The temporary restrictions, which were put into effect at noon Monday, extend from the western boundary of unincorporated Jefferson County through the eastern limits of Golden, including Vanover Park.

Kayaks, river boards, whitewater canoes and multi-chambered professionally guided rafts are exempt but are encouraged to take extreme caution due to the safety concerns surrounding swift moving water and floating debris. All authorized users and occupants must use a Type I, Type III or Type V Coast Guard-approved flotation vest and helmet.

Water height and flows are expected to rise as the heavy snowpack continues to melt in the coming days.

The restrictions will be strictly enforced and violators may be issued a summons for a class 2 petty offense, punishable by a fine of up to $100.

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Colorado’s finding of a history of tooth decay in 61% of third graders is both in line with the national average and still far too high, said Dr. Karen Foster, a Denver dentist and previous president of the Colorado Dental Association.

Residue from most types of food will weaken teeth over time, but good oral hygiene, community water fluoridation and regular dental care can prevent that damage, she said.

“Teeth that are kept clean, kept from sugar exposure and fluoridated don’t experience decay,” she said.

Water fluoridation has become controversial in recent years because of studies that found negative effects from drinking high levels of fluoride, though dentists and public health experts say that levels used to prevent tooth decay in the U.S. aren’t high enough to harm children.

The Colorado Department of Public Health and Environment reported that some water systems in the state add fluoride, while others have enough of the mineral in their water naturally that they don’t need to. It didn’t post a breakdown of systems’ fluoridation decisions.

According to the Centers for Disease Control and Prevention, 409 of Colorado’s 947 water systems have fluoridated water, though some, such as Colorado Springs, don’t need to add the mineral because the water picks up naturally occurring fluoride from the surrounding environment.

Water in the reservoirs that supply Denver typically has enough natural fluoride to prevent tooth decay, though Denver Water sometimes adds to its treated water if the supply comes in with a lower-than-expected concentration, according to the utility.

Delayed dental visits during the pandemic may have increased the number of kids experiencing cavities, but even in ordinary times, about half of students in that age group had either current tooth decay, or a filling showing they’d had it before.

The rates of kids with tooth decay ranged from a low of 47% during the 2016-2017 school year to 57% in 2003-2004.

The data comes from Colorado’s Basic Screening Survey, which uses a sample of data collected from free dental check-ups offered to public school students in kindergarten and third grade. Kindergarten students were less likely to have had tooth decay than their older peers, but 46% still had a history of cavities or a current one.

About one-quarter of students in both grades had untreated cavities at the time of their screening. Latino and Black students, and those attending schools with more low-income families, were more likely to have both a history of cavities and current untreated tooth decay.

The screeners recommended that students with untreated cavities see a dental provider before their next scheduled appointment. They also noted about 6.5% of kindergarteners and 4.9% of third graders needed “urgent” dental care because of pain or signs of infection.

To protect children’s teeth, Foster said parents should:

• Arrange a dental visit by the child’s first birthday
• Encourage them to drink water, and limit sugar-sweetened beverages
• Take their children for sealants (resin painted on teeth to block bacteria) on their permanent teeth
• Ensure kids brush twice daily and floss once a day, with supervision for younger children

“If they can tie their shoes by themselves, they are potentially ready to take over” their oral hygiene routine, she said.

As of 2023, about 90% of Coloradans 18 and younger had dental insurance, and 83% said they had visited a dentist or hygienist in the previous year, according to the Delta Dental of Colorado Foundation. Both numbers have trended up since 2013.

Coloradans who avoided the dentist in the previous year reported three main reasons: cost, fear of pain and difficulty finding a provider they related to, said D.J. Close, the foundation’s executive director.

Medicaid covers dental care for both adults and children in Colorado, but not everyone knows that, Close said. And of course, some families earn too much for Medicaid, but not enough to buy dental insurance, he said.

The foundation has also made progress on expanding and diversifying the provider workforce by helping fund new schools for dental hygienists and assistants, Close said. Fear of pain is “harder to chip away at,” but the foundation funds programs to send hygienists into schools, to give kids a preview of what visiting the dentist is like in a place that feels safe, he said.

“Education and exposure are the best way to combat fear,” he said.

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But the road to that reality has been anything but smooth, with a rally last week in Castle Rock decrying the move, a tense town hall meeting at county headquarters that ended in shouts and jeers — and a lawsuit attempting to shut the whole thing down.

