property and it is breeding mosquitoes. What can be done?

Your local municipal code may have an ordinance that can be enforced by a zoning or code
compliance officer. Outside of municipalities, it becomes much more difficult to enforce any
such action due to lack of enforcement authority. However, education is usually the most
effective tool in correcting these issues and the local health department or zoning officer can
most often achieve a favorable outcome when educating the individual about the problem.

4. Are “mosquito magnets” beneficial?

Some may argue that these devices work well for eliminating mosquitoes. However, one must
be aware that, because they are an attractant, their use may actually be inviting the mosquitoes
to your yard. Just because you see a large number of mosquitoes in the trap, doesn’t
necessarily mean that you have a mosquito problem. You may actually be attracting more to
that area than you would if you didn’t have the device. With an increase of mosquitoes in an
area, comes an increased risk of mosquito exposure to you.

5. Prairie dogs keep coming into my yard. What do I do?

The responsibility of keeping prairie dogs out of one’s property falls on the property owner.
There are many different ways of achieving this, most notably fencing the prairie dogs out,
with an underground mesh type fence that acts as a barrier between their territory and that of
the property owner.

6. Isn’t it a “health hazard” when prairie dogs, rabbits, or other small mammals come into my yard?

The only concern of a “health hazard” with apparently healthy, mobile small mammals is that
of potential flea transmission between the animal and you or your pet. It is important to
inspect your pets regularly for fleas and treat them accordingly. This is also one of many
reasons why humans should wear insect sprays when outdoors.

7. I have an old shed on my property that needs to be cleaned out. Since I live in the metro area, do I really need to be concerned about Hantavirus?

Yes, Hantavirus has been found in the metro area in recent years. It is primarily carried by
deer mice, but without knowing what mice have been in your shed, it is best to treat it as if the
virus were present in your shed and take necessary precautions. It is most important not to stir
up any dust or mouse nesting materials as this would have potential to cause the virus to
become airborne which you could easily inhale. Please contact your local Tri-County Environmental Health office for specific information on cleaning up rodent-infested areas.

8. I have seen several dead birds on my property in the last few days. What do I do?

The Health Department can only test certain birds for West Nile Virus specifically. These
birds must be of the Corvid species, which includes jays, crows, ravens, and magpies. You can
call the Colorado Helpline at 877-462-2911 to report all dead birds. The helpline can also
help you to determine what type of birds they are, and if they would be eligible for testing.

9. I found a dead bat outside my home. Does it need to be tested for rabies?

Generally, if a bat has been found outside a home and has not had any known human or pet
interaction, it is not necessary to test the bat for rabies. It is important to dispose of it properly
by wearing gloves and using a long-handled shovel to place it in a double bag, then place the
bat in an outdoor trash and be sure to wash your hands. If a bat is found inside the home,
however, be sure to contact your local Tri-County Health office for further information.

10. There have been several dead rabbits near my home lately. Should this be a concern?

This may be a concern if it cannot be determined that the rabbits are being poisoned, shot, or
killed by a predator or other means. Depending on the circumstances, the Health Department
may be interested in testing the rabbits for plague or tularemia. It is important to avoid
possible flea transmission from the dead rabbits, by keeping pets away, wearing an insect
repellant and using caution when handling animal carcasses.

11. There is a prairie dog village next to my home, and there haven’t been any prairie dogs lately. Is this a concern?

If this has normally been a very active site for prairie dogs and suddenly the activity ceases,
this may be a concern. It is important to contact your local Tri-County Health office, so that surveillance
can be done and possible testing of specimens. It is very important to avoid the area and
inspect pets regularly for fleas and treat accordingly.

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Vital Records

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1. Forms of Payment

In-person payments can be made by cash, check, money order or credit cards. We accept MasterCard, Visa, Discover, and American Express. Certificates are issued same day if record is ready for issuance in our system. Certificates are typically issued within 5 to 15 minutes.