Meanwhile, ballots started hitting mailboxes less than a week ago for the June 24 special election. If voters back the idea, the vote would kickstart the drafting of a home-rule charter by a 21-member commission.

A second vote in November would then seek final approval for the charter itself.

Local control has become a mantra of sorts across Colorado in recent years, with cities and counties lashing out — even taking legal action — against a state government they accuse of overreach in matters of local concern. The resistance ranges from the “Second Amendment sanctuary county” movement of six years ago, which conservative counties launched in response to new gun control laws, to last month’s lawsuit against the state and Gov. Jared Polis by Aurora and five suburban cities. They were attempting to block two recent land-use laws aimed at increasing housing density.

Commissioner George Teal, one of the chief proponents of home-rule authority for the county of nearly 400,000, said the time has come for Douglas County to assert its independence from a state legislature that has shifted decidedly to the left over the last decade.

Home-rule authority, Teal said, will give Douglas County greater legal standing to take on state laws that its leaders believe go too far. It will represent a “shifting of the burden” onto the state, requiring officials to come after the county if the state believes its authority is being usurped — rather than the other way around.

Douglas County has sued Colorado twice recently over disagreements involving property tax valuations and the level of cooperation local law enforcement can give federal immigration authorities. The county lost both cases.

“We will be an independent legal entity under state law — and we are not that as a statutory county,” Teal said. “Home rule is the very mechanism of local control.”

Opponents, operating under the Stop the Power Grab banner, say the run-up to this month’s election has been anything but transparent and open. They accuse the commissioners of quietly concocting the home-rule plan over a series of more than a dozen meetings starting late last year — and then rubber-stamping the decision at a public hearing in late March. That meeting lasted mere minutes.

“What this has brought out in us is the question of — why now?” said Kelly Mayr, a nearly three-decade resident of Highlands Ranch and a member of Stop the Power Grab. “Why are they rushing it? If this is a good idea for the county, why would we not take our time?”

Three Douglas County residents, including state Rep. Bob Marshall and former Commissioner Lora Thomas, sued the Board of County Commissioners in April, alleging multiple violations of Colorado’s open meetings laws. They asked the court to stop the June 24 election from going forward.

But a judge sided with Douglas County last month, saying he didn’t see evidence that the board violated open meetings laws and ruling that a preliminary injunction to stop the election would “sacrifice the public’s right to vote.”

Marshall, a Democrat who represents Highlands Ranch, says the fight is not over, and he expects to prevail in the court case at the appellate level.

In the meantime, he is in the running as one of 49 candidates vying to fill the 21 seats on the commission that would be tasked with drafting Douglas County’s home-rule charter — assuming voters give the OK to the idea on the same June 24 ballot. All three Douglas County commissioners are also running for the charter commission.

“If elected, my main goal will be to ensure transparency,” Marshall told The Denver Post. “There has been none in this process as yet.”

The June election is projected to cost Douglas County around $500,000.

Weld, Pitkin first to adopt home rule

The state first approved home-rule powers for municipalities in 1902, and it extended the same authority to counties in 1970. Until then, counties were considered a statutory creation of the legislature and had to follow state law without exception.

Sixty Colorado counties still do.

Just two — at the opposite ends of the ideological spectrum — took advantage of the new designation in the decade after the law passed: Weld and Pitkin. Denver and Broomfield, though, have de facto home-rule status because of their combined city-and-county structure.

First to take up the home-rule mantle in Colorado was Weld County in 1976. County Attorney Bruce Barker said its three districts had essentially balkanized around that time, each running its own public works department and making its own purchasing decisions.

“The goal was to make things more efficient,” Barker said about the effort behind the switch.

The new charter included a one-of-a-kind five-member Weld County Council, separate from the Board of County Commissioners. The body sets salaries of elected county officials and fills commissioner vacancies. It can also suspend an elected official who has been criminally charged or indicted and it reviews conflicts of interest between county officers, appointees and employees.

“Remember, there was a complete distrust of government after Watergate,” Barker said of the era. “They wanted to have this County Council as a watchdog group.”

Pitkin County made its transition to home-rule governance in 1978, largely in response to concerns about rapid population growth and the desire to conserve threatened natural habitat in the Roaring Fork Valley, said County Manager Jon Peacock. His very role was created by Pitkin County’s new home-rule charter.

The county, home to ritzy Aspen, requires under its charter a vote of the people before it issues debt, as happened with a recent ballot measure that sought expansion of the county’s landfill.

“Home rule gives authority to counties to decide how they are going to organize to carry out the powers and responsibilities that are defined in state statute,” Peacock said. “We cannot exercise authority that is not given to us by state law.”

According to a briefing paper from the state’s nonpartisan Legislative Council Staff, home-rule authority in Colorado was designed to place several administrative functions under counties’ purview. They involve “finances and property, debts and expenses, and the powers and duties of officials, including elections, terms of office, and compensation.”

“In general, home rule ordinances addressing local matters supersede state law,” the briefing paper states. “However, in matters of statewide or mixed concern, state laws may take precedence over conflicting home rule ordinances.”

Weld County learned that the hard way earlier this year when the Colorado Supreme Court struck down a redistricting plan the county had put into play two years ago. Officials drew the boundaries of commissioners’ districts without adhering to a 2021 state law that required it to follow a different protocol.

The high court concluded that redistricting “relates to the county’s function, not the county’s structure.”

“And because the Colorado Constitution requires home rule counties to carry out statutorily mandated functions, home rule counties, like Weld, must comply with the redistricting statutes,” the court ruled.

How much more power would the county get?

Metropolitan State University political science professor Robert Preuhs said it’s clear from the language of Colorado’s home-rule statute and court cases on the issue that “you’re not getting much more policy latitude” with home-rule status.

“Broader issues like gun control and immigration enforcement and police cooperation with (immigration authorities) are still going to be constrained by state law,” Preuhs said. “You are still a creature of the state, but with more internal flexibility — although Douglas County seems intent on testing that.”

Teal, the Douglas County commissioner, said there are bills passed in the statehouse every legislative session that explicitly exempt home-rule counties from having to comply.

“I would like that opportunity for the citizens of Douglas County to take advantage of these exemptions,” he said.

And there are other laws that sit in questionable territory, Teal said. Home-rule status “gives us new tools in the tool belt. At the very least, it allows the county to challenge the state.”

Teal said he could see the county pushing back on Colorado’s mandatory retail bag fee, the way property assessments are calculated and limits that have been placed on law enforcement.

But first, voters must weigh in. As the campaign over home rule heats up with billboards and signs sprouting up along Interstate 25 and other places in Douglas County, the political temperature is rising as well.

At a May 28 town hall, Commissioner Abe Laydon laid out the stakes in front of 100 or so people in the commissioners’ hearing room in Castle Rock.

“Are we OK with how the state handled COVID-19 and the pandemic?” he asked. “Are we OK with how the state has handled illegal immigration?”

There was some sympathy from the audience, but others were skeptical. When the hourlong session ended, several people stood up and demanded that more of their questions on home rule be answered. Each side accused the other side of “fear-mongering.”

“What are you afraid of?” one attendant yelled as Laydon called for order.

Last week, newly released campaign finance data stirred up a new angle of attack for home-rule opponents. The Yes on Local Control committee raised $110,000 from just five donors — one of them Teal’s wife, Laura. The bulk of the total — $100,000 — came from just two developers.

By contrast, Stop the Power Grab has raised just over $30,000 from several hundred individual donors.

That has Marshall, the state representative from Highlands Ranch, questioning just how much grassroots support the home-rule movement has in Douglas County. And layer on that a recent survey of nearly 1,800 residents conducted for the county that showed respondents opposing home rule by a 54% to 44% margin; some information, including the survey’s margin of error, wasn’t available.

“Where is the outpouring of support for home rule the commissioners claim?” Marshall said.

Amanda Budimlya, who grew up in Colorado and has lived near Sedalia for a dozen years, has been dismayed by the state’s sharp turn to the left and supports the home-rule effort. There will be two opportunities — the June and November elections — for residents to weigh in, she said, giving everyone plenty of time to air out their concerns and grievances.

“It gives us standing so we can try and put things in the charter that we want to protect — like our liberty and rights,” she said of home rule.

Budimlya, 50, said it’s rich that the opposition adopted the name Stop the Power Grab for their campaign in a state where political power has only drifted in one direction in recent years.

“There’s already a power grab happening — the governor, the House and the Senate — it’s all Democrat-run,” she said of Colorado’s political makeup. “Any conservative voice is railroaded.”

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Three years later, most of the groundwork is in place for those investments, but threatened federal cuts and a state budget crunch mean even maintaining existing services could be a challenge. The BHA had a difficult start, with conflicts over leadership as well as stakeholders saying the state moved too fast and risked making mistakes.