2. Customer Delivery Options

In-person will usually walk out with certificates, USPS standard mail 5-7 business days, UPS 2-day shipping business delivery day only (No weekend deliveries)

3. Passport Information

•    Processing Times

    o    Routine -  4 to 6 Weeks

    o    Expedited- 2 to 3 weeks

    o    Expedited at Agency-  8 Business Days

    o    *** Based on need, restrictions apply

•    To apply please visit the following link: https://travel.state.gov/content/travel/en/passports/apply-renew-passport/how-to-apply.html

•    If you need your passport quickly, you can expedite your application here: https://travel.state.gov/content/travel/en/passports/apply-renew-passport/hurry.html

•    Frequently asked questions: https://travel.state.gov/content/travel/en/passports/apply-renew-passport/faqs.html

•    Report a lost or stolen passport: https://travel.state.gov/content/travel/en/passports/after/lost-stolen.html

4. Marriage Certificate Information

For a copy of the original marriage license/certificate, contact the clerk and recorder that issued the document.

https://www.sos.state.co.us/pubs/elections/Resources/CountyElectionOffices.html

5. Acknowledgement of Parentage

To add a father/second parent to a birth certificate where a father/second parent is not currently listed, complete and submit the Voluntary Acknowledgement of Parentage form to the state office. 

You can download the acknowledgement of parentage for here: https://drive.google.com/file/d/1xRcwKTTcT-VB-c-jpywvXIcuSoUak4ye/view

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Water

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1. Can I have a rain barrel?

Yes, you can. A new law, effective August 10, 2016, will allow most Colorado home owners to collect a defined amount of rainwater from their rooftops. Read more.

2. How do I test my well?

While most wells provide a clean, safe supply of water, most contaminants cannot be seen, smelled, or tasted. Therefore you should test your well water on a regular basis. Contact a certified laboratory for testing supplies, collect the sample according to directions provided by the laboratory, return the sample to the laboratory within the required time limits. The laboratory should contact you with the results. In addition, Tri-County Health Department's Water Specialist, Elaine Hassinger, can provide information on the best type of test to run and the meaning of the results. Elaine can be reached at 720 200 1583.

3. How do I find my well permit?

Visit the Colorado Division of Water Resources well permit search website. Search by permit number, owner’s name, or subdivision. Once the search results appear, click on view to see the well permit and its associated documents. For more information, call the Groundwater Information line at 303 866-3587.

4. How can I make my water taste better?

Contact your water provider. If your home uses a well, contact the wellcare Hotline at 888-395-1033 or online at Water Systems Council.

5. How do I prepare for a water system inspection?

Review the non-community groundwater system toolkits for transient and non transient systems. Also, you may review Tri-County Health Department's Sanitary Survey Checklist.

6. Do cities monitor drinking water quality?

This information is located in your annual water quality report. This report is usually delivered with summer water bills and most are located online.

7. Can I put a graywater system into my house?

At this time, graywater may only be captured and reused in areas where there is local ordinance approving the use of graywater. For more information, check with your local jurisdiction.

8. How will my water be impacted by oil and gas drilling?

Nearby drinking water wells are monitored for water quality prior to and after oil drilling and pumping operations. Under Colorado law, water used for drinking and agriculture have preference. Water used in the hydraulic fracturing process is a secondary use. When a municipality sells excess water to oil and gas users, they may be able to reduce drinking water cost for their residents. For more information contact Colorado Oil and Gas Association or the Colorado Oil and Gas Conservation Commission. In addition, the Environmental Protection Agency (EPA) is conducting a study to better understand any potential impacts of hydraulic fracturing on drinking water resources.

9. How safe is bottled water?

The Food and Drug Administration (FDA) regulates the production of bottled water. For more information visit the FDA's web site on bottled water or contact the manufacturer of the bottled water directly.

10. Where does my water come from?

This information is located in your annual water quality report. This report is usually delivered with summer water bills and most are located online. If your water is from a well, the well permit will provide information on which aquifer serves the well.

11. I see people dumping chemicals/paint/etc. in the stream or storm drain. I know this is illegal. What can I do?

Contact your local stormwater authority by visiting the Colorado Stormwater Council website.