At a mental health summit in late May, BHA Commissioner Dannette Smith said the agency and the rest of the state’s behavioral health system will have to try to get the most benefit for people out of limited resources. Expanding services isn’t an option in the immediate future, she said.

“We’re trying to hold on to what the BHA is doing and funding right now,” she said.

Colorado could lose anywhere from $7 billion to $12 billion in Medicaid funding over the next decade if the “Big Beautiful Bill,” which includes work requirements and limits states’ ability to draw down federal funding, passes Congress in its current form, according to an analysis by the health-focused nonprofit KFF.

The state faces a budget crunch in the coming year, and Gov. Jared Polis has said it won’t have the resources to make up for lost federal dollars.

The BHA doesn’t provide services, but develops rules for mental health and addiction providers in Colorado, while overseeing contractors that develop a network of providers willing to see patients who can’t pay. The agency also runs campaigns to reduce stigma and encourage people who are suffering to seek help.

Part of its intended role was to find out where the safety net has gaps, and to advise lawmakers on how to deploy funds to close them — a task that almost everyone acknowledges would be futile in the short term, given the state’s budget crunch.

Medicaid is separate from funding for the BHA’s programs to pay for care for uninsured people, but if people lose Medicaid coverage, they’ll have to rely on the BHA programs, straining their budgets, said Kim Bimestefer, executive director the Colorado Department of Health Care Policy and Financing.

Signs suggest Colorado’s Medicaid program may already be in retreat. Providers who expanded their behavioral health services, with the promise of higher Medicaid rates, recently found out they won’t get that money, according to the Colorado Sun.

Most people haven’t seen the BHA make a direct impact in their lives at this point, so lawmakers may see it as an easy target for cuts next year, said Vincent Atchity, president and CEO of Mental Health Colorado.

He said he believes the BHA is on the right track, but lawmakers may interpret the long lead time as a sign the agency is failing and should lose funding. The agency missed early deadlines to get regulations in place, though providers and advocates for patients described lawmakers’ timeline for launching a new agency as borderline impossible, given the complexity of the behavioral health system.

“The feeling may be that anything and everything is up for grabs,” he said.

Atchity said cutting funds to the BHA wouldn’t directly damage mental health and addiction care now, but it would eliminate a chance to make the system work better for patients and families.

“At the end of the day, is it going to just be the same care, the same network of providers, and not the full care coordination that was the dream of the BHA?” he said.

When the agency launched on July 1, 2022, lawmakers thought it would bring all of the state’s behavioral health programs under one roof. BHA officials said that wasn’t feasible with the time and money the legislature gave them, and pivoted to an oversight role, with a goal of ensuring everyone had access to care, while reducing duplicative programs.

Overshadowed by controversy

Controversy over the agency’s leadership largely overshadowed its first two years.

The agency’s first commissioner, Dr. Morgan Medlock, held the job for just over a year before Polis fired her in April 2023. She recently sued the state, alleging racial discrimination, while her critics said she failed to address stakeholders’ concerns about whether the BHA would meet their needs.

Her temporary replacement, Department of Human Services Executive Director Michelle Barnes, faced criticism from Medlock’s supporters and from people with behavioral health conditions who thought the state was moving too fast.

Since Smith took over as commissioner in March 2024, communications with the state have improved significantly, said Racquel Garcia, a person in recovery who founded the peer-support group Hard Beauty, which focuses on mothers struggling with addiction. Garcia and other providers who spoke on a panel at the mental health summit said the BHA has stabilized over the last year or so.

“Progress is happening,” said Kara Johnson-Hufford, executive director of the Colorado Behavioral Healthcare Council. “There’s still work to be done, but there is momentum and there’s hope.”

Most of the BHA’s work in 2024 happened behind the scenes: hiring staff, writing regulations, and conducting meetings with patients and providers. Its most public-facing achievements were awareness campaigns and a care-finding website, ColoradoLifts.org, which will launch in July.

The agency also chose two companies to develop provider networks in the state’s four regions.

Rocky Mountain Health Plans, a division of United Healthcare, oversees most of western and southern Colorado, while Signal Behavioral Health has responsibility for most of the Eastern Plains, the Front Range and the eastern edge of the high country. They split about $203.2 million in the first year to build their networks, provide coordinators to help people navigate the system and pay for care to people who are uninsured or underinsured.

Rocky Mountain Health Plans CEO Patrick Gordon said the company is working with providers, the state and community groups to “build a more integrated, responsive behavioral health care system.”

“Our goal is to ensure Coloradans receive high-quality, whole-person care when and where they need it most,” he said in a statement.

‘It’s going to take hard work’

Essentially, the behavioral health administrative services organizations bring together safety-net addiction services and most crisis services, other than the 988 Lifeline, said Daniel Darting, CEO of Signal.

By standardizing the contracts, they can make sure that providers are working toward the same quality metrics, following the same financial management standards and reaching out to the public in a coordinated way, he said.

“It gives us that common frame of reference,” he said.

When fully implemented, the network will make it easier to direct people to the right care, even if they initially reach out to a provider who can’t meet their needs, Darting said. The contractors also can assess where service gaps are, so that lawmakers know where to direct any funds they have to invest — though that isn’t likely to happen in the short term, he acknowledged.

“It’s going to take hard work,” he said. “I’m very optimistic.”

Josh Winkler, senior adviser to Lt. Gov. Dianne Primavera, urged patience while the BHA and its contractors gradually make the system more comprehensive and patient-friendly. The state is still working on improving its long-term care landscape more than a decade after a 2014 report identified shortcomings, he said.

“It can’t be done in one (combined) eight-year term,” he said. “It probably can’t be done in two governors.”

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A salmonella outbreak linked to a large egg recall has made dozens of people sick in seven states in the West and Midwest, federal health officials said Saturday.

The August Egg Company recalled about 1.7 million brown organic and brown cage-free egg varieties distributed to grocery stores between February and May because of the potential for salmonella, according to a posted announcement Friday on the Food and Drug Administration’s website.

At least 79 people in seven states have gotten a strain of salmonella that was linked to the eggs, and 21 people have been hospitalized. the U.S. Centers for Disease Control and Prevention said.

The recall covers Arizona, California, Illinois, Indiana, Nebraska, New Mexico, Nevada, Washington and Wyoming. A list of brands and plant codes or Julian dates can be found on the FDA and CDC websites.

Symptoms of salmonella poisoning include diarrhea, fever, severe vomiting, dehydration and stomach cramps. Most people who get sick recover within a week.

Infections can be severe in young children, older adults and people with weakened immune systems, who may require hospitalization.

The CDC advises people to throw away recalled eggs or return them to the store where they were purchased. Consumers should also wash and disinfect any surfaces that came in contact with the eggs.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

Measles is one of the most contagious diseases to affect humans, and can linger in the air for up to two hours. People who visited an exposure location should monitor themselves for symptoms for three weeks.

Initial symptoms include a fever, cough, runny nose and red eyes. The red facial rash typically appears about four days after someone becomes contagious.

Anyone who visited an exposure location and develops symptoms should call ahead before seeking medical care, so their provider can protect other patients.

Colorado public health officials say people who visited the following locations — in Denver, Aurora, Glendale, Windsor, Colorado Springs and Grand Junction — are still in the window during which they could develop measles:

• Children’s Hospital Colorado emergency department, 13123 E. 16th Ave., Aurora, from 6 to 10 p.m. May 22; 1:10 to 7:15 a.m. May 26; or 9:25 p.m. May 26 to 4:15 a.m. May 27. Symptoms could develop through June 17.
• Walgreens, 18461 E. Hampden Ave., Aurora, from 10 a.m. to 12:10 p.m. May 23; or 10 a.m. to 12:10 p.m. May 25. Symptoms could develop through June 15.
• Sam’s Club, 880 S. Abilene St., Aurora, from noon to 3:30 p.m. May 25. Symptoms could develop through June 15.
• Natural Grocers, 3440 S. Tower Road, Aurora, from 6 to 8:10 p.m. May 25. Symptoms could develop through June 15.
• Love’s Travel Stop and Carl’s Jr., 748 22 Road, Grand Junction, from 6 to 10 p.m. May 27. Symptoms could develop through June 17.
• Maverick Gas Station, 2588 Airport Road, Colorado Springs, from 9 to 11:30 a.m. May 28. Symptoms could develop through June 18.
• Trader Joe’s, 661 Logan St., Denver, between 9:30 and 11:40 a.m. May 29. Symptoms could appear through June 19.
• Single Barrel Bar And Grill, 5885 Stetson Hills Blvd., Colorado Springs, between 6 and 11:30 p.m. May 30. Symptoms could appear through June 20.
• King Soopers, 1750 W. Uintah St., Colorado Springs, from 8:30 a.m. to 12:45 p.m. May 31. Symptoms could develop through June 21.
• King Soopers, 1520 Main St., Windsor, between 10:30 a.m. and 1:15 p.m. May 31. Symptoms could appear through June 21.
• Target, 4301 E. Virginia Ave., Glendale, between 9:20 and 11:50 p.m. June 2. Symptoms could appear through June 23.