12. Is the water at Chery Creek Reservoir, Chatfield Reservoir, etc. safe to swim in?

Swim beaches are regulated as natural swim areas. They are monitored during the swimming season and records should be kept on-site at the swim beach. If unsafe levels of bacteria are detected the swim beach will be closed to the public. For more information contact park personnel or refer to Colorado Department of Public Health and Environment's  swim beach web page .

13. What can I do to promote drinking water rather than drinks high in sugar?

Water provides many health benefits. The Centers for Disease Control's Healthy Waters Webpage provides information on water and nutrition.

14. How can we coordinate water quality data?

The Colorado Data Sharing Network has a forum for presenting and sharing water quality data.

15. How do I find more environmental and public health data?

For more information, visit the Colorado Environmental Public Health Tracking web page.

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WIC

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1. What is WIC?

The Women, Infants and Children Program, also known as WIC is a federally funded program. WIC provides nutrition information, medical referrals, breastfeeding support, prenatal nutrition education classes, health screenings and nutritious foods to qualifying families. Learn more about WIC and WIC foods by watching the

Welcome to WIC video.

2. Do I qualify for WIC?

You family may qualify if you are a pregnant, breastfeeding, or a postpartum woman, have infants / children up to 5 years old and you live in Colorado. To qualify, you must also meet household income guidelines.

3. Where are the WIC clinics located?

There are 10 WIC clinics located in the Tri-County area. The Tri-County area includes the counties of Adams, Arapahoe and Douglas. Call the nearest WIC Clinic to you to see if you qualify for services. WIC Clinic Locations.

4. How do I apply for WIC?

Call the office closest to your home and answer a few questions over the phone to see if you qualify and set-up an appointment.

5. Can men and other caregivers participate in WIC?

WIC welcomes men and all caregivers of children. WIC recognizes the important roles fathers, and all caregivers play in caring for children. Fathers and all caregivers are encouraged to participate in the WIC Program and use the eWIC in grocery stores.

6. Why are the WIC foods for women, infants and children only?

Pregnant women, women who just delivered, breastfeeding moms and children up to the age of five have extra nutritional needs to stay healthy. Women and children in these groups are growing quickly and moms who just delivered need to recover from their pregnancy. WIC foods are designed to provide the nutrients these groups need such as protein, iron, folate, calcium, vitamins A and C.

7. Where can I learn more about WIC's Community Gardens?

WIC has Community Gardens that provide fresh organic produce. Learn more about the gardens, their locations, how to participate or volunteer by clicking here.

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WIC - Community Gardens

Show All Answers

1. What are the WIC Community Gardens?

The WIC Community Gardens provide fresh produce and physical activity opportunities to families that participate in the WIC Program. There are three locations in the Tri-County Health Department area:

Community Garden Locations.

2. What should I bring with me to the gardens?

You should bring your family, friends, and children. Be sure to pack sunscreen, a hat, and water. Some mornings may start chilly, so layering your clothing may be best. Old shoes and clothes are best when tending the garden. We provide garden gloves and tools to use at the gardens, and plastic bags for you to take home fresh produce.

3. How can I participate at the gardens?

WIC clients and community members can participate in garden activities by working in the garden and assisting with planting, weeding, watering, and harvesting. Students and community members can volunteer time in the gardens assisting garden coordinators with planting day, nutrition education/demonstrations, weighing produce, assisting WIC participants with harvesting fresh produce, and garden outreach. Volunteer for the Community Gardens by filling out the Nutrition Division Volunteer Application/Acknowledgement, Release, and Informed Consent. 

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Worker Health

Show All Answers

1. Can you test air quality in the workplace?

Yes, TCHD charges a fee for this service. You will be provided a quote after an initial consultation. The air quality of office, manufacturing or medical occupations can be investigated and recommendations can then be administered for better air quality. Contact Kayla Lesperance at (720) 435-3490 to schedule a consultation.

2. Can you sample for mold in the workplace?

Yes, TCHD charges a fee for this service. Fungal spores are present in the air indoors and outdoors naturally. Sampling the air for mold will always yield mold spores. Visual inspections for mold are more highly recommended than air sampling for mold. Tri-County Health Department does not provide visual inspections for mold. There are no enforcement standards for mold in Colorado at this point.

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