This list will be updated.

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The new patient is among four people who flew on Turkish Airlines flight 201, which landed at Denver International Airport on May 13, who have since tested positive for measles.

Three additional people who passed through DIA at the same time as the initially infected person — an out-of-state traveler — or shortly thereafter have also contracted the disease.

The measles virus can linger in the air for about two hours.

The new Denver patient was a vaccinated adult who is recovering at home, according to the Denver Department of Public Health and Environment. Two doses of the measles vaccine are about 97% effective in preventing infection.

The public should watch for measles symptoms if they visited the following locations:

• Trader Joe’s, 661 Logan St., Denver, between 9:30 and 11:40 a.m. May 29. Symptoms could appear through June 19.
• King Soopers, 1520 Main St., Windsor, between 10:30 a.m. and 1:15 p.m. Saturday. Symptoms could appear through June 21.
• Target, 4301 E. Virginia Ave., Glendale, between 9:20 and 11:50 p.m. Monday. Symptoms could appear through June 23.

An El Paso County resident who visited the airport also tested positive in the last week. That person visited Single Barrel Bar and Grill, 5885 Stetson Hills Blvd. in Colorado Springs, possibly exposing people who were there between 6 and 11:30 p.m. Friday.

Symptoms can take anywhere from one to three weeks to develop. Unvaccinated people can reduce their risk of infection if they get the shot within 72 hours.

Initial symptoms of measles include a fever, runny nose, red eyes and cough. A red rash develops about four days after someone becomes contagious. If someone who was at an exposure site develops symptoms, they should call ahead before seeking medical care, so their provider can protect other patients from infection.

The state has confirmed 12 measles cases this year.

In a typical year, Colorado has two or fewer, usually involving people who got the virus while traveling overseas, according to the Colorado Department of Public Health and Environment.

The Centers for Disease Control and Prevention now recommends that anyone going abroad who isn’t already vaccinated get the shot before departing.

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Two of the new cases were unvaccinated adults living in El Paso County who passed through the airport at about the same time on May 14. The third was a vaccinated Arapahoe County resident who was a passenger on Turkish Airlines flight 201, which landed at DIA on May 13 and carried a contagious passenger.

Two doses of the vaccine are about 97% effective, meaning a small number of people develop breakthrough cases.

All three patients are recovering at home, according to the Colorado Department of Public Health and Environment.

The Centers for Disease Control and Prevention declare an outbreak if a state has at least three linked cases. The Turkish Airlines flight meets the definition of an outbreak, but the state health department hasn’t seen any evidence of spread throughout the community, spokeswoman Hope Shuler said.

The Arapahoe County resident didn’t go out during their contagious period, so they couldn’t pass on the virus. The El Paso County residents visited three locations between them, and public health officials advised people to watch for symptoms if they went to the following places:

• Love’s Travel Stop and Carl’s Jr., 748 22 Road, Grand Junction, from 6 to 10 p.m. May 27. Symptoms could develop through June 17.
• Maverick Gas Station, 2588 Airport Road, Colorado Springs, from 9 to 11:30 a.m. May 28. Symptoms could develop through June 18.
• King Soopers, 1750 W. Uintah St., Colorado Springs, from 8:30 a.m. to 12:45 p.m. May 31. Symptoms could develop through June 21.

Unvaccinated people can sometimes prevent infection by getting the measles shot within 72 hours of exposure. That window has passed for people exposed at the truck stop and gas station, but those exposed at King Soopers still have the option.

Initial symptoms of measles include a fever, cough, runny nose and red eyes. The red rash typically develops about four days after a person becomes contagious. People who think they could have measles should call ahead before visiting a health care provider, so they can take precautions to avoid infecting other patients.

Other cases among Colorado residents include another Arapahoe County adult and an Arapahoe County child younger than 5, both of whom arrived on the Turkish Airlines flight; an adult from Pueblo; a Denver baby and an unidentified person who lives in the same house; a Denver adult; and an Archuleta County adult.

The child needed care at Children’s Hospital Colorado, which hasn’t released information about their condition. The adult patients all recovered at home.

In a typical year, Colorado has two or fewer measles cases. The last time the state recorded more than 10 in a year was in the 1990s.

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With the benefits rivaling some drugs, experts said cancer centers and insurance plans should consider making exercise coaching a new standard of care for colon cancer survivors. Until then, patients can increase their physical activity after treatment, knowing they are doing their part to prevent cancer from coming back.

“It’s an extremely exciting study,” said Dr. Jeffrey Meyerhardt of Dana-Farber Cancer Institute, who wasn’t involved in the research. It’s the first randomized controlled trial to show a reduction in cancer recurrences and improved survival linked to exercise, Meyerhardt said.

Prior evidence was based on comparing active people with sedentary people, a type of study that can’t prove cause and effect. The new study — conducted in Canada, Australia, the United Kingdom, Israel and the United States — compared people who were randomly selected for an exercise program with those who instead received an educational booklet.

“This is about as high a quality of evidence as you can get,” said Dr. Julie Gralow, chief medical officer of the American Society of Clinical Oncology. “I love this study because it’s something I’ve been promoting but with less strong evidence for a long time.”

The findings were featured Sunday at ASCO’s annual meeting in Chicago and published by the New England Journal of Medicine. Academic research groups in Canada, Australia and the U.K. funded the work.

Researchers followed 889 patients with treatable colon cancer who had completed chemotherapy. Half were given information promoting fitness and nutrition. The others worked with a coach, meeting every two weeks for a year, then monthly for the next two years.

Coaches helped participants find ways to increase their physical activity. Many people, including Terri Swain-Collins, chose to walk for about 45 minutes several times a week.

“This is something I could do for myself to make me feel better,” said Swain-Collins, 62, of Kingston, Ontario. Regular contact with a friendly coach kept her motivated and accountable, she said. “I wouldn’t want to go there and say, ‘I didn’t do anything,’ so I was always doing stuff and making sure I got it done.”

After eight years, the people in the structured exercise program not only became more active than those in the control group but also had 28% fewer cancers and 37% fewer deaths from any cause. There were more muscle strains and other similar problems in the exercise group.

“When we saw the results, we were just astounded,” said study co-author Dr. Christopher Booth, a cancer doctor at Kingston Health Sciences Centre in Kingston, Ontario.

Exercise programs can be offered for several thousand dollars per patient, Booth said, “a remarkably affordable intervention that will make people feel better, have fewer cancer recurrences and help them live longer.”

Researchers collected blood from participants and will look for clues tying exercise to cancer prevention, whether through insulin processing or building up the immune system or something else.

Swain-Collins’ coaching program ended, but she is still exercising. She listens to music while she walks in the countryside near her home.

That kind of behavior change can be achieved when people believe in the benefits, when they find ways to make it fun and when there’s a social component, said paper co-author Kerry Courneya, who studies exercise and cancer at the University of Alberta. The new evidence will give cancer patients a reason to stay motivated.

“Now we can say definitively exercise causes improvements in survival,” Courneya said.

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A report issued last month by the Trump administration’s Department of Health and Human Services on care for transgender and nonbinary people analyzed 17 studies out of more than 3,400 looking into gender-affirming care — an umbrella term that can include talk therapy, puberty blockers, hormone treatments and surgeries.

They included only analyses of other studies that didn’t include any patients older than 26. Those that examined mental health generally found improvements from gender-affirming care, though with low certainty, because they didn’t include a large enough group, the effects were small, or other factors.

The report had more sweeping conclusions, however, stating that people under 19 with gender dysphoria should receive only psychological therapy, rather than being able to choose puberty blockers or hormone therapy. Gender dysphoria refers to distress when someone’s gender identity and their sex, or the way others see them, don’t match.

Major medical groups, such as the American Academy of Pediatrics, have endorsed offering the full range of affirming care to appropriate patients, and experts interviewed by The Denver Post agreed that while some patients only need therapy, others benefit from gender-affirming medical care.

The new report comes as the administration ordered providers to stop offering puberty blockers and hormone therapy to anyone under 19, threatening to take away federal funding from hospitals that didn’t comply. A federal judge blocked Trump’s executive order while a legal challenge plays out from four states, including Colorado.

The Trump administration also forbade transgender people from serving in the military, threatened federal funding for schools if they promote “gender ideology,” removed references to LGBTQ health disparities from health websites, ordered the Justice Department to take action to stop trans girls from playing on sports teams with cisgender girls, forbade the issuing of passports displaying the gender trans people identify with, and moved inmates who are trans women into men’s prisons.

Dr. Rae Narr, a nonbinary psychologist in Denver, said the administration’s actions targeting transgender people suggest the government is going to push therapy that attempts to change someone’s sexual orientation or gender identity. But, done right, therapy can also be affirming, they said.

“On their face, what they are suggesting is therapy and support for these youth,” Narr said. “When you really look at what they’re suggesting, it’s conversion therapy.”

Conversion therapy, as typically practiced today, looks for a pathological root for someone’s sexual orientation or gender identity, Narr said. For example, the practitioner might argue that another condition, such as autism, caused someone to think that they were transgender, or that they wanted to change their gender because of shame about being gay or a history of sexual trauma, they said.

Mainstream medical groups condemn the practice and Colorado banned conversion therapy for minors, though the law faces a challenge at the Supreme Court.

Affirming therapy, in contrast, starts from the position that no identity is right or wrong, Narr said. The goal isn’t to encourage young people to transition, but to help them sort through what would make them comfortable in their bodies and lives, they said.

That can involve talking about how they imagine their adult lives and practical exercises, such as trying on different clothes, Narr said. They also discuss where the young person would feel physically and emotionally safe exploring. For example, someone might go to the next town over to try out going to a store dressed differently, they said.

“I talk to kids a lot about what does it mean to you when you imagine being a boy, or a girl, or something else,” they said.

‘We listen to them’

In 2024, 46% of transgender or nonbinary young people reported seriously considering suicide, and 14% attempted it, according to the LGBTQ nonprofit The Trevor Project.

Those who reported they’d experienced bullying or physical harm because of their gender identity were more likely to report thoughts of suicide, as were those who said their schools didn’t support them.

But the odds of suicide drop when youth report that people in their lives accept them, such as by calling them by their chosen name and pronouns, Narr said.

Dr. Casey Wolf, a child and adolescent psychiatrist at WellPower in Denver, said the field hasn’t agreed to a protocol for treating gender dysphoria, but does have evidence-based therapies for the depression, anxiety or trauma that typically push people to seek help.

Sometimes, those symptoms stem from gender dysphoria or from mistreatment based on someone’s gender identity, but not always, she said.

“We listen to them. We try to understand what their symptoms are,” Wolf said.

While the public is talking about gender identity more than in the past, Wolf said she hasn’t seen an increase in young people experiencing gender dysphoria. Despite the perception that being transgender is trendy, people don’t take on marginalized identities like they change their hairstyles, she said.

Not all trans people experience gender dysphoria, and not everyone who has gender dysphoria decides to transition, said John Mikovits, an assistant professor of nursing who studies care for LGBTQ people at Moravian University in Pennsylvania. Some people may only need emotional support at some points in their life, but may decide to socially or medically transition later, he said.

What the therapist helps the patient work on may also change, Mikovits said. For example, a person who opts to transition may feel relief from gender dysphoria, but needs to learn skills to cope with increased discrimination, he said.

“The treatment is not about curing someone’s transgender or misaligned identity, it’s about affirming that identity and improving their quality of life,” he said.

‘The most basic and easiest thing to do’

Acting as a liaison between kids and parents can also be part of the job.

Young people often struggle to tell their parents what they’re feeling, so the news they’re questioning their gender can feel like it comes out of nowhere, Narr said. Parents also don’t always do the best job explaining their feelings, so confusion or fear for their child’s future can come off as rejection, they said.

“Even if the parents are supportive, it’s reasonable to have some fear and grief” for the life they imagined for their child, they said.

While discussion about affirming care focuses on puberty blockers, hormones and surgeries, just using the right pronouns for someone can be important affirmation, Mikovits said.

“It’s the most basic and easiest thing to do, to refer to people the way they want to be referred to,” he said.

Everyone wants others to see them the way they see themselves, and if that isn’t happening, it can bring shame and hopelessness, Wolf said. When someone says they aren’t wrong or sick because of how they see themselves, that can bring back some hope that the problem is their environment, and they may be able to change it, she said.

“That’s the beginning,” she said.

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